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. 2017 Jun 27;9(1):47.
doi: 10.1186/s13195-017-0272-8.

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

Frédéric Blanc  1   2   3 , Rachid Mahmoudi  4 , Thérèse Jonveaux  5 , Jean Galmiche  6 , Gilles Chopard  6 , Benjamin Cretin  7   8 , Catherine Demuynck  7 , Catherine Martin-Hunyadi  7 , Nathalie Philippi  7   8 , François Sellal  9   10 , Jean-Marc Michel  9   10 , Gregory Tio  11   12   6 , Melanie Stackfleth  7 , Pierre Vandel  11   6 , Eloi Magnin  12   6 , Jean-Luc Novella  4 , Georges Kaltenbach  7 , Athanase Benetos  5 , Erik A Sauleau  13
Affiliations

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

Frédéric Blanc et al. Alzheimers Res Ther. .

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.

Keywords: Alzheimer’s dementia; Alzheimer’s disease; Dementia with Lewy bodies; Lewy body disease; MMSE; Outcome.

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Figures

Fig. 1
Fig. 1
Flowchart of the present study on cognitive outcome in dementia with Lewy, Alzheimer’s disease and double disease. AD Alzheimer’s disease, DLB Dementia with Lewy bodies, AD + DLB Dual disease, RAPID Regional Network for Diagnostic Aid and Management of Patients with Cognitive Impairment
Fig. 2
Fig. 2
Estimated MMSE temporal evolution with beta regression without propensity score (a) and with propensity score (b) of patients with AD, patients with DLB and patients with AD + DLB. AD Alzheimer’s disease, DLB Dementia with Lewy bodies, MMSE Mini Mental State Examination
Fig. 3
Fig. 3
Estimated MMSE temporal evolution with beta regression without propensity score (a) and with propensity score (b) of patients with AD, patients with DLB and patients with AD + DLB, and assuming an initial MMSE value of 20. AD Alzheimer’s disease, DLB Dementia with Lewy bodies, MMSE Mini Mental State Examination
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References

    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. doi: 10.1212/01.wnl.0000187889.17253.b1. - DOI - PubMed
    1. 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. doi: 10.1159/000358051. - DOI - PubMed
    1. 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. doi: 10.1371/journal.pone.0045451. - DOI - PMC - PubMed
    1. 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. doi: 10.1093/ageing/25.3.209. - DOI - PubMed
    1. 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. doi: 10.1212/WNL.51.2.351. - DOI - PubMed