Tsamakis, K; Mueller, C
(2021)
Challenges in Predicting Cognitive Decline in Dementia with Lewy Bodies.
Dement Geriatr Cogn Disord, 50 (1).
pp. 1-8.
ISSN 1421-9824
https://doi.org/10.1159/000515008
SGUL Authors: Tsamakis, Konstantinos
Abstract
Despite being the second most common form of neurodegenerative dementia, dementia with Lewy bodies (DLB) is under-recognized and carries a worse prognosis than other subtypes of the condition. Cognitive impairment is a cardinal feature of all types of dementia and DLB presents with a distinct profile with deficits in attention, executive function, and visuoperceptual abilities. This difference from Alzheimer's disease and the common presence of neuropsychiatric symptoms may lead to challenges in predicting cognitive decline in this patient population. Firstly, the diagnosis of DLB is often delayed in clinical practice leading to variability from which time point in the disease course cognitive decline is measured. Secondly, the most frequently used measurement tools for cognitive difficulties focus on memory and naming rather than the domains affected by DLB. While there is now largely a consensus which tools are useful in diagnosing DLB, their validity in assessing deteriorating cognition is less clear. Thirdly, the presence of fluctuating cognition, the propensity to develop delirium episodes, as well as difficulties in distinguishing the two entities in clinical practice make it difficult to predict the disease course. Sleep disturbances are likely to influence cognitive decline but require further study in patients within established DLB. Fourthly, as in most cases of dementia, neuropathological comorbidities are frequently present in DLB. While the influence of Alzheimer's pathology on cognitive decline in DLB is comparatively well understood, the impact of other pathologies remains unclear. The recent definition of research criteria for mild cognitive impairment in DLB could facilitate earlier diagnosis and more structured follow-up. Assessment tools measuring cognitive domains predominantly affected in DLB need to be more consistently used in longitudinal studies and clinical practice, as well as concurrent measures of fluctuations in cognition. Greater availability of biomarkers and digital healthcare solutions can play an important role in enabling more accurate monitoring and prediction of cognitive decline in DLB.
Item Type: |
Article
|
Additional Information: |
© 2021 The Author(s)Published by S. Karger AG, Basel
This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only. Usage and distribution for commercial purposes requires written permission. |
Keywords: |
Cognition, Delirium, Dementia with Lewy bodies, Fluctuations, Multiple neuropathologies, Dementia with Lewy bodies, Cognition, Fluctuations, Delirium, Multiple neuropathologies, 1103 Clinical Sciences, 1702 Cognitive Sciences, 1109 Neurosciences, Geriatrics |
SGUL Research Institute / Research Centre: |
Academic Structure > Institute of Medical & Biomedical Education (IMBE) |
Journal or Publication Title: |
Dement Geriatr Cogn Disord |
ISSN: |
1421-9824 |
Language: |
eng |
Dates: |
Date | Event |
---|
July 2021 | Published | 29 March 2021 | Published Online | 1 February 2021 | Accepted |
|
Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
PubMed ID: |
33780925 |
Web of Science ID: |
WOS:000635752000001 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/113462 |
Publisher's version: |
https://doi.org/10.1159/000515008 |
Statistics
Item downloaded times since 20 Jul 2021.
Actions (login required)
![Edit Item](/style/images/action_view.png) |
Edit Item |