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Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months

Lookup NU author(s): Professor John-Paul TaylorORCiD, Professor Alan ThomasORCiD, Professor Ian McKeith, Professor John O'Brien



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.OBJECTIVE: This study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive fluctuations, and sleep disturbance. METHODS: One hundred sixteen patients with Lewy body dementia (DLB = 72, PDD = 44) underwent assessment at baseline and 3 and 6 months as part of a prospective multicenter randomized controlled trial. Linear mixed models were constructed for core outcome measures using the Mini-Mental State Examination (MMSE), motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Dementia Cognitive Fluctuations Scale (DCFS), and Neuropsychiatric Inventory (NPI). RESULTS: Within the time frame of our study (6 months), we were able to identify a significant cognitive decline of 1.3 points on the MMSE (p = 0.002) and significant worsening of motor parkinsonism with an increase in UPDRS-III score of 3.2 points (p = 0.018). Fluctuation severity also increased using the DCFS with a 6-month change in score of 1.3 points (p = 0.001). Uniquely, a signal for increased severity of sleep symptoms of 1.2 points (NPI-sleep) was also detectable (p = 0.04). Significant changes in neuropsychiatric symptoms were not detected. There was no difference in rates of change of scores between DLB and PDD. DISCUSSION: Clinically significant rates of change in core clinical features can be detected and quantified in Lewy body dementia over a relatively short period (6 months) using common clinical instruments and thus may be useful as clinical endpoints for therapeutic trials of disease-modifying and symptomatic agents.

Publication metadata

Author(s): Matar E, White SR, Taylor J-P, Thomas A, McKeith IG, Kane JPM, Surendranathan A, Halliday GM, Lewis SJG, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2021

Volume: 97

Issue: 10

Pages: e1031-e1040

Print publication date: 07/09/2021

Online publication date: 17/08/2021

Acceptance date: 15/06/2021

Date deposited: 11/10/2021

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0000000000012450

PubMed id: 34404743


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Funder referenceFunder name
National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (grant reference No. DTC-RP-PG-0311-12001)