Risk factors for dementia with Lewy bodies

Abstract

Objective: To determine the risk factors associated with dementia with Lewy bodies (DLB). Methods:We identified 147 subjects with DLB and sampled 2 sex-and age-matched cognitively normal control subjects for each case. We also identified an unmatched comparison group of 236 subjects with Alzheimer disease (AD). We evaluated 19 candidate risk factors in the study cohort.Results: Compared with controls, subjects with DLB were more likely to have a history of anxiety (odds ratio; 95% confidence interval) (7.4; 3.5-16; p , 0.0001), depression (6.0; 3.7-9.5; p , 0.0001), stroke (2.8; 1.3-6.3; p 5 0.01), a family history of Parkinson disease (PD) (4.6; 2.5-8.6; p , 0.0001), and carry APOE e4 alleles (2.2; 1.5-3.3; p , 0.0001), but less likely to have had cancer (0.44; 0.27-0.70; p 5 0.0006) or use caffeine (0.29; 0.14-0.57; p , 0.0001) with a similar trend for alcohol (0.65; 0.42-1.0; p 5 0.0501). Compared with subjects with AD, subjects with DLB were younger (72.5 vs 74.9 years, p 5 0.021) and more likely to be male (odds ratio; 95% confidence interval) (5.3; 3.3-8.5; p , 0.0001), have a history of depression (4.3; 2.4-7.5; p , 0.0001), be more educated (2.5; 1.1-5.6; p 5 0.031), have a positive family history of PD (5.0; 2.4-10; p , 0.0001), have no APOE e4 alleles (0.61; 0.40-0.93; p 5 0.02), and to have had an oophorectomy before age 45 years (7.6; 1.5-39; p 5 0.015).Conclusion: DLB risk factors are an amalgam of those for AD and PD. Smoking and education, which have opposing risk effects on AD and PD, are not risk factors for DLB; however, depression and low caffeine intake, both risk factors for AD and PD, increase risk of DLB more strongly than in either. Neurology Dementia with Lewy bodies (DLB) is the second most common dementia syndrome, representing 10% to 15% of cases. Knowledge of risk factors for DLB may provide clues to the underlying pathophysiology, yet the only known risk factors are advanced age, male sex, 1 and a family history of dementia.2 We compared the frequency of Alzheimer disease (AD) and Parkinson disease (PD) risk factors among subjects with DLB to age-and sex-matched controls, and to subjects with AD. Risk factors driving amyloid pathology should be present in AD and, to a lesser extent, in DLB. In contrast, risk factors driving Lewy body pathology should be found in DLB, but not AD or control subjects.METHODS Standard protocol approvals, registrations, and patient consents. All protocols were approved by our institutional review board, and consent was obtained from subjects and carers.Subjects. Subjects were recruited into 3 longitudinal studies at Mayo Clinic, Rochester, MN. The Alzheimer Disease Patient Registry (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) 3 and Alzheimer Disease Research Center Study (1999-present) recruited patients with incident dementia and age-and sex-matched controls. The Mayo Clinic Study of Aging (2004-present) follows all community-dwelling persons aged 70 to 89 years.

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

“…The connection between RBD and increased smoking is notable, because it is well-established that smoking is actually associated with a lower risk of PD and is also not associated with higher risk of DLB [39]. This has also been reported in other studies: the RBD study group in PSG-confirmed RBD cases found an OR of 1.41 for ever-smokers [40].…”

Caffeine Intake from Coffee or Tea and Cognitive Disorders: A Meta-Analysis of Observational Studies

“…Among them, 34 articles were excluded because of insufficient data (n = 15), irrelevant outcomes (n = 10), irrelevant study design (n = 6), identical trial (n = 2), and sharing participants with another study (n = 1). The remaining 20 studies (six cross-sectional studies, fiver case-control studies, and nine cohort studies) from 19 articles [11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,35,36,37,38] were included in the final analysis.…”

“…For studies reporting age and sex at the time of the enrollment period, the mean age of the study participants was 71.9 (range, 45 to 108 years), and 51.8% of them were women. The included studies were published from 1990 to 2014, spanning 24 years and were performed in the following countries: China (n = 3) [12,13,38], Finland (n = 2) [23,24], Portugal (n = 2) [18,25], USA (n = 3) [19,21,35], Australia (n = 1) [16], Canada (n = 1) [20], France (n = 1) [22], Norway (n = 1) [14], Taiwan (n = 1) [15], England (n = 1) [17], Japan (n = 2) [11,37], and Jordan (n = 1) [36]. In cohort studies, follow-up periods ranged between 1.3 years and 28 years (mean, 8.4 years), and the completeness of follow-up ranged from 58.2 to 98.2% (mean, 75.8%).…”

Associations of brain lesions at autopsy with polysomnography features before death

“…Smoking has been associated with a reduced risk of LBs 36 but not clinical dementia with LBs. 37 Avoidance of severe hypoxia during REM, by contrast, appeared to protect against neuronal degeneration in the locus ceruleus, an area involved in alertness and control of sleep architecture. In animal studies, hypoxia 38 and extended wakefulness 39 lead to neuronal degeneration in the locus ceruleus, and damage to this area is seen in Parkinson disease and REM sleep behavior disorder.…”