Clinical characteristics of Lewy body dementia in Chinese memory clinics

Gan, Jinghuan; Liu, Shuai; Wang, Xiaodan; Shi, Zhihong; Shen, Lu; Li, Xudong; Guo, Qihao; Yuan, Junliang; Zhang, Nan; You, Yong; Lv, Yang; Zheng, Dongming; Ji, Yong

doi:10.1186/s12883-021-02169-w

Cited by 15 publications

(13 citation statements)

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“…Patients with DLB demonstrated a poorer cognitive situation at their visit than patients with PDD. The ages at onset and at visit were both older in DLB than PDD, which was consistent with our multicenter findings [ 62 ] in Chinese memory clinics. Moreover, patients with DLB suffered more from hypertension and DM than PDD patients.…”

Section: Discussionsupporting

confidence: 91%

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

et al. 2022

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Introduction Geriatric symptoms are common in dementia cases, while few studies have focused on these symptoms in Lewy body dementia (LBD). The purpose of this study is to investigate the distributions of Apolipoprotein E (APOE) ε4 and geriatric symptoms, and explore their associaitons in Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). Methods A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4. Results DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082–11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079–8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups. Conclusion The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.

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Section: Discussionsupporting

confidence: 91%

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

et al. 2022

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“…PDD can also occur in many patients with PD up to 90% in their long-term, with illness progression ( 11 ). The incidence of DLB, which is the second most common neurodegenerative dementia, is approximately 3.5 per 100,000 person-years ( 12 ) and accounts for 10%–20% of all dementias ( 13 , 14 ). The prevalence of sleep disturbance in LBD is 44%–55% ( 15 ) and is more prominent than in Alzheimer’s disease (AD) patients.…”

Section: Introductionmentioning

confidence: 99%

Orexin-A in Patients With Lewy Body Disease: A Systematic Review and Meta-Analysis

et al. 2021

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BackgroundAbnormal orexin-A levels in cerebrospinal fluid (CSF) have been identified in Alzheimer’s disease (AD) and other neurodegenerative diseases. However, few studies have focused on Lewy body disease (LBD) and often with debatable outcomes. Thus, we performed this systematic review and meta-analysis to investigate orexin-A levels in LBD by incorporating data from different studies.MethodsWe gathered studies comparing orexin-A levels in patients with LBD and controls (including healthy controls and other dementia subtypes). In the initial search, 117 relevant articles were identified. After a selection process, seven studies, conducted in Japan, USA, Spain, Switzerland, France, Italy, and Netherlands, were chosen.ResultsIn total, 179 patients with LBD and 253 controls were included. Patients with LBD had significantly lower mean orexin-A CSF levels when compared with patients with AD [standard mean difference (SMD): −0.35, 95% confidence interval (CI): −0.70 to −0.00, Z = 1.96, P = 0.05], whereas mean orexin-A levels were significantly higher when compared with patients with frontotemporal lobar degeneration (FTLD) (SMD: 0.61, 95% CI: 0.23–0.99, Z = 3.12, P = 0.002). Orexin-A CSF levels in LBD patients were approximately equal to levels in healthy elderly individuals, whereas they were significantly decreased in LBD patients with excessive daytime sleepiness (EDS) (SMD: -0.15, 95% CI: -0.59 to 0.29, Z = 0.67, P = 0.50).ConclusionsWe showed that orexin-A levels in patients with LBD were not very different from those in normal elderly individuals, whereas they were lower than those in AD patients and higher than those in FTLD patients. The influence of hypersomnia on orexin-A levels should be carefully interpreted.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021265900.

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“…RBD often begins many years before other symptoms and may become less vigorous or even quiescent over time, which led to inadequate unidentification of RBD in the current study. Compared with the DLBs who took the initiative to see the doctor, those diagnosed “passively” in this investigation were significantly older and had worse cognition performance (Gan et al, 2021 ). Participants with DLB experienced severe autonomic dysfunction (such as orthostatic hypotension, hyperhidrosis, constipation, urinary incontinence), repeated falls, hypersomnolence and other psychiatric symptoms such as delusions, hallucinations (except visual hallucinations), apathy, anxiety, and depression.…”

Section: Discussionmentioning

confidence: 80%

Association between prevalence rate of dementia with Lewy bodies and sleep characteristics in Chinese old adults

Gan

Liu

Wang

et al. 2022

Front. Hum. Neurosci.

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Introduction: Few studies are available on the prevalence and sleep-related factors of dementia with Lewy bodies (DLB) in Chinese older adults, aiming to explore the associations between sleep characteristics and DLB.Methods: A cross-sectional study with 7,528 individuals aged ≥65 years in 106 communities in Northern China was conducted from April 2019 to January 2020. Questionaries (including demographic characteristics, comorbidities, lifestyles, and sleep characteristics) were administered, and neuropsychological assessments and physical examination were conducted in phase I; screening for probable DLB was done in phase II. Logistic regressions were used to assess associations.Results: A total of 919 (12.2%, 919/7,528) participants had dementia, and 101 (1.3%, 101/7,528) participants were diagnosed with DLB. The prevalence of dementia and DLB were slightly higher or equal in women, increased with age, and roughly decreased with nighttime sleep duration. Of the 101 participants, all of them (100.0%) had cognitive impairment, 46 (44.54%) displayed fluctuating cognition, 72 (71.29%) of them showed visual hallucination, 22 (21.78%) individuals reported RBD, and 27.71% showed Parkinsonism. Sleeping for <5 h (adjusted OR = 1.795, 95%CI: 1.055–3.054, p < 0.05) or having hypersomnolence (adjusted OR = 31.213, 95% CI: 17.618–55.301, p < 0.001) were significantly associated with the occurrence of DLB. Sleep duration of <5 h or >8 h had combined diagnostic value for DLB (AUC = 0.783, 95%CI: 0.734–0.831, p < 0.001).Conclusions: The current prevalence of DLB is 1.3% in Northern China. Short or long nighttime sleep duration is independently associated with the occurrence of dementia and DLB.

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Clinical characteristics of Lewy body dementia in Chinese memory clinics

Cited by 15 publications

References 50 publications

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

Orexin-A in Patients With Lewy Body Disease: A Systematic Review and Meta-Analysis

Association between prevalence rate of dementia with Lewy bodies and sleep characteristics in Chinese old adults

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