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The progression of cognitive impairment in dementia with Lewy bodies, vascular dementia and Alzheimer's disease

✍ Scribed by C. Ballard; J. O'Brien; C. M. Morris; R. Barber; A. Swann; D. Neill; I. McKeith

Publisher
John Wiley and Sons
Year
2001
Tongue
English
Weight
63 KB
Volume
16
Category
Article
ISSN
0885-6230

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✦ Synopsis

Abstract

Background

Little is known about the rate of progression or associations of cognitive impairment in dementia with Lewy bodies (DLB), or the associations of accelerated decline.

Method

Dementia patients from a case register were evaluated at baseline and 1 year follow‐up using the Cambridge Assessment for Mental Disorders in the Elderly, section B (CAMCOG) and the Mini‐Mental State Examination (MMSE) to determine the rate of cognitive decline. Operationalized clinical diagnoses were applied (NINCDS ADRDA for Alzheimer's disease (AD), NINCDS AIRENS for vascular dementia (VaD) and consensus criteria for DLB).

Results

One hundred and ninety‐three patients completed annual MMSE schedules (AD, 101; DLB, 64; VaD, 38), of whom 154 completed the CAMCOG. The magnitude of cognitive decline (MMSE, 4–5 points; CAMCOG, 12–14 points) was similar in each of the dementias. The strongest predictor of accelerated cognitive decline in DLB was the apolipoprotein E4 allele (17.5 vs 8.3 points decline on the CAMCOG).

Conclusion

Over 1 year, DLB, VaD and AD patients had similar rates of cognitive decline overall. Apolipoprotein E4 may be an important predictor of more rapid decline in DLB. Copyright © 2001 John Wiley & Sons, Ltd

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