title: Long-Term Cognitive Decline in Dementia with Lewy Bodies in a Large Multicenter, International Cohort.
abstract: The aim of this study was to describe the rate and clinical predictors of cognitive decline in dementia with Lewy bodies (DLB), and compare the findings with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) patients.
  
  
  
  Longitudinal scores for the Mini-Mental State Examination (MMSE) in 1,290 patients (835 DLB, 198 PDD, and 257 AD) were available from 18 centers with up to three years longitudinal data. Linear mixed effects analyses with appropriate covariates were used to model MMSE decline over time. Several subgroup analyses were performed, defined by anti-dementia medication use, baseline MMSE score, and DLB core features.
  
  
  
  The mean annual decline in MMSE score was 2.1 points in DLB, compared to 1.6 in AD (p = 0.07 compared to DLB) and 1.8 in PDD (p = 0.19). Rates of decline were significantly higher in DLB compared to AD and PDD when baseline MMSE score was included as a covariate, and when only those DLB patients with an abnormal dopamine transporter SPECT scan were included. Decline was not predicted by sex, baseline MMSE score, or presence of specific DLB core features.
  
  
  
  The average annual decline in MMSE score in DLB is approximately two points. Although in the overall analyses there were no differences in the rate of decline between the three neurodegenerative disorders, there were indications of a more rapid decline in DLB than in AD and PDD. Further studies are needed to understand the predictors and mechanisms of cognitive decline in DLB.
authors.affiliation: Department of Neurology, University Medical Centre, Ljubljana, Slovenia.|Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Milica G
authors.initials: MG
authors.lastname: Kramberger
authors.affiliation: Research Department, Stavanger University Hospital and Department of Mathematics and Natural Sciences, The University of Stavanger, Stavanger, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Auestad
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.|Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Garcia-Ptacek
authors.affiliation: Fundació ACE Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Carla
authors.initials: C
authors.lastname: Abdelnour
authors.affiliation: Girona Biomedical Research Institute, Girona, Spain.
authors.forename: Josep Garre
authors.initials: JG
authors.lastname: Olmo
authors.affiliation: Division of Psychiatry, University College London and North Essex Partnership University NHS Foundation Trust, UK.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Walker
authors.affiliation: Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Afina W
authors.initials: AW
authors.lastname: Lemstra
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Londos
authors.affiliation: Service of Neurology and Geriatrics, University Hospital of Strasbourg and Icube laboratory, University of Strasbourg, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Blanc
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Department of Neuroscience and Imaging and Aging Research Centre, G. d'Annunzio University, Chieti, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bonanni
authors.affiliation: Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: McKeith
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Winblad
authors.affiliation: Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors.forename: Frank Jan
authors.initials: FJ
authors.lastname: de Jong
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Nobili
authors.affiliation: Institute of Neurology CCS, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Elka
authors.initials: E
authors.lastname: Stefanova
authors.affiliation: University Hospital "Alexandrovska", Department of Neurology, Sofia, Bulgaria.
authors.forename: Maria
authors.initials: M
authors.lastname: Petrova
authors.affiliation: Department of Neurology, County Emergency Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Falup-Pecurariu
authors.affiliation: Brain and Mind Research Program, Central European Institute of Technology, Central European Institute of Technology Masaryk University, Masaryk University, Brno, Czech Republic.
authors.forename: Irena
authors.initials: I
authors.lastname: Rektorova
authors.affiliation: 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Greece.
authors.forename: Sevasti
authors.initials: S
authors.lastname: Bostantjopoulou
authors.affiliation: Center for Parkinson's disease and Movement Disorder "Fondazione Ospedale San Camillo" - Istituto di Ricovero e Cura a Carattere Scientifico, Venice-Lido, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Biundo
authors.affiliation: Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.|Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.|Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D020961:Lewy Body Disease / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged
keywords: Dementia with Lewy bodies; international cohort; long-term cognitive decline; multicenter study