| 1. |
- Aarsland, D, et al.
(författare)
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Early discriminatory diagnosis of dementia with Lewy bodies. The emerging role of CSF and imaging biomarkers
- 2008
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 25:3, s. 195-205
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The clinical diagnostic criteria for dementia with Lewy bodies (DLB) have a low sensitivity, and there are no generally accepted biomarkers to distinguish DLB from other dementias. Our aim was to identify biomarkers that may differentiate DLB from Alzheimer’s disease (AD). <i>Method:</i> We performed a systematic literature search for studies of EEG, imaging techniques and genetic and CSF markers that provide sensitivity and specificity in the identification of DLB. <i>Results:</i> The best evidence was for scintigraphy of the striatal dopamine transporter system using FP-CIT SPECT. Several small scintigraphy studies of cardiovascular autonomic function using metaiodobenzylguanidine SPECT have reported promising results. Studies exploring innovative techniques based on CSF have reported interesting findings for the combination of amyloid β (aβ) isoforms as well as α-synuclein, and there are interesting results emerging from preliminary studies applying proteomic techniques. Data from studies using structural MRI, perfusion SPECT, genetics and EEG studies show differences between DLB and AD but only at a group level. <i>Conclusion:</i> Several potential biomarkers for the differential diagnosis of probable DLB and AD have shown good diagnostic accuracy in the research setting. Data from large multicentre studies and from studies with autopsy confirmation exist for scintigraphy of the dopamine transporter system. Future studies should explore its value in possible DLB and for clinical management and health economics.
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| 2. |
- Aarsland, D, et al.
(författare)
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Frequency and case identification of dementia with Lewy bodies using the revised consensus criteria
- 2008
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 26:5, s. 445-452
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objective:</i> To find the proportion of dementia with Lewy bodies (DLB) in a referral cohort of patients with a first-time diagnosis of mild dementia. <i>Background:</i> The proportion of DLB among the dementia sufferers is not known and the clinical consensus criteria have low sensitivity. We employed the revised DLB criteria to study the proportion with DLB in a community sample of patients with mild dementia. <i>Methods:</i> From March 2005 to March 2007, we included 196 patients from referrals to all geriatric medicine, old age psychiatry and neurology outpatient clinics in Rogaland and Hordaland counties in Western Norway. Standardized clinical instruments and diagnostic criteria were employed. <i>Results:</i> 65% had Alzheimer dementia, 20% DLB (16% probable DLB), 5.6% vascular dementia, 5.6% Parkinson disease with dementia, 2.0% frontotemporal dementia and 1.5% alcoholic dementia. There were no significant differences in the proportion with DLB according to age bands and dementia severity groups. The revised criteria for a clinical diagnosis of DLB increased the proportion of probable DLB by 25% compared to the previous criteria. <i>Conclusion:</i> DLB is common in patients with mild dementia, and is the second most common type of dementia. The introduction of new clinical criteria for DLB leads to an increase in the proportion diagnosed with probable DLB.
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| 3. |
- Auning, E, et al.
(författare)
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Early and presenting symptoms of dementia with lewy bodies
- 2011
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 32:3, s. 202-208
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background/Aims:</i> To explore the presenting and early symptoms of dementia with Lewy bodies (DLB). <i>Method:</i> Patients with mild dementia fulfilling diagnostic criteria for DLB (n = 61) and Alzheimer’s disease (AD) (n = 109) were recruited from outpatient dementia clinics in western Norway. At diagnosis, caregivers were asked which symptom had been the presenting symptom of dementia. <i>Results:</i> Caregivers reported that memory impairment was the most common presenting symptom in DLB (57%), followed by visual hallucinations (44%), depression (34%), problem solving difficulties (33%), gait problems (28%), and tremor/stiffness (25%). In contrast, 99% of AD carers reported impaired memory as a presenting symptom, whereas visual hallucinations were a presenting symptom in 3% of the AD cases. <i>Conclusion:</i> DLB should be suspected in predementia cases with visual hallucinations.
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| 4. |
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| 5. |
- Fritze, F, et al.
(författare)
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Depressive symptoms in Alzheimer's disease and lewy body dementia: a one-year follow-up study
- 2011
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 32:2, s. 143-149
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objective:</i> To explore the course of depression in people with mild dementia and identify predictors for depression at 1-year follow-up. <i>Methods:</i> Patients with mild dementia (n = 199) were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS) and the depression item from Neuropsychiatric Inventory (NPI) at baseline and after 1 year. A score above 6 on MADRS indicates at least mild depression. Linear and logistic regression analyses were performed to identify predictors of change in depression scores. <i>Results:</i> Among subjects with depression at baseline, 68.1% remained depressed at follow-up, whereas 31.9% had remitted, based on MADRS. Among patients without depression at baseline, 77.1% remained non-depressed at follow-up, whereas 22.9% had incident depression. The proportion with persistent depression was higher in the combined dementia with Lewy bodies (DLB)/Parkinson’s disease with dementia (PDD) group (45.5%) compared to AD (28%) (p < 0.05). Greater decline on the Mini Mental State Examination (p < 0.001) and higher baseline MADRS score (p < 0.001) were significant predictors of increased MADRS score. <i>Conclusion:</i> Two thirds of patients with depression at baseline were still depressed at follow-up, more so in DLB with PDD compared to AD. Cognitive decline was associated with worsening of depressive symptoms.
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| 6. |
- Gatt, A, et al.
(författare)
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Importance of Proactive Treatment of Depression in Lewy Body Dementias: The Impact on Hippocampal Neurogenesis and Cognition in a Post-Mortem Study
- 2017
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 44:5-6, s. 283-293
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Objective:</i></b> To examine the impact of selective serotonin reuptake inhibitors (SSRIs) and depression on neurogenesis and cognition in dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD). <b><i>Methods:</i></b> Late-stage progenitor cells were quantified in the subgranular zone (SGZ) of the hippocampal dentate gyrus of DLB/PDD patients (<i>n</i> = 41) and controls without dementia (<i>n</i> = 15) and compared between treatment groups (unmedicated, SSRIs, acetyl cholinesterase inhibitors [AChEIs], combined SSRIs and AChEIs). <b><i>Results:</i></b> DLB/PDD patients had more doublecortin-positive cells in the SGZ compared to controls. The doublecortin-positive cell count was higher in the SGZ of patients treated with SSRIs and correlated to higher cognitive scores. <b><i>Conclusion:</i></b> SSRI treatment was associated with increased hippocampal neurogenesis and preservation of cognition in DLB/PDD patients.
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| 7. |
- Kurz, MW, et al.
(författare)
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Familial occurrence of dementia and parkinsonism: a systematic review
- 2006
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 22:4, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Parkinson’s disease with dementia (PDD) and dementia with Lewy bodies (DLB) are common clinical dementias characterized neuropathologically by the presence of cortical Lewy body pathology and with distinct clinical and neurobiological similarities. Importantly, genetic factors seem to play a key role in the pathogenesis of Parkinson’s disease. In the current article, we examine the evidence for a genetic component to DLB and PDD by reviewing studies of familial PDD and DLB as well as familial coincidental PDD and DLB, and report the genes involved. There is a convincing genetic overlap between both syndromes, suggesting that they share a common etiological factor.
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| 8. |
- Oesterhus, R, et al.
(författare)
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Long-term mortality in a cohort of home-dwelling elderly with mild Alzheimer's disease and Lewy body dementia
- 2014
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 38:3-4, s. 161-169
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Objective:</i></b> To study mortality in subjects with mild dementia in Norway with a special focus on patients with Lewy body dementia (LBD) compared to Alzheimer's disease (AD). <b><i>Methods:</i></b> All referrals of mild dementia patients to dementia clinics in western Norway from March 2005 to March 2007 were included and followed until December 2012. Diagnoses were based on a comprehensive standardized assessment program. <b><i>Results:</i></b> Of 209 patients, 137 (66%) had AD and 53 (25%) had LBD. Dementia was associated with increased mortality (standardized mortality ratio = 1.8, AD 1.5, LBD 2.6). The median survival time was 6.2 years (95% CI 5.4-6.9). Predictors of mortality were age at diagnosis (HR 1.1 per year) and LBD diagnosis (HR 2.4). <b><i>Conclusion:</i></b> Dementia patients had an increased mortality, particularly those with LBD.
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| 9. |
- Rongve, A, et al.
(författare)
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Core and suggestive symptoms of dementia with lewy bodies cluster in persons with mild dementia
- 2010
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 29:4, s. 317-324
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objectives:</i> To explore how the core and suggestive symptoms of dementia with Lewy bodies (DLB) cluster in persons with newly diagnosed mild dementia, and whether they are associated with a particular pattern of cognitive impairment. <i>Method:</i> Persons with mild dementia (n = 139) were recruited from dementia clinics in western Norway. Symptoms were rated using standardized instruments. A 2-step cluster analysis was applied to classify persons into groups according to scores on scales for hallucinations, parkinsonism, fluctuations and REM sleep behaviour disorder (RBD). <i>Result:</i> Four distinct clusters were revealed: a ‘Lewy body dementia’ (LBD) cluster with high scores for hallucinations, parkinsonism and fluctuation, and a ‘non-LBD’ cluster with low scores on all DLB symptom scales. In addition, 2 clusters with high scores on either RBD or cognitive fluctuation scales emerged. Persons in the LBD cluster had lower scores for visuospatial cognitive abilities as compared to the non-LBD group (p = 0.002). <i>Conclusion:</i> Applying cluster analysis, we identified distinct subgroups in mild dementia based on symptoms such as hallucinations, parkinsonism and cognitive fluctuations. Our findings provide empirical support for diagnosing DLB. Visual hallucinations and motor parkinsonism might be the most distinguishing symptoms for DLB in mild dementia.
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| 10. |
- Skogseth, R, et al.
(författare)
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Neuropsychiatric correlates of cerebrospinal fluid biomarkers in Alzheimer's disease
- 2008
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 25:6, s. 559-563
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The aim of this study was to explore the relationship between cerebrospinal fluid biomarkers and neuropsychiatric symptoms in people with Alzheimer’s disease. Psychosis, agitation, apathy and depression were assessed using standardised measures in 32 patients with mild Alzheimer’s disease. <i>Methods:</i> The levels of the 42-amino-acid form of β-amyloid (Aβ<sub>1–42</sub>), tau and p-tau (phosphorylated at threonine 181) were quantified using the conventional enzyme-linked immunosorbent assay method. <i>Results:</i> Our result shows that apathy is significantly correlated with tau and p-tau but not with Aβ<sub>1–42</sub>. There were no significant correlations between indices of psychosis/agitation,or depression and cerebrospinal fluid Aβ<sub>1–42</sub>, tau or p-tau concentrations. <i>Conclusion:</i> Our finding suggests that apathy is associated with the level of neurofibrillary tangles in people with mild Alzheimer’s disease. In contrast, the overall levels of neurofibrillary tangles or amyloid plaques do not seem to be associated with depression or psychosis, indicating that other brain changes contribute to these symptoms.
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