Mild cognitive impairment with Lewy bodies: neuropsychiatric supportive symptoms and cognitive profile
Donaghy, PC; Ciafone, J; Durcan, R; et al.Hamilton, CA; Barker, S; Lloyd, J; Firbank, M; Allan, LM; O'Brien, JT; Taylor, J-P; Thomas, AJ
Date: 25 August 2020
Article
Journal
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Publisher DOI
Abstract
Background
Recently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB)
include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions,
apathy, anxiety and depression). We have previously demonstrated that the presence of two or
more of these symptoms differentiates ...
Background
Recently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB)
include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions,
apathy, anxiety and depression). We have previously demonstrated that the presence of two or
more of these symptoms differentiates MCI-LB from MCI due to Alzheimer’s disease (MCI-AD) with a
likelihood ratio >4. The aim of this study was to replicate the findings in an independent cohort.
Methods
Participants ≥60 years old with MCI were recruited. Each participant had a detailed clinical, cognitive
and imaging assessment including FP-CIT SPECT and cardiac MIBG. The presence of neuropsychiatric
supportive symptoms was determined using the neuropsychiatric inventory (NPI). Participants were
classified as MCI-AD, possible MCI-LB and probable MCI-LB based on current diagnostic criteria.
Participants with possible MCI-LB were excluded from further analysis.
Results
Probable MCI-LB (n=28) had higher NPI total and distress scores than MCI-AD (n=30). 59% of MCI-LB
had two or more neuropsychiatric supportive symptoms compared with 9% of MCI-AD (likelihood
ratio 6.5, p<0.001). MCI-LB participants also had significantly greater delayed recall and a lower
Trails A:Trails B ratio than MCI-AD.
Conclusions
5
MCI-LB is associated with significantly greater neuropsychiatric symptoms than MCI-AD. The
presence of two or more neuropsychiatric supportive symptoms as defined by MCI-LB diagnostic
criteria is highly specific and moderately sensitive for a diagnosis of MCI-LB. The cognitive profile of
MCI-LB differs from MCI-AD, with greater executive and lesser memory impairment, but these
differences are not sufficient to differentiate MCI-LB from MCI-AD.
Institute of Health Research
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