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Nonamnestic mild cognitive impairment progresses to dementia with Lewy bodies

Tanis J Ferman1, Glenn E Smith, Kejal Kantarci

  • 1From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Pathology (D.W.D., M.E.M.), and Neurology (N.R.G.-R, Z.W., J.V.G., R.U.), Mayo Clinic, Jacksonville, FL; and Departments of Psychiatry and Psychology (G.E.S.), Radiology (K.K.), Neurology (B.F.B., D.S.K., R.C.P.), Health Sciences Research (V.S.P., J.A.), and Laboratory Medicine and Pathology (J.P.), Mayo Clinic, Rochester, MN.

Neurology
|November 12, 2013
PubMed
Abstract

Insights

Patients with nonamnestic mild cognitive impairment (MCI) are more likely to progress to dementia with Lewy bodies (DLB). Amnestic MCI typically progresses to Alzheimer disease (AD).

Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia.
  • Understanding the progression pathways of MCI is crucial for early diagnosis and intervention.
  • Dementia with Lewy bodies (DLB) and Alzheimer disease (AD) are common neurodegenerative disorders with distinct clinical features.

Purpose of the Study:

  • To determine the rate of progression of mild cognitive impairment (MCI) to dementia with Lewy bodies (DLB).
  • To compare the progression rates of MCI to DLB versus AD.
  • To identify baseline MCI characteristics associated with progression to DLB or AD.

Main Methods:

  • A cohort of 337 patients with MCI was followed for 2-12 years at the Mayo Alzheimer's Disease Research Center.
  • Competing risks survival models were employed to analyze progression rates to clinically probable DLB and AD.
  • Neuropathologic examination was performed on a subset of patients for confirmation.

Main Results:

  • Of the 337 MCI patients, 49 progressed to probable DLB and 162 to probable AD.
  • Nonamnestic MCI progressed to DLB at a rate of 20 per 100 person-years, while amnestic MCI progressed to AD at 17 per 100 person-years.
  • Baseline attention/visuospatial deficits in MCI predicted DLB progression (88%), while memory impairment predicted AD progression (99%).

Conclusions:

  • Nonamnestic MCI is a significant risk factor for developing DLB.
  • Amnestic MCI is more likely to progress to AD.
  • Baseline cognitive profiles in MCI can predict the specific type of dementia that develops.

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