ABSTRACT
It is currently unknown whether patients with dementia with Lewy bodies (DLB) with relatives with dementia or Parkinson's disease (familial DLB patients) have a different phenotype than sporadic DLB patients. In this study, we aimed to examine disease onset, rate of cognitive decline, survival, and Alzheimer's disease (AD) biomarkers in patients with familial DLB (nâ=â154) and sporadic DLB (nâ=â137), using linear mixed model analysis and Cox regression analysis, among others. Familial patients had a shorter survival (8.0 years) and more often elevated cerebrospinal fluid AD biomarkers (47%) than sporadic patients (9.0 years; p≤0.001; 30%, pâ=â0.037). Our findings suggest that genetic factors are important in DLB and that the identification of new genetic factors will probably improve the prediction of prognosis.
Subject(s)
Lewy Body Disease/diagnostic imaging , Age of Onset , Aged , Aged, 80 and over , Alzheimer Disease/cerebrospinal fluid , Biomarkers/cerebrospinal fluid , Cognitive Dysfunction , Family , Female , Humans , Kaplan-Meier Estimate , Lewy Body Disease/epidemiology , Male , Middle Aged , Phenotype , Prognosis , Retrospective Studies , Survival AnalysisABSTRACT
AIMS: To determine whether the pentagon copying test (PCT) and the clock drawing test (CDT) are associated with nursing home admission or survival in dementia with Lewy bodies (DLB). METHODS: The PCT and/or the CDT were retrospectively collected from 103 clinically diagnosed probable DLB patients at a university medical center and general hospital. Patients with high versus low scores on these tests were compared. RESULTS: Kaplan-Meier analysis showed that patients with a low score on the PCT had a shorter time to nursing home admission than patients with a high score (log-rank χ2 = 6.1, p = 0.01). Patients with a low score on the PCT or the CDT had a shorter survival than patients with a high score (log-rank χ2 = 5.4, p = 0.02, and log-rank χ2 = 11.2, p < 0.001, respectively). Cox regression analyses showed the same associations with an HR of 2.2 (95% CI 1.2-4.1) for the PCT and an HR of 2.9 (95% CI 1.6-5.4) for the CDT. CONCLUSION: The PCT and the CDT may function as prognostic markers in DLB. This finding is clinically relevant as these tests can be applied easily in the clinical setting and can provide valuable prognostic information. Furthermore, it may improve disease management and patient selection for research purposes.
Subject(s)
Lewy Body Disease/diagnosis , Neuropsychological Tests , Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Nursing Homes , Patient Admission/statistics & numerical data , Prognosis , Retrospective Studies , Risk FactorsABSTRACT
A 71-year-old man underwent a coronary angiography (CAG). Afterwards he experienced vision loss. Neurologic examination revealed bilateral cortical blindness. A cerebral CT-scan showed occipital hyperdensity, due to contrast accumulation and oedema. There was complete recovery of vision within 2 days. Transient cortical blindness after CAG is a rare complication of iodinated contrast agents.
