The prognosis of dementia with Lewy bodies

“…LBD is associated with increased mortality, earlier nursing home admissions, higher risk of falls, poorer quality of life, higher costs, and more caregivers' burden than AD. Overall, LBD carries a poorer prognosis than AD, with accelerated cognitive decline and a greater negative impact on quality of life . The search for disease modifying drugs and reliable peripheral biomarkers for LBD is still ongoing …”

Section: Introductionmentioning

confidence: 99%

Systematic review of genetic association studies in people with Lewy body dementia

Sanghvi

Singh

Morrin

et al. 2020

Int J Geriat Psychiatry

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Objectives Lewy body dementia (LBD) causes more morbidity, disability, and earlier mortality than Alzheimer disease. Molecular mechanisms underlying neurodegeneration in LBD are poorly understood. We aimed to do a systematic review of all genetic association studies that investigated people with LBD for improving our understanding of LBD molecular genetics and for facilitating discovery of novel biomarkers and therapeutic targets for LBD. Methods We systematically reviewed five online databases (PROSPERO protocol: CRD42018087114) and completed the quality assessment using the quality of genetic association studies tool. Results Eight thousand five hundred twenty‐one articles were screened, and 75 articles were eligible to be included. Genetic associations of LBD with APOE, GBA, and SNCA variants have been replicated by two or more good quality studies. Our meta‐analyses confirmed that APOE‐ε4 is significantly associated with dementia with Lewy bodies (pooled odds ratio [POR] = 2.70; 95% CI, 2.37‐3.07; P < .001) and Parkinson's disease dementia (POR = 1.60; 95% CI, 1.21‐2.11; P = .001). Other reported genetic associations that need further replication include variants in A2M, BCHE‐K, BCL7C, CHRFAM7A, CNTN1, ESR1, GABRB3, MAPT, mitochondrial DNA (mtDNA) haplogroup H, NOS2A, PSEN1, SCARB2, TFAM, TREM2, and UCHL1. Conclusions The reported genetic associations and their potential interactions indicate the importance of α‐synuclein, amyloid, and tau pathology, autophagy lysosomal pathway, ubiquitin proteasome system, oxidative stress, and mitochondrial dysfunction in LBD. There is a need for larger genome‐wide association study (GWAS) for identifying more LBD‐associated genes. Future hypothesis‐driven studies should aim to replicate reported genetic associations of LBD and to explore their functional implications.

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“…Functional status is an important factor to consider over the course of aging, especially for those older adults with dementia, because currently, there are no disease modifying therapies . As dementia progresses, impaired functional status diminishes the level of independence of older adults …”

Section: Introductionmentioning

confidence: 99%

Associations among Braak stage, Parkinsonian gait, cognition, and functional status in autopsy‐confirmed dementia with Lewy bodies

Mayo

Peavy

2019

Int J Geriat Psychiatry

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Objective Compromised functional abilities in older adults with dementia with Lewy bodies (DLB) represent a significant burden to families and frequently lead to institutionalization. Contributing factors to this compromise are poorly understood. Methods Using data collected at a first study visit, multiple regression modeling was used to examine the associations between Braak staged Alzheimer disease (AD) pathology, Apolipoprotein E (ApoE) status, Parkinsonian gait, cognition, and functional status from a cohort of 102 cases with an autopsy‐confirmed diagnosis of dementia stemming from combined Lewy body and AD pathology. Results On average, 60% of functional activities were compromised per case. Worse functional status was associated with older age at first study visit, compromised cognitive status, and Parkinsonian gait after controlling for gender, mental status, and other covariates. Worse cognitive status predicted worse functional status in both the low and high Braak groups. Conclusions Older persons with DLB presenting with moderately compromised cognition and Parkinsonian gait should be expected to have impaired functional abilities. Providing these patients with supportive environments may help them to remain independent for longer periods of time.

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The prognosis of dementia with Lewy bodies

Cited by 185 publications

References 81 publications

Lewy Body Dementia: A Review

Lewy Body Dementia: A Review

Systematic review of genetic association studies in people with Lewy body dementia

Associations among Braak stage, Parkinsonian gait, cognition, and functional status in autopsy‐confirmed dementia with Lewy bodies

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