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Mild cognitive impairment with Lewy bodies: neuropsychiatric supportive symptoms and cognitive profile.

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Peer-reviewed

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Article

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Authors

Ciafone, Joanna 
Durcan, Rory 
Hamilton, Calum A 
Barker, Sally 

Abstract

BACKGROUND: Recently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB) include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions, apathy, anxiety and depression). We have previously demonstrated that the presence of two or more of these symptoms differentiates MCI-LB from MCI due to Alzheimer's disease (MCI-AD) with a likelihood ratio >4. The aim of this study was to replicate the findings in an independent cohort. METHODS: Participants ⩾60 years old with MCI were recruited. Each participant had a detailed clinical, cognitive and imaging assessment including FP-CIT SPECT and cardiac MIBG. The presence of neuropsychiatric supportive symptoms was determined using the Neuropsychiatric Inventory (NPI). Participants were classified as MCI-AD, possible MCI-LB and probable MCI-LB based on current diagnostic criteria. Participants with possible MCI-LB were excluded from further analysis. RESULTS: Probable MCI-LB (n = 28) had higher NPI total and distress scores than MCI-AD (n = 30). In total, 59% of MCI-LB had two or more neuropsychiatric supportive symptoms compared with 9% of MCI-AD (likelihood ratio 6.5, p < 0.001). MCI-LB participants also had a significantly greater delayed recall and a lower Trails A:Trails B ratio than MCI-AD. CONCLUSIONS: MCI-LB is associated with significantly greater neuropsychiatric symptoms than MCI-AD. The presence of two or more neuropsychiatric supportive symptoms as defined by MCI-LB diagnostic criteria is highly specific and moderately sensitive for a diagnosis of MCI-LB. The cognitive profile of MCI-LB differs from MCI-AD, with greater executive and lesser memory impairment, but these differences are not sufficient to differentiate MCI-LB from MCI-AD.

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Keywords

Agitation, Anxiety, Apathy, Cognition, Dementia with Lewy bodies, Depression, MCI, Mild cognitive impairment with Lewy bodies, Neuropsychiatric symptoms, Humans, Middle Aged, Lewy Bodies, Cognitive Dysfunction, Alzheimer Disease, Delusions, Cognition, Lewy Body Disease

Journal Title

Psychol Med

Conference Name

Journal ISSN

0033-2917
1469-8978

Volume Title

Publisher

Cambridge University Press (CUP)

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All rights reserved