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Clinical Features of Alzheimer Disease With and Without Lewy Bodies.


ABSTRACT: Lewy bodies are a frequent coexisting pathology in late-onset Alzheimer disease (AD). Previous studies have examined the contribution of Lewy bodies to the clinical phenotype of late-onset AD with variable findings.To determine whether the presence of Lewy body pathology influences the clinical phenotype and progression of symptoms in longitudinally assessed participants with AD.Retrospective clinical and pathological cohort study of 531 deceased participants who met the neuropathologic criteria for intermediate or high likelihood of AD according to the National Institute on Aging-Ronald Reagan Institute guidelines for the neuropathologic diagnosis of AD. All participants had a clinical assessment within 2 years of death. The data were obtained from 34 AD centers maintained by the National Alzheimer Coordinating Center and spanned from September 12, 2005, to April 30, 2013.Standardized neuropathologic assessment and then brain autopsy after death.Clinical and neuropsychiatric test scores.The mean (SD) age at death was statistically significantly younger for participants who had AD with Lewy bodies (77.9 [9.5] years) than for participants who had AD without Lewy bodies (80.2 [11.1] years) (P?=?.01). The mean (SD) age at onset of dementia symptoms was also younger for participants who had AD with Lewy bodies (70.0 [9.9] years) than for participants who had AD without Lewy bodies (72.2 [12.3] years) (P?=?.03). More men than women had AD with Lewy bodies (P?=?.01). The frequency of having at least 1 APOE ?4 allele was higher for participants who had AD with Lewy bodies than for participants who had AD without Lewy bodies (P?=?.03). After adjusting for age, sex, education, frequency of plaques (neuritic and diffuse), and tangle stage, we found that participants who had AD with Lewy bodies had a statistically significantly higher mean (SD) Neuropsychiatric Inventory Questionnaire score (6.59 [1.44] [95% CI, 3.75-9.42] vs 5.49 [1.39] [95% CI, 2.76-8.23]; P?=?.04) and a statistically significantly higher mean (SD) Unified Parkinson Disease Rating Scale motor score (0.81 [0.18] [95% CI, 0.45-1.17] vs 0.54 [0.18] [95% CI, 0.19-0.88]; P?

SUBMITTER: Chung EJ 

PROVIDER: S-EPMC4501861 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Clinical Features of Alzheimer Disease With and Without Lewy Bodies.

Chung Eun Joo EJ   Babulal Ganesh M GM   Monsell Sarah E SE   Cairns Nigel J NJ   Roe Catherine M CM   Morris John C JC  

JAMA neurology 20150701 7


<h4>Importance</h4>Lewy bodies are a frequent coexisting pathology in late-onset Alzheimer disease (AD). Previous studies have examined the contribution of Lewy bodies to the clinical phenotype of late-onset AD with variable findings.<h4>Objective</h4>To determine whether the presence of Lewy body pathology influences the clinical phenotype and progression of symptoms in longitudinally assessed participants with AD.<h4>Design, setting, and participants</h4>Retrospective clinical and pathological  ...[more]

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