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Mild cognitive impairment with Lewy bodies: neuropsychiatric supportive symptoms and cognitive profile

Lookup NU author(s): Dr Paul Donaghy, Dr Joanna Ciafone, Dr Rory Durcan, Dr Calum Hamilton, Sally Barker, Dr James Lloyd, Dr Michael Firbank, Dr Louise Allan, Professor John O'Brien, Professor John-Paul Taylor, Professor Alan Thomas

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

BackgroundRecently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB) include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions, apathy, anxiety and depression). We have previously demonstrated that the presence of two or more of these symptoms differentiates MCI-LB from MCI due to Alzheimer’s disease (MCI-AD) with a likelihood ratio >4. The aim of this study was to replicate the findings in an independent cohort.MethodsParticipants ≥60 years old with MCI were recruited. Each participant had a detailed clinical, cognitive and imaging assessment including FP-CIT SPECT and cardiac MIBG. The presence of neuropsychiatric supportive symptoms was determined using the neuropsychiatric inventory (NPI). Participants were classified as MCI-AD, possible MCI-LB and probable MCI-LB based on current diagnostic criteria. Participants with possible MCI-LB were excluded from further analysis.ResultsProbable MCI-LB (n=28) had higher NPI total and distress scores than MCI-AD (n=30). 59% of MCI-LB had two or more neuropsychiatric supportive symptoms compared with 9% of MCI-AD (likelihood ratio 6.5, p<0.001). MCI-LB participants also had significantly greater delayed recall and a lower Trails A:Trails B ratio than MCI-AD.ConclusionsMCI-LB is associated with significantly greater neuropsychiatric symptoms than MCI-AD. The presence of two or more neuropsychiatric supportive symptoms as defined by MCI-LB diagnostic criteria is highly specific and moderately sensitive for a diagnosis of MCI-LB. The cognitive profile of MCI-LB differs from MCI-AD, with greater executive and lesser memory impairment, but these differences are not sufficient to differentiate MCI-LB from MCI-AD.


Publication metadata

Author(s): Donaghy PC, Ciafone J, Durcan R, Hamilton CA, Barker S, Lloyd J, Firbank M, Allan LM, O'Brien JT, Taylor JP, Thomas AJ

Publication type: Article

Publication status: Published

Journal: Psychological Medicine

Year: 2020

Pages: epub ahead of print

Online publication date: 25/08/2020

Acceptance date: 28/07/2020

Date deposited: 28/07/2020

ISSN (print): 0033-2917

ISSN (electronic): 1469-8978

Publisher: Cambridge University Press

URL: https://doi.org/10.1017/S0033291720002901


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