Delusions in Patients with Dementia with Lewy Bodies and the Associated Factors

Objective. Delusions are common neuropsychiatric symptoms in patients with dementia with Lewy bodies (DLB). The aim of this study was to investigate the associated factors of delusions in patients with DLB. Method. A retrospective study of outpatients with DLB registered in a regional hospital’s database was performed. The associated factors including cognitive performance, clinical features, vascular risk factors, and neuropsychiatric symptoms between delusional and nondelusional patients with DLB were compared. Results. Among 207 patients with DLB, 106 (51.2%) were delusional and 101 (48.8%) were not. Delusion of other persons are stealing was the most common symptom (35.3%). The delusional group had a significantly higher diagnostic rate of probable than possible DLB, higher disease severity, poorer cognitive performance, more severe neuropsychiatric symptoms, and higher caregiver burden (all p<0.05). In addition, the delusional group had a significantly lower frequency of diabetes compared to the nondelusional group (odds ratio=0.28, p<0.001). Conclusion. Delusion of other persons are stealing was the most common delusional symptom. The patients with DLB who presented with delusions had poorer cognitive function and more severe neuropsychiatric symptoms. A novel finding is that the DLB patients with diabetes had a lower frequency of delusions.

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The influence of vascular risk factors on the survival rate of patients with dementia with Lewy bodies and Alzheimer disease

Neurologia i Neurochirurgia Polska ◽

10.1016/s0028-3843(14)60005-0 ◽

2010 ◽

Vol 44 (2) ◽

pp. 139-147 ◽

Cited By ~ 15

Author(s):

Radosław Magierski ◽

Iwona Kłoszewska ◽

Tomasz M. Sobów

Keyword(s):

Risk Factors ◽

Survival Rate ◽

Alzheimer Disease ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Vascular Risk Factors ◽

Vascular Risk

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Reduced vascular risk factors in Parkinson's disease dementia and dementia with Lewy bodies compared to Alzheimer's disease

Brain and Behavior ◽

10.1002/brb3.916 ◽

2018 ◽

Vol 8 (3) ◽

pp. e00916 ◽

Cited By ~ 6

Author(s):

Po-Chi Chan ◽

Cheng-Yu Wei ◽

Guang-Uei Hung ◽

Pai-Yi Chiu

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Parkinson’S Disease ◽

Alzheimer's Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Parkinson’S Disease Dementia

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Characterization of symptoms and determinants of disease burden in dementia with Lewy bodies: DEvELOP design and baseline results

Alzheimer s Research & Therapy ◽

10.1186/s13195-021-00792-w ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

M. van de Beek ◽

I. van Steenoven ◽

J. J. van der Zande ◽

I. Porcelijn ◽

F. Barkhof ◽

...

Keyword(s):

Caregiver Burden ◽

Dementia With Lewy Bodies ◽

Disease Burden ◽

Neuropsychiatric Symptoms ◽

Lewy Bodies ◽

Blood Collection ◽

Functional Activities

Abstract Background The DEmEntia with LEwy bOdies Project (DEvELOP) aims to phenotype patients with dementia with Lewy bodies (DLB) and study the symptoms and biomarkers over time. Here, we describe the design and baseline results of DEvELOP. We investigated the associations between core and suggestive DLB symptoms and different aspects of disease burden, i.e., instrumental activities of daily living (IADL) functioning, quality of life (QoL), and caregiver burden. Methods We included 100 DLB patients (69 ± 6 years, 10%F, MMSE 25 ± 3) in the prospective DEvELOP cohort. Patients underwent extensive assessment including MRI, EEG/MEG, 123FP-CIT SPECT, and CSF and blood collection, with annual follow-up. Core (hallucinations, parkinsonism, fluctuations, RBD) and suggestive (autonomous dysfunction, neuropsychiatric symptoms) symptoms were assessed using standardized questionnaires. We used multivariate regression analyses, adjusted for age, sex, and MMSE, to evaluate how symptoms related to the Functional Activities Questionnaire, QoL-AD questionnaire, and Zarit Caregiver Burden Interview. Results In our cohort, RBD was the most frequently reported core feature (75%), while visual hallucinations were least frequently reported (39%) and caused minimal distress. Suggestive clinical features were commonly present, of which orthostatic hypotension was most frequently reported (64%). Ninety-five percent of patients showed EEG/MEG abnormalities, 88% of 123FP-CIT SPECT scans were abnormal, and 53% had a CSF Alzheimer’s disease profile. Presence of fluctuations, lower MMSE, parkinsonism, and apathy were associated with higher IADL dependency. Depression, constipation, and lower IADL were associated with lower QoL-AD. Apathy and higher IADL dependency predisposed for higher caregiver burden. Conclusion Baseline data of our prospective DLB cohort show clinically relevant associations between symptomatology and disease burden. Cognitive and motor symptoms are related to IADL functioning, while negative neuropsychiatric symptoms and functional dependency are important determinants of QoL and caregiver burden. Follow-up is currently ongoing to address specific gaps in DLB research.

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Neuropsychiatric profiles and conversion to dementia in mild cognitive impairment, a latent class analysis

Scientific Reports ◽

10.1038/s41598-021-83126-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Natalia Roberto ◽

Maria J. Portella ◽

Marta Marquié ◽

Montserrat Alegret ◽

Isabel Hernández ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Dementia With Lewy Bodies ◽

Latent Class ◽

Neuropsychiatric Symptoms ◽

Lewy Bodies ◽

Memory Clinic ◽

Risk Effect ◽

Anxiety Depression

AbstractNeuropsychiatric symptoms (NPS) have been recently addressed as risk factors of conversion to Alzheimer’s disease (AD) and other dementia types in patients diagnosed with Mild Cognitive Impairment (MCI). Our aim was to determine profiles based on the prominent NPS in MCI patients and to explore the predictive value of these profiles on conversion to specific types of dementia. A total of 2137 MCI patients monitored in a memory clinic were included in the study. Four NPS profiles emerged (classes), which were defined by preeminent symptoms: Irritability, Apathy, Anxiety/Depression and Asymptomatic. Irritability and Apathy were predictors of conversion to dementia (HR = 1.43 and 1.56, respectively). Anxiety/depression class showed no risk effect of conversion when compared to Asymptomatic class. Irritability class appeared as the most discriminant neuropsychiatric condition to identify non-AD converters (i.e., frontotemporal dementia, vascular dementia, Parkinson’s disease and dementia with Lewy Bodies). The findings revealed that consistent subgroups of MCI patients could be identified among comorbid basal NPS. The preeminent NPS showed to behave differentially on conversion to dementia, beyond AD. Therefore, NPS should be used as early diagnosis facilitators, and should also guide clinicians to detect patients with different illness trajectories in the progression of MCI.

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Caregiver burden, sleep quality, depression, and anxiety in dementia caregivers: a comparison of frontotemporal lobar degeneration, dementia with Lewy bodies, and Alzheimer's disease

International Psychogeriatrics ◽

10.1017/s1041610217002630 ◽

2017 ◽

Vol 30 (8) ◽

pp. 1131-1138 ◽

Cited By ~ 13

Author(s):

Shuai Liu ◽

Jing Liu ◽

Xiao-Dan Wang ◽

Zhihong Shi ◽

Yuying Zhou ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Sleep Quality ◽

Caregiver Burden ◽

Frontotemporal Lobar Degeneration ◽

Dementia With Lewy Bodies ◽

Neuropsychiatric Symptoms ◽

Lewy Bodies ◽

Index Patient ◽

Behavioral Disturbances

ABSTRACTBackground:Very few recent studies are available that compare caregiver burden, sleep quality, and stress in caregivers of different types of dementia. We aimed to investigate caregiver burden, sleep quality, and stress in caregivers of patients with frontotemporal lobar degeneration and dementia with Lewy bodies, as compared with caregivers of patients with Alzheimer's disease.Methods:This study was carried out from March 2011 to January 2014. In total, 492 dyads of patient and caregiver (frontotemporal lobar degeneration, n = 131; dementia with Lewy bodies, n = 36; Alzheimer's disease, n = 325) participated in this study. We compared patients with respect to the Neuropsychiatric Inventory and caregivers with respect to the Zarit Caregiver Burden Interview, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder scale.Results:Frontotemporal lobar degeneration and dementia with Lewy bodies patients presented significantly more neuropsychiatric symptoms compared to Alzheimer's disease patients. Caregivers of frontotemporal lobar degeneration and dementia with Lewy bodies patients experienced significantly more burden compared to Alzheimer's disease caregivers. Furthermore, among caregivers of both frontotemporal lobar degeneration and dementia with Lewy bodies patients burden was predicted by the neuropsychiatric symptoms, PHQ-9 scores, and GAD-7 scores.Conclusions:The frequency and severity of behavioral disturbances in patient and caregiver stress accounted for the increased caregiver burden, which suggests that frontotemporal lobar degeneration and dementia with Lewy bodies caregivers should receive more support than is currently available.

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Comparison of vascular risk factors and metabolic syndrome among patients with dementia with Lewy bodies, Alzheimer’s disease, and normal elderly

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.912 ◽

2017 ◽

Vol 381 ◽

pp. 322

Author(s):

P.Y. Chiu ◽

M.H. Hsu

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Metabolic Syndrome ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Vascular Risk Factors ◽

Vascular Risk

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

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211023586 ◽

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.

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