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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

Calum A. Hamilton

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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