Early Life Quality on Instrumental, Daily and Neuropsychological Activities of Lewy Body Disease about 70 Patients in the Geriatric Department at the Pitié Salpêtrière Hospital of Paris, France
Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.
References
[1]
Hansen, L.A., Masliah, E., Galasko, D. and Terry, R.D. (1993) Plaque-Only Alzheimer Disease Is Usually the Lewy Body Variant, and Vice Versa. Journal of Neuropathology & Experimental Neurology, 52, 648-654. https://doi.org/10.1097/00005072-199311000-00012
[2]
Merdes, A.R., Hansen, L.A., Jeste, D.V., Galasko, D., Hofstetter, C.R., Ho, G.J., et al. (2003) Influence of Alzheimer Pathology on Clinical Diagnostic Accuracy in Dementia with Lewy Bodies. Neurology, 60, 1586-1590. https://doi.org/10.1212/01.WNL.0000065889.42856.F2
[3]
Kaur, B., Harvey, D.J., Decarli, C.S., Zhang, L., Sabbagh, M.N. and Olichney, J.M. (2013) Extrapyramidal Signs by Dementia Severity in Alzheimer Disease and Dementia with Lewy Bodies. Alzheimer Disease & Associated Disorders, 27, 226-232.
[4]
Hamilton, J.M., Salmon, D.P., Galasko, D., Raman, R., Emond, J., Hansen, L.A., et al. (2008) Visuospatial Deficits Predict Rate of Cognitive Decline in Autopsy-Verified Dementia with Lewy Bodies. Neuropsychology, 22, 729-737. https://doi.org/10.1037/a0012949
[5]
Rockwell, E., Choure, J., Galasko, D., Olichney, J. and Jeste, D.V. (2000) Psychopathology at Initial Diagnosis in Dementia with Lewy Bodies versus Alzheimer Disease: Comparison of Matched Groups with Autopsy-Confirmed Diagnoses. International Journal of Geriatric Psychiatry, 15, 819-823. https://doi.org/10.1002/1099-1166(200009)15:9<819::AID-GPS206>3.0.CO;2-1
[6]
Ballard, C., Holmes, C., McKeith, I., Neill, D., O’Brien, J., Cairns, N., et al. (1999) Psychiatric Morbidity in Dementia with Lewy Bodies: A Prospective Clinical and Neuropathological Comparative Study with Alzheimer’s Disease. American Journal of Psychiatry, 156, 1039-1045.
[7]
McKeith, I.G., Boeve, B.F., Dickson, D.W., Halliday, G., Taylor, J.-P., Weintraub, P.D., Aarsland, D., Galvin, J., Attems, J., Ballard, C.G. and Bayston, A. (2017) Diagnosis and Management of Dementia with Lewy Bodies Fourth Consensus Report of the DLB Consortium. Neurology, 89, 88-100. https://doi.org/10.1212/WNL.0000000000004058
[8]
McKeith, I.G., Galasko, D., Kosaka, K., Perry, E.K., Dickson, D.W., Hansen, L.A., et al. (1996) Consensus Guidelines for the Clinical and Pathologic Diagnosis of Dementia with Lewy Bodies (DLB): Report of the Consortium on DLB International Workshop. Neurology, 47, 1113-1124. https://doi.org/10.1212/WNL.47.5.1113
[9]
McKeith, I.G., Dickson, D.W., Lowe, J., Emre, M., O’Brien, J.T., Feldman, H., et al. (2005) Dementia with Lewy Bodies: Diagnosis and Management: Third Report of the DLB Consortium. Neurology, 65, 1863-1872. https://doi.org/10.1212/01.wnl.0000187889.17253.b1
[10]
Hepp, D.H., Vergoossen, D.L.E., Huisman, E., Lemstra, A.W., Berendse, H.W., Rozemuller, A.J., et al. (2016) Distribution and Load of Amyloid-β Pathology in Parkinson Disease and Dementia with Lewy Bodies. Journal of Neuropathology & Experimental Neurology, 75, 936-945. https://doi.org/10.1093/jnen/nlw070
[11]
Ware Jr., J.E. and Sherbourne, C.D. (1992) The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection. Medical Care, 30, 473-483. https://doi.org/10.1097/00005650-199206000-00002
[12]
Banerjee, S., Samsi, K., Petrie, C.D., Alvir, J., Treglia, M., Schwam, E.M., et al. (2009) What Do We Know about Quality of Life in Dementia? A Review of the Emerging Evidence on the Predictive and Explanatory Value of Disease Specific Measures of Health Related Quality of Life in People with Dementia. International Journal of Geriatric Psychiatry, 24, 15-24. https://doi.org/10.1002/gps.2090
[13]
Guidi, M., Paciaroni, L., Paolini, S., De Padova, S. and Scarpino, O. (2006) Differences and Similarities in the Neuropsychological Profile of Dementia with Lewy Bodies and Alzheimer’s Disease in the Early Stage. Journal of the Neurological Sciences, 248, 120-123. https://doi.org/10.1016/j.jns.2006.05.017
[14]
Crowell, T.A., Luis, C.A., Cox, D.E. and Mullan, M. (2007) Neuropsychological Comparison of Alzheimer’s Disease and Dementia with Lewy Bodies. Dementia and Geriatric Cognitive Disorders, 23, 120-125. https://doi.org/10.1159/000097791
[15]
Metzler-Baddeley, C. (2007) A Review of Cognitive Impairments in Dementia with Lewy Bodies Relative to Alzheimer’s Disease and Parkinson’s Disease with Dementia. Cortex, 43, 583-600. https://doi.org/10.1016/S0010-9452(08)70489-1
[16]
Allan, L., McKeith, I., Ballard, C. and Kenny, R.A. (2006) The Prevalence of Autonomic Symptoms in Dementia and Their Association with Physical Activity, Activities of Daily Living and Quality of life. Dementia and Geriatric Cognitive Disorders, 22, 230-237. https://doi.org/10.1159/000094971
[17]
Berrios, G.E., Campbell, C. and Politynska, B.E. (1995) Autonomic Failure, Depression and Anxiety in Parkinson’s Disease. British Journal of Psychiatry, 166, 789-792. https://doi.org/10.1192/bjp.166.6.789
[18]
Mchorney, C., Johne Jr., W. and Anastasiae, R. (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs. Medical Care, 31, 247-263. https://doi.org/10.1097/00005650-199303000-00006
[19]
Stavitsky, K., Brickman, A.M., Scarmeas, N., Torgan, L.R., Tang, M.X., Albert, M., Brandt, J., Blacker, D. and Stern, Y. (2006) The Progression of Cognition, Psychiatric Symptoms and Functional Abilities in Dementia with Lewy Bodies and Alzheimer Disease. Archives of Neurology, 63, 1450-1456. https://doi.org/10.1001/archneur.63.10.1450
[20]
McKeith, I.G., Rowan, E., Askew, K., Naidu, A., Allan, L., Barnett, N., Lett, D., Mosimann, U.P., Burn, D. and O’Brien, J.T. (2006) More Severe Functional Impairment in Dementia with Lewy Bodies than Alzheimer Disease Is Related to Extrapyramidal Motor Dysfunction. American Journal of Geriatric Psychiatry, 14, 582-588. https://doi.org/10.1097/01.JGP.0000216177.08010.f4
[21]
Ricci, M., Guidoni, S.V., Sepe-Monti, M., Bomboi, G., Antonini, G., Blundo, C. and Giubilei, F. (2009) Clinical Findings, Functional Abilities and Caregiver Distress in the Early Stage of Dementia with Lewy Bodies (DLB) and Alzheimer’s Disease (AD). Archives of Gerontology and Geriatrics, 49, e101-e104. https://doi.org/10.1016/j.archger.2008.10.001
[22]
Baquero, M. and Martin, N. (2015) Depressive Symptoms in Neuro-Degenerative Diseases. World Journal of Clinical Cases, 3, 682-693. https://doi.org/10.12998/wjcc.v3.i8.682
[23]
Mueller, C., Ballard, C., Corbett, A. and Aarsland, D. (2017) The Prognosis of Dementia with Lewy Bodies. Lancet Neurology, 16, 390-398. https://doi.org/10.1016/S1474-4422(17)30074-1
[24]
Ferman, T.J., Boeve, B.F., Smith, G.E., Lin, S.C., Silber, M.H., Pedraza O, et al. (2011) Inclusion of RBD Improves the Diagnostic Classification of Dementia with Lewy Bodies. Neurology, 77, 875-882. https://doi.org/10.1212/WNL.0b013e31822c9148
[25]
Pillai, J.A. and Leverenz, J.B. (2017) Sleep and Neurodegeneration: A Critical Appraisal. Chest, 151, 1375-1386. https://doi.org/10.1016/j.chest.2017.01.002
[26]
Pao, W.C., Boeve, B.F., Ferman, T.J., Lin, S.C., Smith, G.E., Knopman, D.S., et al. (2013) Polysomnographic Findings in Dementia with Lewy Bodies. The Neurologist, 19, 1-6. https://doi.org/10.1097/NRL.0b013e31827c6bdd
[27]
Ballard, C., Holmes, C. and McKeithetal, I. (1999) Psychiatric Morbidity in Dementia with Lewy Bodies: A Prospective Clinical and Neuropathological Comparative Study with Alzheimer’s Disease. American Journal of Psychiatry, 156, 1039-1045.
[28]
Ferman, T.J., Smith, G.E., Boeve, B.F., Graff-Radford, N.R., Lucas, J.A., Knopman, D.S., et al. (2006) Neuropsychological Differentiation of Dementia with Lewy Bodies from Normal Aging and Alzheimer’s Disease. The Clinical Neuropsychologist, 20, 623-636. https://doi.org/10.1080/13854040500376831
[29]
Erskine, D., Thomas, A.J., Taylor, J.P., Savage, M.A., Attems, J., McKeith, I.G., et al. (2017) Neuronal Loss and Α-Synuclein Pathology in the Superior Colliculus and Its Relationship to Visual Hallucinations in Dementia with Lewy Bodies. The American Journal of Geriatric Psychiatry, 25, 595-604. https://doi.org/10.1016/j.jagp.2017.01.005
[30]
Tzeng, R.-C., Tsai, C.-F., Wang, C.-T., Wang, T.-Y. and Chiu, P.-Y. (2018) Delusions in Patients with Dementia with Lewy Bodies and the Associated Factors. Behavioural Neurology, 2018, Article ID: 6707291. https://doi.org/10.1155/2018/6707291
