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Clinical symptoms in mild cognitive impairment with Lewy bodies: Frequency, time of onset, and discriminant ability

Lookup NU author(s): Dr Paul Donaghy, Dr Calum Hamilton, Dr Rory Durcan, Dr Sarah Lawley, Sally Barker, Dr Joanna Ciafone, Nicola Barnett, Kirsty OlsenORCiD, Dr Michael FirbankORCiD, Dr Gemma Roberts, Dr James LloydORCiD, Dr Ranjan Saha, Professor Ian McKeith, Professor John O'Brien, Professor John-Paul TaylorORCiD, Professor Alan ThomasORCiD



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


© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.Background and purpose: Mild cognitive impairment with Lewy bodies (MCI-LB) is associated with a range of cognitive, motor, neuropsychiatric, sleep, autonomic, and visual symptoms. We investigated the cumulative frequency of symptoms in a longitudinal cohort of MCI-LB compared with MCI due to Alzheimer disease (MCI-AD) and analysed the ability of a previously described 10-point symptom scale to differentiate MCI-LB and MCI-AD, in an independent cohort. Methods: Participants with probable MCI-LB (n = 70), MCI-AD (n = 51), and controls (n = 34) had a detailed clinical assessment and annual follow-up (mean duration = 1.7 years). The presence of a range of symptoms was ascertained using a modified version of the Lewy Body Disease Association Comprehensive LBD Symptom Checklist at baseline assessment and then annually. Results: MCI-LB participants experienced a greater mean number of symptoms (24.2, SD = 7.6) compared with MCI-AD (11.3, SD = 7.4) and controls (4.2, SD = 3.1; p < 0.001 for all comparisons). A range of cognitive, parkinsonian, neuropsychiatric, sleep, and autonomic symptoms were significantly more common in MCI-LB than MCI-AD, although when present, the time of onset was similar between the two groups. A previously defined 10-point symptom scale demonstrated very good discrimination between MCI-LB and MCI-AD (area under the receiver operating characteristic curve = 0.91, 95% confidence interval = 0.84–0.98), replicating our previous finding in a new cohort. Conclusions: MCI-LB is associated with the frequent presence of a particular profile of symptoms compared to MCI-AD. Clinicians should look for evidence of these symptoms in MCI and be aware of the potential for treatment. The presence of these symptoms may help to discriminate MCI-LB from MCI-AD.

Publication metadata

Author(s): Donaghy PC, Hamilton C, Durcan R, Lawley S, Barker S, Ciafone J, Barnett N, Olsen K, Firbank M, Roberts G, Lloyd J, Allan LM, Saha R, McKeith IG, O'Brien JT, Taylor J-P, Thomas AJ

Publication type: Article

Publication status: Published

Journal: European Journal of Neurology

Year: 2023

Volume: 30

Issue: 6

Pages: 1585-1593

Print publication date: 01/06/2023

Online publication date: 13/03/2023

Acceptance date: 08/03/2023

Date deposited: 11/04/2023

ISSN (print): 1351-5101

ISSN (electronic): 1468-1331

Publisher: John Wiley and Sons Inc


DOI: 10.1111/ene.15783

PubMed id: 36912421


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