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Predicting cognitive decline using neuropsychiatric symptoms in prodromal Lewy body dementia: A longitudinal study

Lookup NU author(s): Dr Laura WrightORCiD, Dr Paul Donaghy, Professor David Burn, Professor John-Paul TaylorORCiD, Professor John O'Brien, Professor Alison Yarnall, Professor Fiona MatthewsORCiD, Dr Michael FirbankORCiD, Professor Alan ThomasORCiD, Dr Rachael LawsonORCiD



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


Introduction: Neuropsychiatric symptoms (NPS) in Lewy body dementias (LBD) occur frequently andearly in disease progression. Such symptoms are associated with worse quality of life, caregiverburden and functional limitations. Limited evidence exists, however, outlining the longitudinalrelationship between NPS and cognitive decline in prodromal LBD.Methods: 123 participants were derived from three cohort studies. Patients with mild cognitiveimpairment relating to probable dementia with Lewy bodies (MCI-LB, n=67) and Parkinson’s disease(PD-MCI, n=56) completed comprehensive cognitive and neuropsychiatric assessment and werefollowed up longitudinally. Linear regression and mixed effects models assessed the relationshipbetween baseline NPS and cognition at baseline and over time.Results: In MCI-LB, overall NPS burden was associated with declines over time in executive function(p=0.026) and processing speed (p=0.028) and baseline aberrant motor behaviour was associatedwith declines in attention (p<0.025). Anxiety was significantly associated with poorer visuospatialfunctioning (p=0.016) at baseline and poorer attention both at baseline (p=0.017) and across timepoints (p=0.024). In PD-MCI, psychosis was associated with poorer executive functioning at baseline(p=0.008) and across time points (p=0.002) but had no association with changes longitudinally.Conclusions: Core neuropsychiatric components of LBD are not strongly associated with cognition inprodromal disease. This may suggest that neuropathological mechanisms underlying NPS maynot be the same as those underlying cognitive impairment. Non-core NPS, however, may bemore directly associated with cognitive change. Future studies utilising neuroimagingtechniques are needed to explore the neuropathological basis of NPS in prodromal LBD.

Publication metadata

Author(s): Wright LM, Donaghy PC, Burn DJ, Taylor JP, O'Brien JT, Yarnall AJ, Matthews FE, Firbank MJ, Thomas AJ, Lawson RA

Publication type: Article

Publication status: Published

Journal: Parkinsonism and Related Disorders

Year: 2023

Volume: 113

Print publication date: 01/08/2023

Online publication date: 08/07/2023

Acceptance date: 07/07/2023

Date deposited: 10/07/2023

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Ltd


DOI: 10.1016/j.parkreldis.2023.105762


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Funder referenceFunder name
ARUK-PG2015-13Alzheimer`s Research UK
F-1801Parkinson`s UK (formerly Parkinson`s Disease Society)
J-0802Parkinson`s UK (formerly Parkinson`s Disease Society)
Lewy Body Society
Lockhart Parkinson's Disease Research Fund