Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-j7tnp Total loading time: 0.186 Render date: 2021-07-26T21:26:31.291Z Has data issue: false Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease

Published online by Cambridge University Press:  05 May 2020

Calum A. Hamilton
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Fiona E. Matthews
Affiliation:
Population Health Sciences Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Paul C. Donaghy
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
John-Paul Taylor
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
John T. O'Brien
Affiliation:
Department of Psychiatry, Level E4, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SZ, UK
Nicola Barnett
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Kirsty Olsen
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Ian G. McKeith
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Alan J. Thomas
Affiliation:
Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
Corresponding

Abstract

Background

Mild cognitive impairment (MCI) may gradually worsen to dementia, but often remains stable for extended periods of time. Little is known about the predictors of decline to help explain this variation. We aimed to explore whether this heterogeneous course of MCI may be predicted by the presence of Lewy body (LB) symptoms in a prospectively-recruited longitudinal cohort of MCI with Lewy bodies (MCI-LB) and Alzheimer's disease (MCI-AD).

Methods

A prospective cohort (n = 76) aged ⩾60 years underwent detailed assessment after recent MCI diagnosis, and were followed up annually with repeated neuropsychological testing and clinical review of cognitive status and LB symptoms. Latent class mixture modelling identified data-driven sub-groups with distinct trajectories of global cognitive function.

Results

Three distinct trajectories were identified in the full cohort: slow/stable progression (46%), intermediate progressive decline (41%) and a small group with a much faster decline (13%). The presence of LB symptomology, and visual hallucinations in particular, predicted decline v. a stable cognitive trajectory. With time zeroed on study end (death, dementia or withdrawal) where available (n = 39), the same subgroups were identified. Adjustment for baseline functioning obscured the presence of any latent classes, suggesting that baseline function is an important parameter in prospective decline.

Conclusions

These results highlight some potential signals for impending decline in MCI; poorer baseline function and the presence of probable LB symptoms – particularly visual hallucinations. Identifying people with a rapid decline is important but our findings are preliminary given the modest cohort size.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, M. S., DeKosky, S. T., Dickson, D., Dubois, B., Feldman, H. H., Fox, N. C., … Petersen, R. C. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7(3), 270279.CrossRefGoogle Scholar
Blanc, F., Mahmoudi, R., Jonveaux, T., Galmiche, J., Chopard, G., Cretin, B., … Sauleau, E. A. (2017). Long-term cognitive outcome of Alzheimer's disease and dementia with Lewy bodies: Dual disease is worse. Alzheimer's Research & Therapy, 9(1), 47. doi: 10.1186/s13195-017-0272-8CrossRefGoogle ScholarPubMed
Brennan, L., Devlin, K. M., Xie, S. X., Mechanic-Hamilton, D., Tran, B., Hurtig, H. H., … Weintraub, D. (2017). Neuropsychological subgroups in non-demented Parkinson's disease: A latent class analysis. Journal of Parkinson's Disease, 7(2), 385395. doi: 10.3233/JPD-171081CrossRefGoogle ScholarPubMed
Brenowitz, W. D., Hubbard, R. A., Keene, C. D., Hawes, S. E., Longstreth, W. Jr., Woltjer, R. L., & Kukull, W. A. (2017 a). Mixed neuropathologies and estimated rates of clinical progression in a large autopsy sample. Alzheimer's & Dementia, 13(6), 654662. doi: 10.1016/j.jalz.2016.09.015CrossRefGoogle Scholar
Brenowitz, W. D., Hubbard, R. A., Keene, C. D., Hawes, S. E., Longstreth, W. T., Woltjer, R. L., & Kukull, W. A. (2017 b). Mixed neuropathologies and associations with domain-specific cognitive decline. Neurology, 89(17), 17731781. doi: 10.1212/WNL.0000000000004567CrossRefGoogle ScholarPubMed
Chwiszczuk, L., Breitve, M. H., Bronnick, K., Gjerstad, M. D., Hynninen, M., Aarsland, D., & Rongve, A. (2017). REM sleep behavior disorder is not associated with a more rapid cognitive decline in mild dementia. Frontiers in Neurology, 8, 375. doi: 10.3389/fneur.2017.00375CrossRefGoogle Scholar
Cromwell, D. A., Eagar, K., & Poulos, R. G. (2003). The performance of instrumental activities of daily living scale in screening for cognitive impairment in elderly community residents. Journal of Clinical Epidemiology, 56(2), 131137.CrossRefGoogle ScholarPubMed
Department for Communities and Local Government. (2011). The English indices of deprivation 2010. London: Department for Communities and Local Government.Google Scholar
Donaghy, P. C., Barnett, N., Olsen, K., Taylor, J. P., McKeith, I. G., O'Brien, J. T., & Thomas, A. J. (2017). Symptoms associated with Lewy body disease in mild cognitive impairment. International Journal of Geriatric Psychiatry, 32(11), 11631171. doi: 10.1002/gps.4742CrossRefGoogle ScholarPubMed
Donaghy, P. C., Taylor, J.-P., O'Brien, J. T., Barnett, N., Olsen, K., Colloby, S. J., … Thomas, A. J. (2018). Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies. Psychological Medicine, 48(14), 23842390. doi: 10.1017/S0033291717003956CrossRefGoogle ScholarPubMed
Estevez-Gonzalez, A., Kulisevsky, J., Boltes, A., Otermin, P., & Garcia-Sanchez, C. (2003). Rey verbal learning test is a useful tool for differential diagnosis in the preclinical phase of Alzheimer's disease: Comparison with mild cognitive impairment and normal aging. International Journal of Geriatric Psychiatry, 18(11), 10211028. doi: 10.1002/gps.1010CrossRefGoogle ScholarPubMed
Ferman, T. J., Smith, G. E., Boeve, B. F., Graff-Radford, N. R., Lucas, J. A., Knopman, D. S., … Dickson, D. W. (2006). Neuropsychological differentiation of dementia with Lewy bodies from normal aging and Alzheimer's disease. The Clinical Neuropsychologist, 20(4), 623636. doi: 10.1080/13854040500376831CrossRefGoogle ScholarPubMed
Geslani, D. M., Tierney, M. C., Herrmann, N., & Szalai, J. P. (2005). Mild cognitive impairment: An operational definition and its conversion rate to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 19(5-6), 383389.CrossRefGoogle ScholarPubMed
Hanfelt, J. J., Wuu, J., Sollinger, A. B., Greenaway, M. C., Lah, J. J., Levey, A. I., & Goldstein, F. C. (2011). An exploration of subgroups of mild cognitive impairment based on cognitive, neuropsychiatric and functional features: Analysis of data from the National Alzheimer's Coordinating Center. The American Journal of Geriatric Psychiatry, 19(11), 940950. doi: 10.1097/JGP.0b013e31820ee9d2CrossRefGoogle ScholarPubMed
Huang, C., Wahlund, L. O., Dierks, T., Julin, P., Winblad, B., & Jelic, V. (2000). Discrimination of Alzheimer's disease and mild cognitive impairment by equivalent EEG sources: A cross-sectional and longitudinal study. Clinical Neurophysiology, 111(11), 19611967. doi: 10.1016/S1388-2457(00)00454-5CrossRefGoogle ScholarPubMed
Kramberger, M. G., Auestad, B., Garcia-Ptacek, S., Abdelnour, C., Olmo, J. G., Walker, Z., … Aarsland, D. (2017). Long-term cognitive decline in dementia with Lewy bodies in a large multicenter, international cohort. Journal of Alzheimer's Disease, 57(3), 787795. doi: 10.3233/jad-161109CrossRefGoogle Scholar
Leoutsakos, J. S., Forrester, S. N., Corcoran, C. D., Norton, M. C., Rabins, P. V., Steinberg, M. I., … Lyketsos, C. G. (2015). Latent classes of course in Alzheimer's disease and predictors: The Cache County Dementia Progression Study. International Journal of Geriatric Psychiatry, 30(8), 824832. doi: 10.1002/gps.4221CrossRefGoogle ScholarPubMed
Malek-Ahmadi, M., Beach, T. G., Zamrini, E., Adler, C. H., Sabbagh, M. N., Shill, H. A., … Reiman, E. M. (2019). Faster cognitive decline in dementia due to Alzheimer disease with clinically undiagnosed Lewy body disease. PLoS ONE, 14(6), e0217566. doi: 10.1371/journal.pone.0217566CrossRefGoogle ScholarPubMed
Mauri, M., Sinforiani, E., Zucchella, C., Cuzzoni, M. G., & Bono, G. (2012). Progression to dementia in a population with amnestic mild cognitive impairment: Clinical variables associated with conversion. Functional Neurology, 27(1), 4954.Google Scholar
McKeith, I. G., Boeve, B. F., Dickson, D. W., Halliday, G., Taylor, J. P., Weintraub, D., … Kosaka, K. (2017). Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology, 89(1), 88100. doi: 10.1212/WNL.0000000000004058CrossRefGoogle ScholarPubMed
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Kawas, C. H., … Mayeux, R. (2011). The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7(3), 263269.CrossRefGoogle Scholar
Merdes, A. R., Hansen, L. A., Jeste, D. V., Galasko, D., Hofstetter, C. R., Ho, G. J., … Corey-Bloom, J. (2003). Influence of Alzheimer pathology on clinical diagnostic accuracy in dementia with Lewy bodies. Neurology, 60(10), 15861590.CrossRefGoogle ScholarPubMed
Mueller, C., Soysal, P., Rongve, A., Isik, A. T., Thompson, T., Maggi, S., … Veronese, N. (2019). Survival time and differences between dementia with Lewy bodies and Alzheimer's disease following diagnosis: A meta-analysis of longitudinal studies. Ageing Research Reviews, 50, 7280. doi: 10.1016/j.arr.2019.01.005CrossRefGoogle ScholarPubMed
Nance, C., Ritter, A., Miller, J. B., Lapin, B., & Banks, S. J. (2019). The pathology of rapid cognitive decline in clinically diagnosed Alzheimer's disease. Journal of Alzheimer's Disease, 70(4), 983993. doi: 10.3233/jad-190302CrossRefGoogle ScholarPubMed
Pagani, M., Dessi, B., Morbelli, S., Brugnolo, A., Salmaso, D., Piccini, A., … Rodriguez, G. (2010). MCI patients declining and not-declining at mid-term follow-up: FDG-PET findings. Current Alzheimer Research, 7(4), 287294.CrossRefGoogle ScholarPubMed
Price, A., Farooq, R., Yuan, J.-M., Menon, V. B., Cardinal, R. N., & O'Brien, J. T. (2017). Mortality in dementia with Lewy bodies compared with Alzheimer's dementia: A retrospective naturalistic cohort study. BMJ Open, 7(11), e017504.CrossRefGoogle ScholarPubMed
Proust-Lima, C., Philipps, V., & Liquet, B. (2017). Estimation of extended mixed models using latent classes and latent processes: The R package lcmm. Journal of Statistical Software, 78(i02), 156. doi: 10.18637/jss.v078.i02.CrossRefGoogle Scholar
Rajan, K. B., Wilson, R. S., Barnes, L. L., Aggarwal, N. T., Weuve, J., & Evans, D. A. (2017). A cognitive turning point in development of clinical Alzheimer's disease dementia and mild cognitive impairment: A biracial population study. The Journals of Gerontology: Series A, 72(3), 424430. doi: 10.1093/gerona/glw246Google ScholarPubMed
Rongve, A., Soennesyn, H., Skogseth, R., Oesterhus, R., Hortobágyi, T., Ballard, C., … Aarsland, D. (2016). Cognitive decline in dementia with Lewy bodies: A 5-year prospective cohort study. BMJ Open, 6(2), e010357. doi: 10.1136/bmjopen-2015-010357CrossRefGoogle ScholarPubMed
Scarmeas, N., Brandt, J., Albert, M., Hadjigeorgiou, G., Papadimitriou, A., Dubois, B., … Stern, Y. (2005). Delusions and hallucinations are associated with worse outcome in Alzheimer disease. Archives of Neurology, 62(10), 16011608. doi: 10.1001/archneur.62.10.1601CrossRefGoogle ScholarPubMed
Stephens, P., Chikh, K., & Leufkens, H. (2014). Prescribing of antipsychotics in people with dementia in acute general hospitals in England: 2010–2012. European Geriatric Medicine, 5(6), 394398. doi: 10.1016/j.eurger.2014.04.013CrossRefGoogle Scholar
Stone, J., Pal, S., Blackburn, D., Reuber, M., Thekkumpurath, P., & Carson, A. (2015). Functional (psychogenic) cognitive disorders: A perspective from the neurology clinic. Journal of Alzheimer's Disease, 48(s1), S5S17.CrossRefGoogle ScholarPubMed
Thomas, A. J., Donaghy, P. C., Roberts, G., Colloby, S. J., Barnett, N. A., Petrides, G., … O'Brien, J. T. (2019). Diagnostic accuracy of dopaminergic imaging in prodromal dementia with Lewy bodies. Psychological Medicine, 49(3), 396402. doi: 10.1017/S0033291718000995CrossRefGoogle ScholarPubMed
Thomas, A. J., Mahin-Babaei, F., Saidi, M., Lett, D., Taylor, J. P., Walker, L., & Attems, J. (2018). Improving the identification of dementia with Lewy bodies in the context of an Alzheimer's-type dementia. Alzheimer's Research & Therapy, 10(1), 27. doi: 10.1186/s13195-018-0356-0CrossRefGoogle ScholarPubMed
Vann Jones, S. A., & O'Brien, J. T. (2014). The prevalence and incidence of dementia with Lewy bodies: A systematic review of population and clinical studies. Psychological Medicine, 44(4), 673683.CrossRefGoogle ScholarPubMed
Verlinden, V. J. A., van der Geest, J. N., de Bruijn, R. F. A. G., Hofman, A., Koudstaal, P. J., & Ikram, M. A. (2016). Trajectories of decline in cognition and daily functioning in preclinical dementia. Alzheimer's & Dementia, 12(2), 144153. doi: 10.1016/j.jalz.2015.08.001CrossRefGoogle ScholarPubMed
Walker, Z., McKeith, I., Rodda, J., Qassem, T., Tatsch, K., Booij, J., … O'Brien, J. (2012). Comparison of cognitive decline between dementia with Lewy bodies and Alzheimer's disease: A cohort study. BMJ Open, 2(1), e000380. doi: 10.1136/bmjopen-2011-000380CrossRefGoogle ScholarPubMed
Yu, L., Boyle, P. A., Segawa, E., Leurgans, S., Schneider, J. A., Wilson, R. S., & Bennett, D. A. (2015). Residual decline in cognition after adjustment for common neuropathologic conditions. Neuropsychology, 29(3), 335343. doi: 10.1037/neu0000159CrossRefGoogle ScholarPubMed
Zaccai, J., Brayne, C., Matthews, F. E., & Ince, P. G. (2015). Alpha-synucleinopathy and neuropsychological symptoms in a population-based cohort of the elderly. Alzheimer's Research & Therapy, 7(1), 19. doi: 10.1186/s13195-015-0101-xCrossRefGoogle Scholar
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *