Contribution of Lewy body inclusions to dementia in patients with and without Alzheimer disease neuropathological conditions.
BACKGROUND
Lewy bodies (LBs) are intraneuronal inclusions in the brain that have been increasingly recognized as neuropathological lesions with relevance not only to Parkinson disease but also to Alzheimer disease. However, the degree to which the density of LBs in the brain contributes to the severity of dementia has not been clear.


OBJECTIVE
To determine the degree to which LB "burden" contributes to dementia.


METHODS
Brain specimens were examined from 273 consecutive autopsies of elderly subjects residing in a nursing home. The numbers and densities of LBs were determined in multiple brain regions, and their correlation with a measure of cognition and functional status (Clinical Dementia Rating) during the 6 months preceding death was determined.


METHODS
Postmortem study of nursing home residents.


RESULTS
The severity of dementia correlated significantly and positively with the density of LBs. These correlations were independent of other neuropathological disorders commonly associated with dementia, including Alzheimer disease. The density of LBs correlated significantly with dementia severity whether or not the diagnostic criteria for Alzheimer disease were met and after the contribution of classical Alzheimer disease lesions, neuritic plaques, and neurofibrillary tangles had been accounted for by partial correlation analysis.


CONCLUSIONS
Lewy body inclusions appear to contribute significantly to cognitive deficits in the elderly in a manner that is independent of other neuropathological disorders. Arch Neurol. 2000;57:1145-1150
Psychiatry Research, Room 3F-02, Bronx VA Medical Center, 130 W Kingsbridge Rd, Bronx, NY 10468, USA. vh@doc.mssm.edu
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Haroutunian
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Serby
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Purohit
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Perl
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Marin
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Mohs
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D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology*; D020961:Lewy Body Disease / Q000473:pathology*; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index