Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexisten...Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). Methods: The authors reviewed 135 subjects from a community- based study of dementia for wh om autopsy and brain tissue was available. Diagnostic groups were determined acc ording to standard neuropathologic methods and criteria, and the presence of LBs was determined using α - synuclein immunostaining. Neuropathologically define d diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neur opsychological test performance at the time of initial study enrollment. Results : There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), an d 22 with LBP alone (LBP alone). There were no significant differences between g roups demographically or on performance of enrollment Mini- Mental State Examin ation (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than th e LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) an d a naming task (Consortium to Establish a Registry for Alzheimer’ s Disease Na ming; p < 0.05). LBP patients were more impaired than AD patients on executive f unction (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale- Revised Digit Span; p < 0.05). Decline in MMSE and DRS sco res over time were greatest in the patients with AD/LBP. Conclusions: In a commu nity- based sample of older, medically complicated patients with dementia, ther e are neuropsychological differences between dementia subtypes at the time of di agnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy b ody pathology (LBP) had more severe memory impairment than patients with LBP. LB P alone was associated with more severe executive dysfunction. Patients with AD/ LBP had the most rapid rate of cognitive decline.展开更多
文摘Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). Methods: The authors reviewed 135 subjects from a community- based study of dementia for wh om autopsy and brain tissue was available. Diagnostic groups were determined acc ording to standard neuropathologic methods and criteria, and the presence of LBs was determined using α - synuclein immunostaining. Neuropathologically define d diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neur opsychological test performance at the time of initial study enrollment. Results : There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), an d 22 with LBP alone (LBP alone). There were no significant differences between g roups demographically or on performance of enrollment Mini- Mental State Examin ation (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than th e LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) an d a naming task (Consortium to Establish a Registry for Alzheimer’ s Disease Na ming; p < 0.05). LBP patients were more impaired than AD patients on executive f unction (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale- Revised Digit Span; p < 0.05). Decline in MMSE and DRS sco res over time were greatest in the patients with AD/LBP. Conclusions: In a commu nity- based sample of older, medically complicated patients with dementia, ther e are neuropsychological differences between dementia subtypes at the time of di agnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy b ody pathology (LBP) had more severe memory impairment than patients with LBP. LB P alone was associated with more severe executive dysfunction. Patients with AD/ LBP had the most rapid rate of cognitive decline.
