Title | Cognition at Each Stage of Lewy Body Disease with Co-occurring Alzheimer's Disease Pathology. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Ryman, SG, Yutsis, M, Tian, L, Henderson, VW, Montine, TJ, Salmon, DP, Galasko, D, Poston, KL |
Journal | J Alzheimers Dis |
Volume | 80 |
Issue | 3 |
Pagination | 1243-1256 |
Date Published | 2021 |
ISSN | 1875-8908 |
Keywords | Aged, Aged, 80 and over, Alzheimer Disease, Brain, Cognitive Dysfunction, Female, Humans, Lewy Body Disease, Male |
Abstract | BACKGROUND: Alzheimer's disease neuropathologic change (ADNC) may contribute to dementia in patients with Lewy body disease (LBD) pathology. OBJECTIVE: To examine how co-occurring ADNC impacts domain specific cognitive impairments at each pathologic stage (brainstem, limbic, cerebral cortical) of LBD. METHODS: 2,433 participants with antemortem longitudinal neuropsychological assessment and postmortem neuropathological assessment from the National Alzheimer's Coordinating Center's Uniform Data Set were characterized based on the evaluation of ADNC and LBD. Longitudinal mixed-models were used to derive measures of cumulative cognitive deficit for each cognitive domain at each pathologic stage of LBD (brainstem, limbic, and cerebral cortical). RESULTS: 111 participants with a pathologic diagnosis of LBD, 741 participants with combined LBD and ADNC, 1,357 participants with ADNC only, and 224 with no pathology (healthy controls) were included in the analyses. In the executive/visuospatial domain, combined LBD and ADNC showed worse deficits than LBD only when Lewy bodies were confined to the brainstem, but no difference when Lewy bodies extended to the limbic or cerebral cortical regions. The cerebral cortical LBD only group exhibited greater executive/visuospatial deficits than the ADNC only group. By contrast, the ADNC only group and the combined pathology group both demonstrated significantly greater cumulative memory deficits relative to Lewy body disease only, regardless of stage. CONCLUSION: The impact of co-occurring ADNC on antemortem cumulative cognitive deficits varies not only by domain but also on the pathological stage of Lewy bodies. Our findings stress the cognitive impact of different patterns of neuropathological progression in Lewy body diseases. |
DOI | 10.3233/JAD-201187 |
Alternate Journal | J Alzheimers Dis |
PubMed ID | 33646154 |
PubMed Central ID | PMC8150665 |
Grant List | P50 AG005142 / AG / NIA NIH HHS / United States P30 AG010133 / AG / NIA NIH HHS / United States P30 AG066515 / AG / NIA NIH HHS / United States P50 AG047266 / AG / NIA NIH HHS / United States P30 AG008017 / AG / NIA NIH HHS / United States P30 AG010161 / AG / NIA NIH HHS / United States P50 AG025688 / AG / NIA NIH HHS / United States P50 AG005138 / AG / NIA NIH HHS / United States P50 AG047366 / AG / NIA NIH HHS / United States P30 AG019610 / AG / NIA NIH HHS / United States P30 AG028383 / AG / NIA NIH HHS / United States R01 NS115114 / NS / NINDS NIH HHS / United States P30 AG013854 / AG / NIA NIH HHS / United States P30 AG053760 / AG / NIA NIH HHS / United States P30 AG066444 / AG / NIA NIH HHS / United States P30 AG062428 / AG / NIA NIH HHS / United States P30 AG010124 / AG / NIA NIH HHS / United States P50 AG023501 / AG / NIA NIH HHS / United States P50 AG005146 / AG / NIA NIH HHS / United States U24 AG072122 / AG / NIA NIH HHS / United States P30 AG062421 / AG / NIA NIH HHS / United States P30 AG035982 / AG / NIA NIH HHS / United States P50 AG008702 / AG / NIA NIH HHS / United States U01 AG016976 / AG / NIA NIH HHS / United States P30 AG008051 / AG / NIA NIH HHS / United States P50 AG005681 / AG / NIA NIH HHS / United States P30 AG013846 / AG / NIA NIH HHS / United States P50 AG047270 / AG / NIA NIH HHS / United States P30 AG062429 / AG / NIA NIH HHS / United States P50 AG005136 / AG / NIA NIH HHS / United States P30 AG049638 / AG / NIA NIH HHS / United States P30 AG012300 / AG / NIA NIH HHS / United States P30 AG062422 / AG / NIA NIH HHS / United States P50 AG016573 / AG / NIA NIH HHS / United States P50 AG005133 / AG / NIA NIH HHS / United States P50 NS062684 / NS / NINDS NIH HHS / United States P30 AG062715 / AG / NIA NIH HHS / United States P30 AG010129 / AG / NIA NIH HHS / United States |