Calum A. Hamilton
Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease
Hamilton, Calum A.; Matthews, Fiona E.; Donaghy, Paul C.; Taylor, John Paul; O'Brien, John T.; Barnett, Nicola; Olsen, Kirsty; McKeith, Ian G.; Thomas, Alan J.
Authors
Professor Fiona Matthews F.Matthews@hull.ac.uk
Pro-Vice-Chancellor Research and Enterprise
Paul C. Donaghy
John Paul Taylor
John T. O'Brien
Nicola Barnett
Kirsty Olsen
Ian G. McKeith
Alan J. Thomas
Abstract
Background Mild cognitive impairment (MCI) may gradually worsen to dementia, but often remains stable for extended periods of time. Little is known about the predictors of decline to help explain this variation. We aimed to explore whether this heterogeneous course of MCI may be predicted by the presence of Lewy body (LB) symptoms in a prospectively-recruited longitudinal cohort of MCI with Lewy bodies (MCI-LB) and Alzheimer's disease (MCI-AD). Methods A prospective cohort (n = 76) aged 60 years underwent detailed assessment after recent MCI diagnosis, and were followed up annually with repeated neuropsychological testing and clinical review of cognitive status and LB symptoms. Latent class mixture modelling identified data-driven sub-groups with distinct trajectories of global cognitive function. Results Three distinct trajectories were identified in the full cohort: slow/stable progression (46%), intermediate progressive decline (41%) and a small group with a much faster decline (13%). The presence of LB symptomology, and visual hallucinations in particular, predicted decline v. a stable cognitive trajectory. With time zeroed on study end (death, dementia or withdrawal) where available (n = 39), the same subgroups were identified. Adjustment for baseline functioning obscured the presence of any latent classes, suggesting that baseline function is an important parameter in prospective decline. Conclusions These results highlight some potential signals for impending decline in MCI; poorer baseline function and the presence of probable LB symptoms - particularly visual hallucinations. Identifying people with a rapid decline is important but our findings are preliminary given the modest cohort size.
Citation
Hamilton, C. A., Matthews, F. E., Donaghy, P. C., Taylor, J. P., O'Brien, J. T., Barnett, N., …Thomas, A. J. (2021). Prospective predictors of decline v. stability in mild cognitive impairment with Lewy bodies or Alzheimer's disease. Psychological Medicine, 51(15), 2590-2598. https://doi.org/10.1017/S0033291720001130
Journal Article Type | Article |
---|---|
Acceptance Date | Apr 7, 2020 |
Online Publication Date | May 5, 2020 |
Publication Date | Nov 5, 2021 |
Deposit Date | Mar 31, 2024 |
Publicly Available Date | Apr 3, 2024 |
Journal | Psychological Medicine |
Print ISSN | 0033-2917 |
Electronic ISSN | 1469-8978 |
Publisher | Cambridge University Press |
Peer Reviewed | Peer Reviewed |
Volume | 51 |
Issue | 15 |
Pages | 2590-2598 |
DOI | https://doi.org/10.1017/S0033291720001130 |
Keywords | Alzheimer's disease; Dementia with Lewy bodies; Latent class mixture modelling; Longitudinal decline; Mild cognitive impairment |
Public URL | https://hull-repository.worktribe.com/output/4451232 |
Related Public URLs | https://eprints.ncl.ac.uk/265820 |
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
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