Dementia with Lewy bodies

Kaufer, Daniel I.; Catt, Karyn E.; López, Oscar L.; DeKosky, Steven T.

doi:10.1212/wnl.51.5.1512

Cited by 107 publications

(44 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The profile of attentional and electrocortical variability is consistent with the previously hypothesised FC model proposing a compromised ascending cholinergic system as a causal influence [19,38,39]. This model also receives circumstantial support from a number of observations including the established relationship between cholinergic function, attention [40] and electrocortical arousal [41], together with provisional DLB case reports describing improvements in fluctuating cognitive behaviour following cholinesterase therapy [42]. Additional work combining these measures with pharmacological challenge studies, neuroimaging investigations and clinico-pathological correlative analysis is now required.…”

Section: Discussionsupporting

confidence: 83%

Quantification and Characterisation of Fluctuating Cognition in Dementia with Lewy Bodies and Alzheimer’s Disease

Walker

Ayre

Perry

et al. 2000

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Fluctuating cognition (FC) is a common and important symptom in dementia, particularly dementia with Lewy bodies (DLB), although it has not been empirically quantified or characterised. Forty subjects (15 DLB, 15 AD, 10 elderly controls) were evaluated using a clinical FC severity scale, as well as receiving measures of variability in attentional performance and slow EEG rhythms across 90 s, 1 h and 1 week. DLB patients had significantly more severe FC and more severe variability in attentional and slow electrocortical measures than either AD patients or normal controls in all time frames. Attentional and EEG variability also correlated significantly with independent clinical ratings of FC. Clinical quantification and measures of attention and EEG variability can therefore make an important and standardised contribution to the assessment of FC in dementia, facilitating future treatment studies with important implications for the potential causative mechanisms and differential diagnosis.

show abstract

Section: Discussionsupporting

confidence: 83%

Quantification and Characterisation of Fluctuating Cognition in Dementia with Lewy Bodies and Alzheimer’s Disease

Walker

Ayre

Perry

et al. 2000

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…Previously published accounts of the usage of AChEI in DLB consisted of individual case material and were uncontrolled and retrospective [20,23,25]. Quantitative neuropsychological test methods were not employed.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, 4 tacrine 'responders' were found at autopsy to have diffuse cortical Lewy bodies [20]. Two patients with DLB responded to donepezil in a case report [23], and a small positive effect was seen in an uncontrolled study of 9 DLP patients treated for variable durations with donepezil [24]. A single retrospective trial concluded that none of the 5 DLB patients had responded to tacrine [25].…”

Section: Introductionmentioning

confidence: 99%

Acetylcholinesterase Inhibition in Dementia with Lewy Bodies: Results of a Prospective Pilot Trial

Querfurth

Allam

et al. 2000

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Objective: Dementia with Lewy bodies (DLB) is the second commonest form of dementia. The response to acetylcholinesterase inhibition (AChEI) could be greater in DLB than in Alzheimer’s disease (AD) because cholineacetyl-transferase levels are more reduced in the former. This preliminary trial seeks to compare performances in cognitive tasks before and after tacrine administration in DLB and AD subjects. Methods: Six DLB and 6 AD patients were enrolled in an open, nonrandomized, intervention trial using 80 mg/day tacrine. Patients met ADRDA or DLB consortium criteria for probable diseases. Subjects were matched for Mini Mental State Examination (MMSE) score, age and sex. Mattis Dementia Rating Scale (DRS), Controlled Oral Word Association Test (FAS) and Boston Naming tests were administered at baseline and at 6 months into treatment. Results: AD and DLB groups did not differ in initial mean total DRS scores. In the primary analysis, both groups declined during the course of treatment (–7.3 ± 4.2 and –16.8 ± 39.2 DRS points, respectively). Due to the large variability in DLB posttreatment scores, this group was divided post hoc into responders (DLBr) and nonresponders (DLBnr). The DLBr group outperformed the DLBnr group at baseline (p < 0.05) and, notably, in follow-up DRS test scores (p < 0.001). Two-way MANOVA comparing both DLB subgroups with either the entire AD cohort or similarly stratified AD subgroups showed a significant interaction (F = 7.6; p < 0.015), attributed mostly to declines in DLBnr group scores (p < 0.01). Surprisingly, on DRS memory subscale and FAS tests, there were significant improvements in DLBr scores (p < 0.02). A baseline MMSE (or DRS memory) score ≥15 predicted a positive response to tacrine in DLB. Acceleration of parkinsonism occurred in all DLB subjects. Conclusion: Results from a primary analysis of the therapeutic effect of 80 mg/day tacrine in DLB and AD were negative. However, post hoc analysis showed that mild to moderate DLB responds favorably to AChEI relative to AD through stabilization of global cognitive decline and improvements in specific cognitive areas. These results could be useful in the planning of a more definitive study.

show abstract

“…Patients with Lewy body dementia have several features common to delirious patients: severe cognitive impairment, fluctuating symptom severity, visual hallucinations and EEG slowing [13]. Their symptoms may also respond to cholinesterase inhibitors [14]. An assay that measures serum anticholinergic activity (SAA) has been developed and an association has been found between SAA levels and delirium in medical in-patients [15].…”

Section: Neuropathophysiology Of Delirium Post-strokementioning

confidence: 99%

Delirium post-stroke

et al. 2007

View full text Add to dashboard Cite

Delirium is not only one of the most common complications that older patients develop after admission to hospital but it is also one of the most serious. Although stroke is a known predisposing factor for delirium, few studies have investigated this association and results from existing studies give conflicting results with prevalence estimates ranging from 13 to 48%. The aetiology of delirium post-stroke is poorly understood. There is no consensus on the best screening tool to use to detect delirium in the post-stroke setting. Specific stroke types may be more likely to precipitate delirium than others, for example, delirium is more frequent after intracerebral haemorrhage and total anterior circulation infarction (TACI). In addition, case reports have suggested that delirium may be associated with specific lesions, for example, in the thalamus and caudate nucleus. There is a lack of intervention data in both the prevention and treatment of delirium post-stroke. However, it is known that the development of delirium post-stroke has grave prognostic implications. It is associated with longer stay in hospital, increased mortality and increased risk of institutionalisation post discharge. In this article, we review the literature to date on delirium in the acute stroke setting.

show abstract

Dementia with Lewy bodies

Cited by 107 publications

References 5 publications

Quantification and Characterisation of Fluctuating Cognition in Dementia with Lewy Bodies and Alzheimer’s Disease

Quantification and Characterisation of Fluctuating Cognition in Dementia with Lewy Bodies and Alzheimer’s Disease

Acetylcholinesterase Inhibition in Dementia with Lewy Bodies: Results of a Prospective Pilot Trial

Delirium post-stroke

Contact Info

Product

Resources

About