Mild Cognitive Impairment with Lewy Bodies or Alzheimer’s Disease and Risk of Progression to Dementia

Pavankumar Kamat.

Disclosures

April 26, 2021

Takeaway

  • Patients with mild cognitive impairment (MCI) and clinical characteristics of dementia with Lewy bodies (DLB) had a worse prognosis than MCI-Alzheimer’s disease (MCI-AD), with an increased annual risk of transition from MCI to dementia.

  • More the characteristics, higher the risk was.

  • The presence of cognitive fluctuations or visual hallucinations was associated with a worse prognosis.

Why this matters

  • Findings suggest that seeking information on the presence or absence of diagnostic features of Lewy body disease in MCI will help identify individuals at risk of further clinical decline.

Study design

  • 2 prospective longitudinal cohort studies included 111 patients with MCI (age, ≥60 years).

  • The associations between diagnostic characteristics of DLB and clinical progression from MCI to dementia, with death as a competing outcome, were evaluated.

  • Funding: NIHR Newcastle Biomedical Research Centre and others.

Key results

  • After a mean follow-up of 2.2 years, 38/111 (34%) participants had progressed to dementia:

    • AD (n=10);

    • possible DLB (n=3); and

    • probable DLB (n=25).

  • The presence of any DLB characteristic was associated with an increased risk of transition from MCI to dementia; this risk further increased with more characteristics (HR, 1.33; 95% CI, 1.11-1.60).

  • The risk was higher in those who experienced complex visual hallucinations (HR, 1.98; 95% CI, 0.92-4.29) and cognitive fluctuations (HR, 3.99; 95% CI, 2.03-7.84).

Limitations

  • Observational design.

 

Hamilton CA, Matthews FE, Donaghy PC, Taylor JP, O'Brien JT, Barnett N, Olsen K, Durcan R, Roberts G, Ciafone J, Barker SAH, Firbank M, McKeith IG, Thomas AJ. Progression to Dementia in Mild Cognitive Impairment With Lewy Bodies or Alzheimer Disease. Neurology. 2021 Apr 19 [Epub ahead of print]. doi: 10.1212/WNL.0000000000012024. PMID: 33875556.  View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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