Temporal Variation in Disease Onset and Clinical Features of Lewy Body Disease in China

Article type: Research Article

Authors: Gan, Jinghuan^{a; 1} | Chen, Zhichao^{b; 1} | Shi, Zhihong^c | Li, Xudong^a | Liu, Shuai^c | Liu, Yiming^d | Zhu, Hongcan^e | Shen, Lu^f | Zhang, Guili^a | You, Yong^g | Guo, Qihao^h | Zhang, Nanⁱ | Lv, Yang^j | Gang, Baozhi ^k | Yuan, Junliang^l | Ji, Yong^{a; c; *}

Affiliations: [a] Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Centerfor Neurological Diseases, Beijing, China | [b] Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China | [c] Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Departmentof Neurology, Tianjin Huanhu Hospital, Tianjin, China | [d] Department of Neurology, Qilu Hospital, ShandongUniversity, Shandong, China | [e] Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China | [f] Department of Neurology, Xiangya Hospital, Central South University, Hunan, China | [g] Department of Neurology, Second Affiliated Hospital of Hainan Medical University, Haikou, China | [h] Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China | [i] Department of Neurology,Tianjin Medical University General Hospital, Tianjin, China | [j] Department of Geriatrics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China | [k] Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China | [l] Department of Neurology, Peking University Sixth Hospital, Beijing, China

Correspondence: [*] Correspondence to: Yong Ji, MD, PhD, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases, No. 119 Nansihuan xilu, Fengtai District, Beijing, 100070, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China. Tel.: +86 13612048681; E-mail: jiyongusa@126.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background: Lewy body dementia is the second most common neurodegenerative dementia, but data concerning the onset age and clinical features in the prodromal stage remain limited in China. Objective: To investigate the associations between onset age and clinical manifestations of cognitive impairment with Lewy bodies in a large-sample cohort. Methods: We included 74 patients with mild cognitive impairment with Lewy bodies (MCI-LB), 533 patients with dementia with Lewy bodies (DLB), 118 patients with Parkinson’s disease with MCI (PD-MCI), and 313 patients with Parkinson’s disease dementia (PDD) in this multicenter cohort from 22 memory clinics of China from 1 January 2018 to 31 March 2022. The onset age, clinical manifestations, and neuropsychological assessments were recorded and analyzed after reviewing the medical records. Results: The average onset age of memory loss was 68.28 (±7.00) years, and parkinsonism happened 2.00 (±1.24) years later for patients with MCI-LB. The average onset age of parkinsonism was 60.56 (±8.96) years, and the memory loss happened 3.49 (±3.02) years later for patients with PD-MCI. Rapid eye movement sleep behavior disorder and visual hallucinations were frequently reported in MCI-LB, DLB, and PDD, while visual hallucinations were least frequently reported in PD-MCI. Lower scores of MMSE and depression, and higher scores of activities of daily living and delusions, were independently associated with older onset age in DLB. Conclusion: The onset of PD-MCI precedes MCI-LB, and memory loss occurs 3 years after parkinsonism. The onset age is associated with cognition and neuropsychiatric symptoms in process.

Keywords: Age, sep Lewy body, sep mild cognitive impairment, sep multicenter, sep Parkinson’s disease

DOI: 10.3233/JAD-220657

Journal: Journal of Alzheimer's Disease, vol. 90, no. 3, pp. 1263-1275, 2022