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Lewy body dementia (DLB) is the second most common form of neurodegenerative dementia in the elderly after Alzheimer's disease (AD), affecting 4-10% of all dementia cases
.
Although the incidence of DLB is high, compared with AD, research work is still lagging behind, and there is an unmet need for understanding the manifestations and progression of the disease
Not all patients will have all symptoms during the course of the disease, and there is a clinical and pathological overlap with AD and Parkinson's disease, which makes DLB a complicated disease in terms of pathology, diagnosis and disease management
.
DLB has a high disease burden.
Compared with AD, the quality of life (QoL) is lower, the dependency on instrumental activities of daily living (IADL) is higher, and the burden of caregivers is also higher
.
Which DLB characteristics and symptoms contribute to the measurement of the burden of these diseases has not yet been fully elucidated
.
Understand that these contributions are related to the development of outcome measures for trials and treatments
However, the treatment of DLB patients is challenging due to the large side effects of the drug
.
There is little evidence from clinical trials that specifically target DLB
In order to fill in the specific knowledge gaps in clinical manifestations, biological mechanisms, biomarker development, disease progression and predictive factors, M.
van de Beek of the University of Amsterdam and others launched the LEwy BOdies Project (DEvELOP) cohort
.
Through this observational cohort, they described the characteristics of DLB patients and determined the decline in biological and clinical prognostic factors
They enrolled 100 DLB patients (69 ± 6 years, 10% F, MMSE 25 ± 3) into the prospective DEvELOP cohort
.
The patient underwent extensive evaluation, including MRI, EEG/MEG, 123FP-CIT SPECT, CSF and blood collection, and was followed up annually
They found that RBD was the most frequently reported core feature (75%), while visual hallucinations were the least frequently reported (39%) and caused the least pain
.
Suggestive clinical features are common, and orthostatic hypotension (64%) is the most commonly reported
95% of patients showed abnormal EEG/MEG, 88% of 123FP-CIT SPECT scans were abnormal, and 53% of patients had features of CSF Alzheimer's disease
.
The presence of volatility, lower MMSE, Parkinson's disease and apathy are associated with higher IADL dependence
Indifference and high IADL dependence easily lead to an increase in the burden of caregivers
.
The important significance of this study lies in the discovery: There is a clinically relevant link between DLB symptomology and disease burden
.
Cognitive and motor symptoms are related to IADL function, and negative neuropsychiatric symptoms and functional dependence are important factors that determine QoL and the burden of caregivers
.
There is a clinically relevant link between DLB symptomology and disease burden
Original source:
van de Beek M, van Steenoven I, van der Zande JJ, et al.
Characterization of symptoms and determinants of disease burden in dementia with Lewy bodies: DEvELOP design and baseline results .
Alz Res Therapy.
2021;13(1) :53.
doi:10.
1186/s13195-021-00792-w
