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

Published online by Cambridge University Press:  25 August 2020

Paul C Donaghy Open the ORCID record for Paul C Donaghy [Opens in a new window] ,
Joanna Ciafone ,
Rory Durcan ,
Calum A Hamilton ,
Sally Barker ,
Jim Lloyd ,
Michael Firbank ,
Louise M Allan ,
John T O'Brien  and
John-Paul Taylor
...Show all authors
Paul C Donaghy*
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Joanna Ciafone
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Rory Durcan
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Calum A Hamilton
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Sally Barker
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Jim Lloyd
Affiliation:
Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
Michael Firbank
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Louise M Allan
Affiliation:
College of Medicine and Health, Exeter University, Exeter, UK
John T O'Brien
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK
John-Paul Taylor
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Alan J Thomas
Affiliation:
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
*
Author for correspondence: Paul C Donaghy, E-mail: [email protected]
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Abstract

Background

Recently 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.

Methods

Participants ⩾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.

Results

Probable MCI-LB (n = 28) had higher NPI total and distress scores than MCI-AD (n = 30). In total, 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 a significantly greater delayed recall and a lower Trails A:Trails B ratio than MCI-AD.

Conclusions

MCI-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.

Keywords

AgitationAnxietyApathyCognitionDementia with Lewy bodiesDepressionMCIMild cognitive impairment with Lewy bodiesNeuropsychiatric symptoms
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 6 , April 2022 , pp. 1147 - 1155
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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