Cognitive decline in mild cognitive impairment with Lewy bodies or Alzheimer’s disease: a prospective cohort study

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Objectives

We explored whether the mild cognitive impairment (MCI) stages of dementia with Lewy
bodies (DLB) and Alzheimer’s disease (AD) differ in their cognitive profiles, and
longitudinal progression.

Design

A prospective, longitudinal design was utilized with annual follow-up (Max 5 years,
Mean 1.9, SD 1.1) after diagnosis. Participants underwent repeated cognitive testing,
and review of their clinical diagnosis and symptoms, including evaluation of core
features of DLB.

Setting

This was an observational study of independently-living individuals, recruited from
local healthcare trusts in North East England, UK.

Participants

An MCI cohort (n = 76) aged ≥ 60 years was utilized, differentially diagnosed with
MCI due to AD (MCI-AD), or possible/probable MCI with Lewy bodies (MCI-LB).

Measurements

A comprehensive clinical and neuropsychological testing battery was administered,
including ACE-R, trailmaking tests, FAS verbal fluency, and computerized battery of
attention and perception tasks.

Results

Probable MCI-LB presented with less impaired recognition memory than MCI-AD, greater
initial impairments in verbal fluency and perception of line orientation, and thereafter
demonstrated an expedited decline in visuo-constructional functions in the ACE-R compared
to MCI-AD. No clear diagnostic group differences were found in deterioration speeds
for global cognition, language, overall memory, attention or other executive functions.

Conclusions

These findings provide further evidence for differences in severity and decline of
visuospatial dysfunctions in DLB compared with AD; further exploration is required
to clarify when and how differences in attention, executive, and memory functions
emerge, as well as speed of decline to dementia.

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