Abstract | INTRODUCTION: METHODS: We retrospectively reviewed 23 patients with Lewy body dementia supported by functional imaging. Baseline demographics, presenting clinical and behavioural and psychological symptoms of dementia, functional and cognitive assessment scores, and complications during follow-up were reviewed. Patients with Lewy body dementia were further classified as having an Alzheimer's disease imaging pattern if functional imaging demonstrated bilateral temporoparietal hypometabolism or hypoperfusion with or without precuneus and posterior cingulate gyrus hypometabolism or hypoperfusion. RESULTS: The pre-imaging accuracy of clinical diagnosis was 52%. In 83% of patients, behavioural and psychological symptoms of dementia were evident. Falls, dysphagia, aspiration pneumonia, pressure sores, and death occurred in 70%, 52%, 26%, 26%, and 30% of patients, respectively with corresponding event rates per person-years of 0.32, 0.17, 0.18, 0.08, and 0.10. Patients with aspiration pneumonia compared with those without were more likely to have dysphagia (100% vs 35%; P=0.01). Deceased patients with Lewy body dementia, compared with alive patients, had a higher (median [interquartile range]) presenting Clinical Dementia Rating score (1 [1-2] vs 0.5 [0.5-1.0]; P=0.01), lower mean (± standard deviation) baseline Barthel index (13 ± 7 vs 18 ± 4; P=0.04), and were more likely to be prescribed levodopa (86% vs 31%; P=0.03). Patients with Lewy body dementia with an Alzheimer's disease pattern of functional imaging, compared with those without the pattern, were younger at presentation (mean ± standard deviation, 73 ± 6 vs 80 ± 6 years; P=0.02) and had a lower Mini-Mental State Examination score at 1 year (15 ± 8 vs 22 ± 6; P=0.05). CONCLUSIONS:
|
Authors | Y F Shea, L W Chu, S C Lee |
Journal | Hong Kong medical journal = Xianggang yi xue za zhi
(Hong Kong Med J)
Vol. 23
Issue 3
Pg. 222-30
(Jun 2017)
ISSN: 1024-2708 [Print] China |
PMID | 28473650
(Publication Type: Journal Article)
|
Topics |
- Accidental Falls
(statistics & numerical data)
- Age of Onset
- Aged
- Alzheimer Disease
(diagnostic imaging)
- China
- Deglutition Disorders
(epidemiology, etiology)
- Female
- Humans
- Lewy Body Disease
(diagnostic imaging, etiology, physiopathology)
- Male
- Pneumonia, Aspiration
(epidemiology, etiology)
- Pressure Ulcer
(epidemiology, etiology)
- Retrospective Studies
- Risk Factors
|