Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies
Authors
Frith, James
Donaghy, Paul C
Barker, Sally AH
Durcan, Rory
Lawley, Sarah
Barnett, Nicola
Firbank, Michael
Roberts, Gemma
Taylor, John‐Paul
Allan, Louise M
O’Brien, John
Yarnall, Alison J
Thomas, Alan J
Publication Date
2022-04Journal Title
International Journal of Geriatric Psychiatry
ISSN
0885-6230
Publisher
Wiley
Volume
37
Issue
4
Language
en
Type
Article
This Version
AO
VoR
Metadata
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Hamilton, C. A., Frith, J., Donaghy, P. C., Barker, S. A., Durcan, R., Lawley, S., Barnett, N., et al. (2022). Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies. International Journal of Geriatric Psychiatry, 37 (4) https://doi.org/10.1002/gps.5703
Description
Funder: GE Healthcare; Id: http://dx.doi.org/10.13039/100006775
Funder: Alzheimer's Research UK; Id: http://dx.doi.org/10.13039/501100002283
Funder: NIHR Newcastle Biomedical Research Centre; Id: http://dx.doi.org/10.13039/501100012295
Abstract
Abstract: Objectives: 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.
Keywords
RESEARCH ARTICLE, autonomic symptoms, dementia with Lewy bodies, mild cognitive impairment
Identifiers
gps5703
External DOI: https://doi.org/10.1002/gps.5703
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335156
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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