echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Study of Nervous System > Neurology: With these characteristics, the risk from mild cognitive impairment to dementia is greatly increased!

    Neurology: With these characteristics, the risk from mild cognitive impairment to dementia is greatly increased!

    • Last Update: 2021-06-10
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

    Lewy body dementia (DLB) is one of the most common neurodegenerative dementias, second only to Alzheimer's disease (AD).
    In addition to dementia, its characteristic clinical manifestations also include: visual hallucinations, Parkinson's syndrome, fluctuating cognitive impairment, autonomic dysfunction, sleep disorders, and sensitivity to antipsychotics.

    In addition to dementia, its characteristic clinical manifestations also include: visual hallucinations, Parkinson's syndrome, fluctuating cognitive impairment, autonomic dysfunction, sleep disorders, and sensitivity to antipsychotics.
    In addition to dementia, its characteristic clinical manifestations also include: visual hallucinations, Parkinson's syndrome, fluctuating cognitive impairment, autonomic dysfunction, sleep disorders, and sensitivity to antipsychotics.

    The pathological feature of DLB ​​is the presence of intracytoplasmic eosinophilic inclusion bodies (called Lewy bodies) in the deep cortex of the whole brain (especially the prefrontal lobe, anterior temporal lobe, cingulate gyrus and insula), which contain aggregated α -Synuclein (Aβ).
    However, the understanding of DLB ​​is still insufficient, and clinical diagnostic criteriastill need to be improvedto improve specificity and sensitivity.

    The pathological feature of DLB ​​is the presence of intracytoplasmic eosinophilic inclusion bodies (called Lewy bodies) in the deep cortex of the whole brain (especially the prefrontal lobe, anterior temporal lobe, cingulate gyrus and insula), which contain aggregated α -Synuclein (Aβ).
    The pathological feature of DLB ​​is the presence of intracytoplasmic eosinophilic inclusion bodies (called Lewy bodies) in the deep cortex of the whole brain (especially the prefrontal lobe, anterior temporal lobe, cingulate gyrus and insula), which contain aggregated α -Synuclein (Aβ).
    diagnosis

    Studies have shown that compared with AD, DLB patients progress faster, have a higher hospitalization rate, and have a worse prognosis.
    At the same time, the cognitive prodrome of DLB, that is, mild cognitive impairment with Lewy bodies (MCI-LB) is more likely to show progressive cognitive decline than MCI (MCI-AD) caused by AD.

    Studies have shown that compared with AD, DLB patients progress faster, have a higher hospitalization rate, and have a worse prognosis.
    Studies have shown that compared with AD, DLB patients progress faster, have a higher hospitalization rate, and have a worse prognosis.

    Therefore, the respective cognitive prodromal symptoms may develop at different speeds.
    However, it is still unclear whether MCI (rapid eye movement sleep behavior disorder [RBD], Parkinson's disease, complex visual hallucinations and cognitive fluctuations) with the core clinical features of DLB ​​has a worse clinical prognosis than MCI-AD, and the onset of dementia Faster.

    In order to determine whether the clinical progression rates associated with MCI-LB or MCI-AD are different, experts from the University of Cambridge in the United Kingdom conducted longitudinal observations on MCI cases and conducted detailed clinical evaluations of the diagnostic features of Lewy bodies.
    The results were published in the latest "Neurology" journal.

    Researchers annually evaluate a prospective longitudinal cohort of 111 MCI patients ≥60 years of age to track cognitive and clinical progress, including core clinical characteristics and DLB biomarkers.
    The polymorphic model was used to assess the association between the diagnostic features of DLB ​​and the clinical progression from MCI to dementia.

    Survival curve of MCI patients with visual hallucinations or cognitive fluctuations at baseline

    Survival curve of MCI patients with visual hallucinations or cognitive fluctuations at baseline

    After an average follow-up of 2.
    2 years (1-6.
    7 years), 38 of the 111 participants (34%) progressed to dementia: 10 had AD, 3 may have DLB, and 25 were likely to have DLB .
    The existence of any feature of Lewy body disease is related to the risk of transition to dementia; as more diagnostic features are observed, this risk further increases (OR=1.
    33 for each feature, 95% CI: 1.
    11-1.
    60) , For those who have complex visual hallucinations (OR=1.
    98, 95%CI: 0.
    92-4.
    29) or cognitive fluctuations (OR=3.
    99, 95%CI: 2.
    03-7.
    84), the risk is particularly high.

    The existence of any feature of Lewy body disease is related to the risk of transition to dementia; as more diagnostic features are observed, this risk further increases (OR=1.
    33 for each feature, 95% CI: 1.
    11-1.
    60) , For those who have complex visual hallucinations (OR=1.
    98, 95%CI: 0.
    92-4.
    29) or cognitive fluctuations (OR=3.
    99, 95%CI: 2.
    03-7.
    84), the risk is particularly high.
    The existence of any feature of Lewy body disease is related to the risk of transition to dementia; as more diagnostic features are observed, this risk further increases (OR=1.
    33 for each feature, 95% CI: 1.
    11-1.
    60) , For those who have complex visual hallucinations (OR=1.
    98, 95%CI: 0.
    92-4.
    29) or cognitive fluctuations (OR=3.
    99, 95%CI: 2.
    03-7.
    84), the risk is particularly high.

    The relationship between age and the existence of Lewy body characteristics in the transition from MCI to death or dementia.

    The relationship between age and the existence of Lewy body characteristics in the transition from MCI to death or dementia.

    Further in the additional analysis to control the use of cholinesterase inhibitors, the association between cognitive fluctuations and the onset of dementia (HR=2.
    6) and the association between visual hallucinations and death (HR=15.
    2) remained.
    However, there was no obvious association between visual hallucinations and the risk of dementia (HR=1.
    3, 95% CI 0.
    5-3.
    0).

    Further in the additional analysis to control the use of cholinesterase inhibitors, the association between cognitive fluctuations and the onset of dementia (HR=2.
    6) and the association between visual hallucinations and death (HR=15.
    2) remained.
    Further in the additional analysis to control the use of cholinesterase inhibitors, the association between cognitive fluctuations and the onset of dementia (HR=2.
    6) and the association between visual hallucinations and death (HR=15.
    2) remained.

    In summary, the diagnostic features of Lewy body dementia are related to the increased risk of transition from mild cognitive impairment to dementia.

    In summary, the diagnostic features of Lewy body dementia are related to the increased risk of transition from mild cognitive impairment to dementia.
    In summary, the diagnostic features of Lewy body dementia are related to the increased risk of transition from mild cognitive impairment to dementia.

     

    references:

    Progression to Dementia in Mild Cognitive Impairment With Lewy Bodies or Alzheimer Disease.
    Neurology Jun 2021, 96 (22) e2685-e2693; DOI: 10.
    1212/WNL.
    0000000000012024

    Progression to Dementia in Mild Cognitive Impairment With Lewy Bodies or Alzheimer Disease.


    Leave a message here
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent Echemi's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.