Prodromal clinical manifestations of neuropathologically confirmed Lewy body disease

• Published in: Neurobiology of aging Vol. 31; no. 10; pp. 1805 - 1813
• Main Authors: Jicha, G.A, Schmitt, F.A, Abner, E, Nelson, P.T, Cooper, G.E, Smith, C.D, Markesbery, W.R
• Format: Journal Article
• Language: English
• Published: London Elsevier Inc 01.10.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Aging; Alzheimer's disease; Apolipoproteins E - analysis; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognition Disorders - pathology; Cohort Studies; Delirium - pathology; Dementia - diagnosis; Dementia - etiology; Dementia - pathology; Dementia with Lewy bodies; Development. Senescence. Regeneration. Transplantation; Educational Status; Female; Fundamental and applied biological sciences. Psychology; Geriatrics; Hallucinations - pathology; Humans; Internal Medicine; Lewy Body Disease - complications; Lewy Body Disease - diagnosis; Lewy Body Disease - pathology; Male; Medical sciences; Mild cognitive impairment; Neurology; Neuropsychological Tests; Parkinson Disease - pathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Vertebrates: nervous system and sense organs; Mild cognitive impairment; Alzheimer's disease; Dementia with Lewy bodies; Nervous system diseases; Senescence; Alzheimer disease; Central nervous system disease; Dementia with Lewy bodie; Degenerative disease; mild cognitive impairment; Cerebral disorder; Lewy body
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2008.09.017

Abstract The mild cognitive impairment (MCI) stage of dementia with Lewy bodies (MCI-DLB) has not yet been defined, but is likely to differ in the MCI stage of Alzheimer's disease (MCI-AD). To determine whether clinical features distinguish MCI-DLB and MCI-AD, 9 cases of neuropathologically confirmed MCI-DLB and 12 cases of MCI-AD were compared. No significant differences were found between MCI-DLB and MCI-AD cases in age at death, gender, ApoE status, education, time followed while clinically normal, or duration of MCI. MCI-DLB and MCI-AD cases differed clinically in the expression of Parkinsonism ( P = 0.012), provoked hallucinations or delirium ( P = 0.042), or the presence of any of these noncognitive symptoms of DLB ( P < 0.0001). Letter fluency ( P = 0.007) was significantly lower and Wechsler Logical Memory I ( P = 0.019) was significantly higher in MCI-DLB compared to MCI-AD cases. These data demonstrate the feasibility of differentiating underlying pathologic processes responsible for cognitive decline in the preclinical disease state and suggest that further refinement in diagnostic criteria may allow more accurate early detection of prodromal DLB and AD.