Contrasts Between Patients With Lewy Body Dementia Syndromes and APOE-ε3/ε3 Patients With Late-onset Alzheimer Disease Dementia.
BACKGROUND
Neuropsychiatric and epidemiological patterns may compensate for insufficient specificity of diagnostic criteria of Lewy body dementia (LBD) syndromes in differential analysis with Alzheimer disease (AD) dementia. We aimed to compare and distinguish demographic and neuropsychiatric features between LBD and APOE-ε3/ε3 late-onset AD.


METHODS
A total of 39 consecutive patients with Parkinson disease dementia or dementia with Lewy bodies were matched with 39 APOE-ε3/ε3 patients with late-onset AD according to sex and Mini-Mental State Examination scores, and evaluated for education, age at disease onset, lifetime sanitary conditions, anthropometric measures, alcohol use, smoking, history of head trauma or bacterial infections, family history of neurodegenerative diseases, caregiver burden, functional independence, cognitive decline, neuropsychiatric symptoms, and pharmacological treatment.


RESULTS
Family history of parkinsonism and worse motor performance were more prevalent in Parkinson disease dementia, also impacting sleep satisfaction and physical self-maintenance. Patients with AD had higher systolic blood pressure, were more independent, and had better performance in visuospatial tasks and calculations, whereas patients with LBD were more oriented and previously lived longer in rural areas without sanitation. Among neuropsychiatric symptoms, hallucinations, apathy, dysphoria, anxiety, and aberrant motor behavior were the most significant for discrimination amidst dementia diagnoses.


CONCLUSIONS
Functional performance, visuospatial skills, and behavioral symptoms are helpful for differential diagnoses between LBD and AD. Cerebrovascular risk might be more important for AD pathogenesis, whereas environmental factors might impact development of LBD.
Departments of *Neurology and Neurosurgery †Morphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
Fabricio F
FF
Oliveira
Fernando C
FC
Machado
Gustavo
G
Sampaio
Sheilla M C
SM
Marin
Elizabeth S
ES
Chen
Marilia C
MC
Smith
Paulo H F
PH
Bertolucci
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000235:genetics*; D001057:Apolipoproteins E / Q000235:genetics*; D001526:Behavioral Symptoms / Q000209:etiology*; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D005838:Genotype; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
D001057:Apolipoproteins E