title: Duration and Pathologic Correlates of Lewy Body Disease.
abstract: OBJECTIVE
  Although patients with dementia with Lewy bodies (DLB) have shorter disease duration than patients with Alzheimer disease dementia, little is known about which factors influence disease duration among patients with DLB.
  
  
  OBJECTIVE
  To identify pathologic correlates of disease duration in participants with Lewy body disease (LBD).
  
  
  METHODS
  This observational study, performed from September 1, 2005, to June 1, 2015, using the National Alzheimer's Coordinating Center database included 807 participants with transitional or diffuse LBD.
  
  
  METHODS
  The study used Braak neurofibrillary tangle (NFT) stage, frequency of neuritic plaques, and LBD stage to determine whether pathologic variables are associated with disease duration.
  
  
  RESULTS
  This study included 807 participants with transitional or diffuse LBD (mean [SD] age, 70.0 [9.9] at the onset of cognitive decline and 79.2 [9.8] years at death; 509 male [63.1%]). Shorter disease duration from cognitive symptom onset to death was observed in men (β, -0.73; 95% CI, -1.33 to -0.14; P = .02) and in those with a later age at onset (β, -0.11; 95% CI, -0.14 to -0.08; P < .001). Diffuse (neocortical) LBD was associated with shorter disease duration compared with transitional LBD (β, -1.52; 95% CI, -2.11 to -0.93; P < .001). Braak NFT stage and the presence of neuritic plaques were not significantly associated with differences in disease duration.
  
  
  CONCLUSIONS
  Diffuse LBD was associated with shorter disease duration compared with transitional LBD, and this effect is independent of Braak NFT stage or extent of neuritic plaque disease. Identifying antemortem biomarkers of LBD stage may provide important prognostic information to patients with DLB.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Graff-Radford
authors.affiliation: Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Aakre
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Savica
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Bradley
authors.initials: B
authors.lastname: Boeve
authors.affiliation: Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota.
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kremers
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Tanis J
authors.initials: TJ
authors.lastname: Ferman
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota4Department of Radiology, Mayo Clinic, Jacksonville, Florida.
authors.forename: David T
authors.initials: DT
authors.lastname: Jones
authors.affiliation: Department of Radiology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Kejal
authors.initials: K
authors.lastname: Kantarci
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, Florida.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Dickson
authors.affiliation: National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Kukull
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology*; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications* / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D016874:Neurofibrillary Tangles / Q000473:pathology; D009460:Neurologic Examination; D058225:Plaque, Amyloid / Q000473:pathology; D011237:Predictive Value of Tests; D013997:Time Factors