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Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies

Published version
Peer-reviewed

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Authors

Frith, James 
Donaghy, Paul C 
Barker, Sally AH 
Durcan, Rory 

Abstract

jats:titleAbstract</jats:title>jats:secjats:titleObjectives</jats:title>jats:pAutonomic 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.</jats:p></jats:sec>jats:secjats:titleMethods</jats:title>jats:pNinety‐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.</jats:p></jats:sec>jats:secjats:titleResults</jats:title>jats:pAge‐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).</jats:p></jats:sec>jats:secjats:titleConclusions</jats:title>jats:pMild 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.</jats:p></jats:sec>

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

Keywords

RESEARCH ARTICLE, autonomic symptoms, dementia with Lewy bodies, mild cognitive impairment

Journal Title

International Journal of Geriatric Psychiatry

Conference Name

Journal ISSN

0885-6230
1099-1166

Volume Title

37

Publisher

Wiley