RESUMO
Objective To compare cognitive ,behavioral ,and psychological symptoms observed in Alzheimer's disease (AD ) and dementia with Lewy body (DLB ) in order to provide helpful information for differential diagnosis. Methods We selected 215 patients with AD (AD group)and 66 patients with DLB(DLB group)to retrospectively analyzed their general information ,family history , and disease history.The Mini-Mental State Examination(MMSE scale)was used to evaluate cognitive abilities and Neuropsychiatric Inventory ( NPI scale ) was used for analysis of behavioral and psychological symptoms of dementia in both groups. Results The prevalence of hypertension was higher in the AD group(52.6%,n＝113)than in the DLB group(40%,n＝24)(P＜0.05).The DLB group showed better general cognitive scores ,disorientation scores ,immediate recall scores ,and delayed recall scores than the AD group. Fluctuating cognitive deficiencies and Parkinson's symptoms were more prevalent in the DLB group than in the AD group with 2 patients (0.9%) showing fluctuating cognitive deficiencies in the AD group ,and 19(28.8%)in the DLB group(χ2＝8.580 ,P＝0.003) ;with 26 patients(12.1%)showing Parkinson's symptoms in the AD group and 25(37.9%)in the DLB group(χ2＝ 22.602 ,P＝ 0.000).As to behavioral and psychological symptoms ,the DLB group had higher scores in total NPI ,hallucinations and nighttime abnormal behaviors with 32 patients (14.9%)showing hallucinations and 64 (29.8%)showing nighttime abnormal behaviors in the AD group ;30(46.2%)showing hallucinations and 30 (46.2%)showing nighttime abnormal behaviors in the DLB group (all P ＜ 0.05 ) . Conclusions Hypertension is more prevalent in AD patients. Fluctuating cognitive deficiencies ,Parkinson's symptoms ,hallucinations ,and nighttime abnormal behaviors are prominent manifestations in DLB patients.
RESUMO
Objective To investigate the characteristics of cognitive function and mental behavior symp-toms in patients with Parkinson′s disease dementia(PDD)and dementia with lewy body(DLB).Methods Forty-eight patients with DLB and 38 with PDD were collected in Tianjin Huanhu Hospital and Tianjin Jianhua Hospital. All patients were assessed on cognitive function and mental behavior symptoms using Montreal Cognitive Assess-ment Scale,Mini-Mental State Examination,Hamilton Depression Scale,Hamilton Anxiety Scale and The Neuro-psychiatric Inventory Questionnaire.The Unified Parkinson Disease Rating Scale-Part 3(UPDRSⅢ)and modified Hoehn Yahr staging were used to assess the severity of motor symptoms in patients. Results Scores of UPDRSⅢ,posture and gait disorder were higher in DLB group than those in PDD group but the score of tremor was lower in DLB group than that in PDD group. The proportions of non tremor onset and bilateral onset were also lower in DLB group than those in PDD group,and the differences were statistically significant(P<0.05).Cognitive func-tion impairment was more serious in DLB group than that in PDD group in all cognitive fields including execution, attention,visual space,orientation and the difference was statistically significant(P < 0.05). Hallucinations (81.3%)and irritability/emotional instability(62.5%)were more common in DLB group but apathy(76.9%),de-pression(73.7%)and anxiety(73.7%)were more common in PDD group. Conclusions Cognitive impairment is more progressive in DLB patients than that in PDD patients.Hallucinations and irritability/emotional instability are more common in DLB group but apathy,depression and anxiety are more common in PDD group.
RESUMO
Objective To investigate the clinical features,diagnosis,treatment and prognosis of Dementia with Lewy Body (DLB) in order to improve doctors' understanding and experience.Methods Thirteen cases of clinicall diagnosed DLB were analyzed.The clinical manifestations,neurological examination,laboratory tests,treatment and prognosis were analyzed.Results All of 13 patients had fluctuating dementia.Among them,11 were diagnosed with probable DLB,and 2 were diagnosed with possible DLB.There were 8 cases (8/13) with volatility cognitive impairment,8 cases (8/13) with Parkinson's syndrome,8 casess (8/13) with visual hallucinations,13 cases (13/13) with memory loss,4 patients with limb tremor (4/13),5 cases with delirium (5/13),3 cases with increased sleep (3/ 13),1 case with silence (1/13),9 cases with anxiety and depression (9/13),one case with dizziness (1/13),6 cases with abnormal dysplasia (6/13),and one case with abnormal sensitive to diazepam (1/13).The cognitive function fluctuated,the condition deteriorated and two patients died during the follow-up from 6 months and 5 years.Conclusions Lewy body dementia is an irreversible and progressive neurodegenerative disease.Comprehensive understanding of its clinical features is helpful for the early diagnosis and treatment,which may in turn improve the prognosis.