Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Nov;22(6):729-37.
doi: 10.1037/a0012949.

Visuospatial deficits predict rate of cognitive decline in autopsy-verified dementia with Lewy bodies

Joanne M Hamilton  1 , David P Salmon, Douglas Galasko, Rema Raman, Jenn Emond, Lawrence A Hansen, Eliezer Masliah, Leon J Thal
Affiliations

Visuospatial deficits predict rate of cognitive decline in autopsy-verified dementia with Lewy bodies

Joanne M Hamilton et al. Neuropsychology. 2008 Nov.

Abstract

Dementia with Lewy bodies (DLB) is often characterized by pronounced impairment in visuospatial skills, attention, and executive functions. However, the strength of the phenotypic expression of DLB varies and may be weaker in patients with extensive concomitant Alzheimer's disease (AD). To determine whether strength of the DLB clinical phenotype impacts cognitive decline, visuospatial and language tests were retrospectively used to predict 2-year rate of global cognitive decline in 22 autopsy-confirmed DLB patients (21 with concomitant AD) and 44 autopsy-confirmed "pure" AD patients. Generalized estimating equations (GEE) revealed a significant interaction such that poor baseline performances on tests of visuospatial skills were strongly associated with a rapid rate of cognitive decline in DLB but not AD (p < .001). No effect of confrontation naming was found. DLB patients with poor visuospatial skills had fewer neurofibrillary tangles and were more likely to experience visual hallucinations than those with better visuospatial skills. These results suggest that the severity of visuospatial deficits in DLB may identify those facing a particularly malignant disease course and may designate individuals whose clinical syndrome is impacted more by Lewy body formation than AD pathology.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean Mattis Dementia Rating Scale (DRS) total scores at Baseline, Evaluation 1, and Evaluation 2 in patients with Dementia with Lewy bodies (DLB) or Alzheimer’s disease (AD). Standard error bars are included.
Figure 2
Figure 2
Mean two-year decline on the Mattis Dementia Rating Scale (DRS) as a function of median cognitive test performance at baseline in patients with Dementia with Lewy bodies (DLB: triangles) or Alzheimer’s disease (AD: circles). To graphically represent the complex three-way interactions, patient groups are differentiated by performances above (high: closed symbols) or below (low: open symbols) the overall group median of each cognitive test. Panel A. Wechsler Intelligence Scale for Children-Revised (WISC-R) Block Design score: median = 20. Panel B. Clock Drawing Test—copy: high = 3, low < 3. Panel C. 30-item Boston Naming Test: median = 23. Standard error bars are included.
See this image and copyright information in PMC

References

    1. Aarsland D, Litvan I, Salmon D, Galasko D, Wentzel-Larsen T, Larsen JP. Performance on the dementia rating scale in Parkinson's disease with dementia and dementia with Lewy bodies: comparison with progressive supranuclear palsy and Alzheimer's disease. Journal of Neurology, Neurosurgery, & Psychiatry. 2003;74(9):1215–1220. - PMC - PubMed
    1. Aarsland D, Perry R, Brown A, Larsen JP, Ballard C. Neuropathology of dementia in Parkinson's disease: a prospective, community-based study. Annals of Neurology. 2005;58(5):773–776. - PubMed
    1. Ala TA, Hughes LF, Kyrouac GA, Ghobrial MW, Elble RJ. Pentagon copying is more impaired in dementia with Lewy bodies than in Alzheimer's disease. Journal of Neurology, Neurosurgery, & Psychiatry. 2001;70:483–488. - PMC - PubMed
    1. Albin RL, Minoshima S, D'Amato CJ, Frey KA, Kuhl DA, Sima AAF. Fluoro-deoxyglucose positron emission tomography in diffuse Lewy body disease. Neurology. 1996;47:462–466. - PubMed
    1. Armstrong RA, Cairns NJ, Lantos PL. The spatial patterns of Lewy bodies, senile plaques, and neurofibrillary tangles in dementia with Lewy bodies. Experimental Neurology. 1998;150(1):122–127. - PubMed

Publication types

MeSH terms