Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Alzheimer's Research & Therapy
Published in: Alzheimer's Research & Therapy 1/2017

Open Access 01-12-2017 | Research

Long-term cognitive outcome of Alzheimer’s disease and dementia with Lewy bodies: dual disease is worse

Authors: Frédéric Blanc, Rachid Mahmoudi, Thérèse Jonveaux, Jean Galmiche, Gilles Chopard, Benjamin Cretin, Catherine Demuynck, Catherine Martin-Hunyadi, Nathalie Philippi, François Sellal, Jean-Marc Michel, Gregory Tio, Melanie Stackfleth, Pierre Vandel, Eloi Magnin, Jean-Luc Novella, Georges Kaltenbach, Athanase Benetos, Erik A. Sauleau

Published in: Alzheimer's Research & Therapy | Issue 1/2017

Login to get access

Abstract

Background

Longitudinal studies of dementia with Lewy bodies (DLB) are rare. Clinically, DLB is usually considered to worsen into Alzheimer’s disease (AD). The aim of our study was to compare the rate of the cognitive decline in DLB, AD, and the association of the two diseases (AD + DLB).

Methods

Using the Regional Network for Diagnostic Aid and Management of Patients with Cognitive Impairment database, which includes all the patients seen at all memory clinics (medical consultation and day hospitals) in four French regions, and beta regression, we compared the longitudinal the Mini-Mental State Examination scores of 1159 patients with AD (n = 1000), DLB (n = 131) and AD + DLB (association of the two) (n = 28) during follow-up of at least 4 years.

Results

The mean follow-up of the patients was 5.88 years. Using beta regression without propensity scores, the comparison of the decline of patients with AD and patients with DLB did not show a significant difference, but the decline of patients with AD + DLB was worse than that of either patients with DLB (P = 0.006) or patients with AD (P < 0.001). Using beta regression weighted by a propensity score, comparison of patients with AD and patients with DLB showed a faster decline for patients with DLB (P < 0.001). The comparison of the decline of patients with AD + DLB with that of patients with DLB (P < 0.001) and patients with AD (P < 0.001) showed that the decline was clearly worse in the patients with dual disease.

Conclusions

Whatever the analysis, the rate of decline is faster in patients with AD + DLB dual disease. The identification of such patients is important to enable clinicians to optimise treatment and care and to better inform and help patients and caregivers.
Literature
1.
McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65:1863–72.CrossRefPubMed
2.
Oesterhus R, Soennesyn H, Rongve A, Ballard C, Aarsland D, Vossius C. Long-term mortality in a cohort of home-dwelling elderly with mild Alzheimer’s disease and Lewy body dementia. Dement Geriatr Cogn Disord. 2014;38:161–9.CrossRefPubMed
3.
Stubendorff K, Aarsland D, Minthon L, Londos E. The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson’s disease with dementia. PLoS One. 2012;7:e45451.CrossRefPubMedPubMedCentral
4.
Ballard C, Patel A, Oyebode F, Wilcock G. Cognitive decline in patients with Alzheimer’s disease, vascular dementia and senile dementia of Lewy body type. Age Ageing. 1996;25:209–13.CrossRefPubMed
5.
Olichney JM, Galasko D, Salmon D, Hofstetter C, Hansen L, Katzman R, et al. Cognitive decline is faster in Lewy body variant than in Alzheimer’s disease. Neurology. 1998;51:351–7.CrossRefPubMed
6.
Nelson PT, Kryscio RJ, Jicha GA, Abner EL, Schmitt FA, Xu LO, et al. Relative preservation of MMSE scores in autopsy-proven dementia with Lewy bodies. Neurology. 2009;73:1127–33.CrossRefPubMedPubMedCentral
7.
Nelson PT, Kryscio RJ, Abner EL, Schmitt FA, Jicha GA, Mendiondo MS, et al. Acetylcholinesterase inhibitor treatment is associated with relatively slow cognitive decline in patients with Alzheimer’s disease and AD + DLB. J Alzheimers Dis. 2009;16:29–34.CrossRefPubMedPubMedCentral
8.
Breitve MH, Chwiszczuk LJ, Hynninen MJ, Rongve A, Brønnick K, Janvin C, et al. A systematic review of cognitive decline in dementia with Lewy bodies versus Alzheimer’s disease. Alzheimers Res Ther. 2014;6:53.PubMedPubMedCentral
9.
Williams MM, Xiong C, Morris JC, Galvin JE. Survival and mortality differences between dementia with Lewy bodies vs Alzheimer disease. Neurology. 2006;67:1935–41.CrossRefPubMed
10.
Bereau M, Sylvestre G, Mauny F, Puyraveau M, Baudier F, Magnin E, et al. Assessment of 10 years of memory consultations in the Franche-Comté: description and analysis of the RAPID regional database [in French]. Rev Neurol (Paris). 2015;171:655–61.CrossRef
11.
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34:939–44.CrossRefPubMed
12.
McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the Consortium on DLB International Workshop. Neurology. 1996;47:1113–24.CrossRefPubMed
13.
Derouesne C, Poitreneau J, Hugonot L, Kalafat M, Dubois B, Laurent B. Mini-Mental State Examination: a useful method for the evaluation of the cognitive status of patients by the clinician [in French]. Presse Med. 1999;28:1141–8.PubMed
14.
Smithson M, Verkuilen J. A better lemon squeezer? Maximum-likelihood regression with beta-distributed dependent variables. Psychol Methods. 2006;11:54–71.CrossRefPubMed
15.
McCaffrey DF, Griffin BA, Almirall D, Slaughter ME, Ramchand R, Burgette LF. A tutorial on propensity score estimation for multiple treatments using generalized boosted models. Stat Med. 2013;32:3388–414.CrossRefPubMedPubMedCentral
16.
R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2015.
17.
Letenneur L, Gilleron V, Commenges D, Helmer C, Orgogozo JM, Dartigues JF. Are sex and educational level independent predictors of dementia and Alzheimer’s disease? Incidence data from the PAQUID project. J Neurol Neurosurg Psychiatry. 1999;66:177–83.CrossRefPubMedPubMedCentral
18.
Savica R, Grossardt BR, Bower JH, Boeve BF, Ahlskog JE, Rocca WA. Incidence of dementia with Lewy bodies and Parkinson’s disease dementia. JAMA Neurol. 2013;70:1396–402.CrossRefPubMedPubMedCentral
19.
Nelson PT, Schmitt FA, Jicha GA, Kryscio RJ, Abner EL, Smith CD, et al. Association between male gender and cortical Lewy body pathology in large autopsy series. J Neurol. 2010;257:1875–81.CrossRefPubMedPubMedCentral
20.
Zaccai J, McCracken C, Brayne C. A systematic review of prevalence and incidence studies of dementia with Lewy bodies. Age Ageing. 2005;34:561–6.CrossRefPubMed
21.
22.
Amieva H, Mokri H, Le Goff M, Meillon C, Jacqmin-Gadda H, Foubert-Samier A, et al. Compensatory mechanisms in higher-educated subjects with Alzheimer’s disease: a study of 20 years of cognitive decline. Brain. 2014;137:1167–75.CrossRefPubMed
23.
Bousiges O, Cretin B, Lavaux T, Philippi N, Jung B, Hezard S, et al. Diagnostic value of cerebrospinal fluid biomarkers (phospho-tau181, total-tau, Aβ42, and Aβ40) in prodromal stage of Alzheimer’s disease and dementia with Lewy bodies. J Alzheimers Dis. 2016;51:1069–83.CrossRefPubMed
24.
Nelson PT, Jicha GA, Kryscio RJ, Abner EL, Schmitt FA, Cooper G, et al. Low sensitivity in clinical diagnoses of dementia with Lewy bodies. J Neurol. 2010;257:359–66.CrossRefPubMed
25.
McKeith IG, Ballard CG, Perry RH, Ince PG, O’Brien JT, Neill D, et al. Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology. 2000;54:1050–8.CrossRefPubMed
26.
Haute Autorité de Santé (HAS). Diagnostic et prise en charge de la maladie d’Alzheimer et des maladies apparentées: recommandation de bonne pratique HAS. St-Denis: HAS; 2008.
27.
Lehmann S, Dumurgier J, Schraen S, Wallon D, Blanc F, Magnin E, et al. A diagnostic scale for Alzheimer’s disease based on cerebrospinal fluid biomarker profiles. Alzheimers Res Ther. 2014;6:38.CrossRefPubMedPubMedCentral
28.
Jellinger KA, Attems J. Prevalence and pathology of dementia with Lewy bodies in the oldest old: a comparison with other dementing disorders. Dement Geriatr Cogn Disord. 2011;31:309–16.CrossRefPubMed
Metadata
Title
Long-term cognitive outcome of Alzheimer’s disease and dementia with Lewy bodies: dual disease is worse
Authors
Frédéric Blanc
Rachid Mahmoudi
Thérèse Jonveaux
Jean Galmiche
Gilles Chopard
Benjamin Cretin
Catherine Demuynck
Catherine Martin-Hunyadi
Nathalie Philippi
François Sellal
Jean-Marc Michel
Gregory Tio
Melanie Stackfleth
Pierre Vandel
Eloi Magnin
Jean-Luc Novella
Georges Kaltenbach
Athanase Benetos
Erik A. Sauleau
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Alzheimer's Research & Therapy / Issue 1/2017
Electronic ISSN: 1758-9193
DOI
https://doi.org/10.1186/s13195-017-0272-8

Other articles of this Issue 1/2017

Alzheimer's Research & Therapy 1/2017 Go to the issue

Research

Memory performance-related dynamic brain connectivity indicates pathological burden and genetic risk for Alzheimer’s disease

Research

Posterior atrophy predicts time to dementia in patients with amyloid-positive mild cognitive impairment

Research

Unbiased estimates of cerebrospinal fluid β-amyloid 1–42 cutoffs in a large memory clinic population

Research

Sensitivity of restriction spectrum imaging to memory and neuropathology in Alzheimer’s disease

Research

Cognitive profile in prodromal dementia with Lewy bodies

Research

Prevention of dendritic and synaptic deficits and cognitive impairment with a neurotrophic compound