Correlates of neuropsychiatric and motor tests with language assessment in patients with Lewy body dementia

Abstract

Background: Lewy body dementia (LBD) impairs performance in daily activities and affects motor, language and visuospatial tasks. Objective: We aimed to correlate neuropsychiatric and motor assessments with language and visual organization tests in LBD. Methods: Twenty-two patients with dementia with Lewy bodies and ten patients with Parkinson's disease dementia participated on a cross-sectional study that assessed cognition, functionality, caregiver burden, verbal fluency, the primer-level dictation section of the Boston Diagnostic Aphasia Examination (PLD-BDAE), the Hooper Visual Organization Test, the Neuropsychiatric Inventory and the Movement Disorder Society -Unified Parkinson's Disease Rating Scale. Results: Language and visuospatial test results followed motor impairment and general cognitive performance. Whereas visual organization did not predict performance in the PLD-BDAE, visuospatial abilities and verbal fluency were concurrently associated, suggesting that linguistic impairment in LBD may be attributed to neuropsychological components of cognition and language. Only visual organization was associated with behaviour, suggesting that neuropsychiatric symptoms associate with differential impairment of visual organization in comparison with language in LBD. Schooling did not affect visual organization or language test performance, while the length of dementia was negatively associated with visual organization and verbal fluency. Discussion: Though visual organization tests follow behaviour and motor performance in LBD, there is differential impairment regarding language skills.

The Cognitive and Language Profile of Dementia with Lewy Bodies

“…However, there can be no doubt that language and cognitive impairments are linked in DLB. 58 The nature and characteristics of the impairments affecting cognitive functions are relatively well established in the scientific literature. In contrast, the data on the deficits affecting the production and comprehension of language is less well developed.…”

Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

“…A previous study exploring visuospatial dysfunctions in PD patients showed that 62.2% of 35 patients could not copy the pentagon drawing 26 . Moreover, Machado et al suggested that language and visual organization tend to follow motor skills and general cognitive performance in patients with DLB 27 . Poor cognitive performance frequently correlates with more advanced stages of the disease, older age, low schooling level, depression, and poorer quality of life 15 ),( 17 ),( 28 .…”

“…Studies conducted in Brazil have assessed the cognitive profile of patients with PD using comprehensive and formal neuropsychological tests, such as the Mattis Dementia Rating Scale (MDRS), Scales for Outcomes in Parkinson’s Disease-Cognition (SCOPA-COG), Wisconsin Card Sorting Test (WCST), Frontal Assessment Battery (FAB), Verbal Fluency Tests 27 ),( 46 , and Trail Making tests 47 . A study applying a comprehensive neuropsychological battery showed cognitive impairment in 56.7% of PD patients in a waiting list for deep brain stimulation (DBS) implantation according to FAB scores and in 76.7% of them according to MoCA, showing the importance of a formal cognitive evaluation in this group of candidates to DBS 48 .…”