The influence of vascular risk factors on the survival rate of patients with dementia with Lewy bodies and Alzheimer disease

• Published in: Neurologia i neurochirurgia polska 2010, Vol.44 (2), p.139-147
• Main Authors: Magierski, Radosław, Kłoszewska, Iwona, Sobów, Tomasz M.
• Format: Article
• Language: English
• Subjects: Age of Onset; Aged; Aged, 80 and over; Alzheimer disease; Alzheimer Disease - diagnosis; Alzheimer Disease - mortality; Alzheimer's disease; choroba Alzheimera; Comorbidity; czas przeżycia; czynniki ryzyka; Dementia; dementia with Lewy bodies; Diabetes Mellitus, Type 2 - epidemiology; Disease Progression; Female; Humans; Hypertension - epidemiology; Lewy Body Disease - diagnosis; Lewy Body Disease - mortality; Male; Medical Records - statistics & numerical data; Middle Aged; Mortality; otępienie z ciałami Lewy'ego; Poland - epidemiology; Retrospective Studies; Risk factors; Socioeconomic Factors; survival; Survival Rate; śmiertelność
• ISSN: 0028-3843; 1897-4260
• DOI: 10.1016/S0028-3843(14)60005-0

The aim of this study was to determine whether dementia with Lewy bodies (DLB) progresses more rapidly than Alzheimer disease (AD) and to compare survival after dementia onset and mortality in both dementia groups. A medical records analysis of AD (n = 183) and DLB (n = 51) patients was performed to determine age at onset of symptoms, the date of first presentation to the psychiatric services, dementia severity at diagnosis (MMSE score), and mean disease duration before diagnosis. Categorical data regarding vascular risk factors were collected. Projected decline rate (MMSE/year), survival rate after the diagnosis of dementia, mean survival time after diagnosis and mortality rate were calculated and compared between DLB and AD groups. The comparison of clinical and demographic parameters revealed no significant differences between groups, apart from a more pronounced decline rate in the DLB group. Diabetes, and to a lesser extent hypertension, influenced survival in AD, but not in DLB subjects. Overall, however, the difference in mortality rates and survival time between DLB and AD subjects cannot be attributed to the presence of any vascular risk factor analysed. DLB, independently of the presence of vascular risk factors, seems to be a more aggressive disorder than AD, when mortality and survival time are taken into account. More rapid progression of cognitive decline and shorter duration of dementia were found in DLB in this naturalistic study. The findings may have important implications for the management and treatment of DLB and should be confirmed in prospective studies. Celem pracy była ocena szybkości progresji otępienia oraz śmiertelności w otępieniu z ciałami Lewy'ego (DLB) i porównanie uzyskanych wartości do obserwowanych w chorobie Alzheimera (ChA). Dokonano retrospektywnej analizy dokumentacji chorych na ChA (n = 183) i DLB (n = 51) i określono wiek zachorowania, wiek zgłoszenia do placówki psychiatrycznej, nasilenie otępienia w chwili rozpoznania (punktacja MMSE) oraz średni czas trwania choroby przed ustaleniem rozpoznania. Zebrano także dane dotyczące naczyniowych czynników ryzyka. Dla obu otępień dokonano porównania wyznaczonego tempa progresji otępienia (MMSE/rok), wskaźnika śmiertelności i czasu przeżycia po rozpoznaniu otępienia. Obie badane grupy były porównywalne pod względem zmiennych demograficznych, z wyjątkiem oszacowanego tempa progresji otępienia, większego w DLB niż w ChA. Cukrzyca, i w mniejszym stopniu nadciśnienie, wpływały