The following article is part of conference coverage from the International Congress of Parkinson’s Disease and Movement Disorders (MDS) Virtual Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the MDS 2021 Virtual Annual Meeting.
Among patients with Lewy body dementia (LBD), Alzheimer disease (AD) co-pathology may contribute to the presence and severity of neuropsychiatric symptoms, according to study results presented at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) Virtual Congress 2021, held from September 17 to 22, 2021.
Previous research has shown that AD co-pathology exists in approximately 50% of patients with LBD, with includes both dementia with Lewy bodies and Parkinson disease dementia.
The current study was aimed at determining the association between AD co-pathology and neuropsychiatric symptoms in LBD.
Using data from the National Alzheimer’s Coordinating Center, 288 patients clinically diagnosed with LBD and neuropathologic confirmation were selected for the study, including 69 patients with no or low levels of AD neuropathologic changes, 120 with intermediate levels of AD neuropathologic changes, and 99 with high levels of AD neuropathologic changes.
Data suggested that more severe AD co-pathology was associated with less neuropsychiatric symptoms, as seen in a lower total Neuropsychiatric Inventory-Questionnaire score (NPI-Q; B=-0.60; P =.013).
With regard to the presence of symptoms, among patients with more severe AD co-pathology, the risk for depression (odds ratio [OR], 0.75; P <.001), delusion (OR, 0.79; P =.006), apathy (OR, 0.80; P =.004) were lower, while the risk for appetite/eating problems was increased (OR, 1.23; P =.006).
With regard to severity of symptoms, more severe AD co-pathology was associated with less severe hallucination (B=-0.089; P =.026), delusion (B=-0.11; P =.021), disinhibition (B=-0.054; P =.048), anxiety (B=-0.075; P =.045), depression (B=-0.12; P <.001); however, appetite/eating changes were more severe (B=0.11; P =.007).
“Further assessment of the neuropsychiatric features at LBD onset and during disease progression in pathologically validated samples can help better elucidate clinicopathological correlations and improve ante-mortem diagnostic accuracy in LBD,” the researchers stated.
DiPane J, Coughlin D, Bayram E. Association between Alzheimer’s disease co-pathology and neuropsychiatric symptoms in Lewy body dementia. Presented at: MDS Virtual Congress 2021; September 17-22, 2021. Poster 637.