scholarly journals 316 - Lewy Body Study: An Australian longitudinal biomarker study of dementia with Lewy bodies

2020 ◽  
Vol 32 (S1) ◽  
pp. 74-74
Author(s):  
Kai Sin Chin ◽  
Nawaf Yassi ◽  
Zina Hijazi ◽  
Victor Villemagne ◽  
Christopher Rowe ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Treatment Strategies ◽  
Lewy Bodies ◽  
Amyloid Β ◽  
Tissue Donation ◽  
Cognitive Assessments ◽  
People With Dementia ◽  
Longitudinal Biomarker ◽  
The Impact

Background:Cerebral multi-morbidity is common in older people with dementia, including people with dementia with Lewy bodies (DLB). We describe the first Australian-based, longitudinal observational biomarker study of DLB.Aims:To investigate the frequency and influence of Alzheimer’s disease (AD) pathology (amyloid-β and tau) and cerebrovascular disease on clinical symptoms and disease outcome in DLB.Methods:The study will recruit 100 people with mild to moderate probable DLB, who will undergo comprehensive clinical and cognitive assessments. Scales targeting DLB-specific clinical features (such as cognitive fluctuations and rapid eye movement sleep behaviour disorder) are administered. Biomarker protocols incorporate blood sampling (including ApoE genotyping and systemic inflammatory markers), molecular imaging (amyloid-β [18F-NAV 4694], tau [18F-MK6240], VMAT2 [18F-AV133] PET scans), 3-tesla magnetic resonance imaging and optional lumbar puncture. Clinical assessments are completed 6 - monthly and imaging 18-monthly. Participants are also invited to register for post-mortem brain tissue donation.Results:Thirty participants with probable DLB have been enrolled to date (mean age 75.4 years, range 64-82; 87% male). All participants have mild to moderate cognitive impairment (mean MMSE 25, range 17-30). Approximately 64% of the participants were amyloid-β positive. Study procedure tolerability has been excellent with no adverse events reported.Conclusions:There is significant overlap of AD-related proteinopathies in people with DLB. Understanding the impact of multi-morbidity is essential in the development of effective treatment strategies. This study supports the feasibility of intensive, longitudinal biomarker studies in DLB in the Australian setting.

scholarly journals Dementia with Lewy bodies: Challenges in the diagnosis and management

2019 ◽  
Vol 53 (4) ◽  
pp. 291-303
Author(s):  
Kai Sin Chin ◽  
Andrew Teodorczuk ◽  
Rosie Watson
Keyword(s):  
Clinical Management ◽  
Dementia With Lewy Bodies ◽  
Treatment Strategies ◽  
Lewy Bodies ◽  
Comprehensive Treatment ◽  
Diagnostic Challenge ◽  
Detection Rates ◽  
Medline Search ◽  
People With Dementia ◽  
Neurodegenerative Dementia

Objective: Dementia with Lewy bodies is the second most common form of neurodegenerative dementia in older age yet is often under-recognised and misdiagnosed. This review aims to provide an overview of the clinical features of dementia with Lewy bodies, discussing the frequent challenges clinicians experience in diagnosing dementia with Lewy bodies, and outlines a practical approach to the clinical management, particularly in the Australian setting. Methods: This paper is a narrative review and a semi-structured database (PubMed and MEDLINE) search strategy was implemented. Articles were screened and clinically relevant studies were selected for inclusion. Results: Dementia with Lewy bodies is clinically characterised by complex visual hallucinations, spontaneous motor parkinsonism, prominent cognitive fluctuations and rapid eye movement sleep behaviour disorder. Neuropsychiatric features and autonomic dysfunction are also common. The new diagnostic criteria and specific diagnostic biomarkers help to improve detection rates and diagnostic accuracy, as well as guide appropriate management. Clinical management of dementia with Lewy bodies is challenging and requires an individualised multidisciplinary approach with specialist input. Conclusion: Dementia with Lewy bodies is a common form of dementia. It often presents as a diagnostic challenge to clinicians, particularly at early stages of disease, and in patients with mixed neuropathological changes, which occur in over 50% of people with dementia with Lewy bodies. Prompt diagnosis and comprehensive treatment strategies are important in improving patients’ care.

Prodromal Dementia With Lewy Bodies: Evolution of Symptoms and Predictors of Dementia Onset

2021 ◽  
pp. 089198872110235
Author(s):  
Kathryn A. Wyman-Chick ◽  
Lauren R. O’Keefe ◽  
Daniel Weintraub ◽  
Melissa J. Armstrong ◽  
Michael Rosenbloom ◽  
...  
Keyword(s):  
Clinical Features ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Data Set ◽  
Wide Range ◽  
Prodromal Dementia ◽  
Dementia Onset

Background: Research criteria for prodromal dementia with Lewy bodies (DLB) were published in 2020, but little is known regarding prodromal DLB in clinical settings. Methods: We identified non-demented participants without neurodegenerative disease from the National Alzheimer’s Coordinating Center Uniform Data Set who converted to DLB at a subsequent visit. Prevalence of neuropsychiatric and motor symptoms were examined up to 5 years prior to DLB diagnosis. Results: The sample included 116 participants clinically diagnosed with DLB and 348 age and sex-matched (1:3) Healthy Controls. Motor slowing was present in approximately 70% of participants 3 years prior to DLB diagnosis. In the prodromal phase, 50% of DLB participants demonstrated gait disorder, 70% had rigidity, 20% endorsed visual hallucinations, and over 50% of participants endorsed REM sleep behavior disorder. Apathy, depression, and anxiety were common prodromal neuropsychiatric symptoms. The presence of 1+ core clinical features of DLB in combination with apathy, depression, or anxiety resulted in the greatest AUC (0.815; 95% CI: 0.767, 0.865) for distinguishing HC from prodromal DLB 1 year prior to diagnosis. The presence of 2+ core clinical features was also accurate in differentiating between groups (AUC = 0.806; 95% CI: 0.756, 0.855). Conclusion: A wide range of motor, neuropsychiatric and other core clinical symptoms are common in prodromal DLB. A combination of core clinical features, neuropsychiatric symptoms and cognitive impairment can accurately differentiate DLB from normal aging prior to dementia onset.

scholarly journals Amyloid-β deposition and regional grey matter atrophy rates in dementia with Lewy bodies

Brain ◽  
2016 ◽  
Vol 139 (10) ◽  
pp. 2740-2750 ◽  
Author(s):  
Lidia Sarro ◽  
Matthew L. Senjem ◽  
Emily S. Lundt ◽  
Scott A. Przybelski ◽  
Timothy G. Lesnick ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Grey Matter ◽  
Lewy Bodies ◽  
Amyloid Β ◽  
Grey Matter Atrophy

Psychosocial support for people with dementia with Lewy bodies

2021 ◽  
Vol 23 (5) ◽  
pp. 1-8
Author(s):  
Alison Killen
Keyword(s):  
Dementia With Lewy Bodies ◽  
Psychosocial Support ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Adverse Outcomes ◽  
Care Staff ◽  
The Core ◽  
People With Dementia ◽  
Age Related ◽  
Core Features

Background Lewy body dementia is the second most common form of age-related neurodegenerative dementia. It has two forms: dementia with Lewy bodies and Parkinson's disease dementia. Methods There are specific core symptoms associated with dementia with Lewy bodies. Optimum care requires awareness of the features associated with these, as well as appropriate support and management strategies, which are provided in this article. Results The core features of dementia with Lewy bodies are visual hallucinations, cognitive fluctuations, Parkinsonism and rapid eye movement sleep behaviour disorder. Appropriate psychosocial strategies includes psychoeducation, social support and environmental modification. Adoption of these approaches can reduce adverse outcomes. Conclusions The core features of dementia with Lewy bodies can significantly impair quality of life. Nursing and residential care staff are ideally placed to address this through the implementation of psychosocial strategies both directly, and through the provision of psychoeducation for family caregivers.

scholarly journals The challenges of COVID ‐19 for people with dementia with Lewy bodies and family caregivers

2020 ◽  
Vol 35 (12) ◽  
pp. 1431-1436 ◽  
Author(s):  
Alison Killen ◽  
Kirsty Olsen ◽  
Ian G. McKeith ◽  
Alan J. Thomas ◽  
John T. O'Brien ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
People With Dementia

scholarly journals Current and Future Treatments in Alzheimer Disease: An Update

2020 ◽  
Vol 12 ◽  
pp. 117957352090739 ◽  
Author(s):  
Konstantina G Yiannopoulou ◽  
Sokratis G Papageorgiou
Keyword(s):  
Alzheimer Disease ◽  
Clinical Symptoms ◽  
Neurofibrillary Tangle ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Amyloid Β ◽  
Cell Therapies ◽  
Novel Biomarkers ◽  
Disease Modifying ◽  
Underlying Mechanisms

Disease-modifying treatment strategies for Alzheimer disease (AD) are still under extensive research. Nowadays, only symptomatic treatments exist for this disease, all trying to counterbalance the neurotransmitter disturbance: 3 cholinesterase inhibitors and memantine. To block the progression of the disease, therapeutic agents are supposed to interfere with the pathogenic steps responsible for the clinical symptoms, classically including the deposition of extracellular amyloid β plaques and intracellular neurofibrillary tangle formation. Other underlying mechanisms are targeted by neuroprotective, anti-inflammatory, growth factor promotive, metabolic efficacious agents and stem cell therapies. Recent therapies have integrated multiple new features such as novel biomarkers, new neuropsychological outcomes, enrollment of earlier populations in the course of the disease, and innovative trial designs. In the near future different specific agents for every patient might be used in a “precision medicine” context, where aberrant biomarkers accompanied with a particular pattern of neuropsychological and neuroimaging findings could determine a specific treatment regimen within a customized therapeutic framework. In this review, we discuss potential disease-modifying therapies that are currently being studied and potential individualized therapeutic frameworks that can be proved beneficial for patients with AD.

scholarly journals Hospitalization in people with dementia with Lewy bodies: Frequency, duration, and cost implications

2017 ◽  
Vol 10 (1) ◽  
pp. 143-152 ◽  
Author(s):  
Christoph Mueller ◽  
Gayan Perera ◽  
Anto P. Rajkumar ◽  
Manorama Bhattarai ◽  
Annabel Price ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
People With Dementia ◽  
Cost Implications

scholarly journals Magnetic Resonance Spectroscopy in the Diagnosis of Dementia with Lewy Bodies

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Radoslaw Magierski ◽  
Tomasz Sobow
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Lewy Bodies ◽  
Resonance Spectroscopy ◽  
Diagnosis Of Dementia

Dementia with Lewy bodies (DLB) is considered to be the second most frequent primary degenerative dementing illness after Alzheimer’s disease (AD). DLB, together with Parkinson’s disease (PD), Parkinson’s disease with dementia (PDD) belong toα-synucleinopathies—a group of neurodegenerative diseases associated with pathological accumulation of theα-synuclein protein. Dementia due to PD and DLB shares clinical symptoms and neuropsychological profiles. Moreover, the core features and additional clinical signs and symptoms for these two very similar diseases are largely the same. Neuroimaging seems to be a promising method in differential diagnosis of dementia studies. The development of imaging methods or other objective measures to supplement clinical criteria for DLB is needed and a method which would accurately facilitate diagnosis of DLB prior to death is still being searched. Proton magnetic resonance spectroscopy (1H-MRS) provides a noninvasive method of assessing anin vivobiochemistry of brain tissue. This review summarizes the main results obtained from the application of neuroimaging techniques in DLB cases focusing on1H-MRS.

Dementia with Lewy bodies and Parkinson’s disease dementia

2013 ◽  
Author(s):  
Arvid Rongve ◽  
Dag Aarsland
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Lewy Bodies ◽  
Epidemiological Data ◽  
Parkinson’S Disease Dementia ◽  
Esterase Inhibitors ◽  
Staging Systems

Dementia with Lewy bodies and Parkinson’s disease dementia belong to the α-synucleinopathies, a family of diseases pathologically characterized by aggregation of α-synuclein in Lewy bodies in the brain. In this chapter we present the epidemiological data for both conditions including new data on MCI. Clinical diagnostic criteria are reviewed and the different neuropathology staging systems for DLB and PDD and the most important genetic findings are considered. Biomarkers in DLB and PDD with particular focus on imaging techniques like CIT-SPECT and MRI are described. Important clinical symptoms in both conditions are presented in detail and the most important clinical differential diagnoses are discussed. Pharmacological and non- pharmacological treatment of different symptoms in both conditions are discussed with particular emphasis on the choline esterase inhibitors and antipsychotic medications.New data on memantine are presented.

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