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dc.contributor.authorHamilton, Calum A
dc.contributor.authorFrith, James
dc.contributor.authorDonaghy, Paul C
dc.contributor.authorBarker, Sally AH
dc.contributor.authorDurcan, Rory
dc.contributor.authorLawley, Sarah
dc.contributor.authorBarnett, Nicola
dc.contributor.authorFirbank, Michael
dc.contributor.authorRoberts, Gemma
dc.contributor.authorTaylor, John-Paul
dc.contributor.authorAllan, Louise M
dc.contributor.authorO'Brien, John
dc.contributor.authorYarnall, Alison J
dc.contributor.authorThomas, Alan J
dc.date.accessioned2022-03-18T00:30:26Z
dc.date.available2022-03-18T00:30:26Z
dc.date.issued2022-04
dc.identifier.issn0885-6230
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335142
dc.description.abstractOBJECTIVES: Autonomic symptoms are a common feature of the synucleinopathies, and may be a distinguishing feature of prodromal Lewy body disease. We aimed to assess whether the cognitive prodrome of dementia with Lewy bodies, mild cognitive impairment (MCI) with Lewy bodies (MCI-LB), would have more severe reported autonomic symptoms than cognitively healthy older adults, with MCI due to Alzheimer's disease (MCI-AD) also included for comparison. We also aimed to assess the utility of an autonomic symptom scale in differentiating MCI-LB from MCI-AD. METHODS: Ninety-three individuals with MCI and 33 healthy controls were assessed with the Composite Autonomic Symptom Score 31-item scale (COMPASS). Mild cognitive impairment patients also underwent detailed clinical assessment and differential classification of MCI-AD or MCI-LB according to current consensus criteria. Differences in overall COMPASS score and individual symptom sub-scales were assessed, controlling for age. RESULTS: Age-adjusted severity of overall autonomic symptomatology was greater in MCI-LB (Ratio = 2.01, 95% CI: 1.37-2.96), with higher orthostatic intolerance and urinary symptom severity than controls, and greater risk of gastrointestinal and secretomotor symptoms. MCI-AD did not have significantly higher autonomic symptom severity than controls overall. A cut-off of 4/5 on the COMPASS was sensitive to MCI-LB (92%) but not specific to this (42% specificity vs. MCI-AD and 52% vs. healthy controls). CONCLUSIONS: Mild cognitive impairment with Lewy bodies had greater autonomic symptom severity than normal ageing and MCI-AD, but such autonomic symptoms are not a specific finding. The COMPASS-31 may therefore have value as a sensitive screening test for early-stage Lewy body disease.
dc.description.sponsorshipThis work was supported by Alzheimer’s Research UK (ARUK-PG2015-13) and by the NIHR Newcastle Biomedical Research Centre. GE Healthcare provided the FP-CIT ligand for this investigator-led study.
dc.publisherJohn Wiley and Sons
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleAssessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies.
dc.typeArticle
dc.publisher.departmentDepartment of Psychiatry
dc.date.updated2022-03-16T18:55:44Z
prism.publicationNameInt J Geriatr Psychiatry
dc.identifier.doi10.17863/CAM.82574
dcterms.dateAccepted2022-03-13
rioxxterms.versionofrecord10.1002/gps.5703
rioxxterms.versionAM
dc.contributor.orcidHamilton, Calum A [0000-0002-9812-3150]
dc.identifier.eissn1099-1166
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-03-18
cam.orpheus.successTue Apr 12 08:22:47 BST 2022 - Embargo updated
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cam.depositDate2022-03-16
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2023-04-30


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