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Updated: Mar 1, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Symptoms associated with Lewy body disease in mild cognitive impairment
Paul C Donaghy1, Nicola Barnett1, Kirsty Olsen1
1Institute for Ageing and Institute of Neuroscience, Newcastle University, UK.
Objective:
Dementia with Lewy bodies (DLB) is associated with a range of cognitive and non-cognitive symptoms. We aimed to identify if some of these symptoms might aid early diagnosis of Lewy body disease in cases of mild cognitive impairment (MCI).
Methods:
Lewy body MCI (MCI-LB; n = 36), Alzheimer's disease MCI (MCI-AD; n = 21), DLB (n = 36), AD (n = 21) and control (n = 20) participants were recruited. An interview-based questionnaire about the presence of symptoms thought to be associated with Lewy body disease was completed by participants with, where possible, their carer/relative. The prevalence of each symptom was compared between MCI-LB and MCI-AD and between established DLB and AD, and a symptom scale based on these findings was devised.
Results:
Fluctuating concentration/attention; episodes of confusion; muscle rigidity; changes in hand-writing, gait and posture; falls; drooling; weak voice; symptoms of REM sleep behaviour disorder (RBD) and misjudging objects were more common in MCI-LB compared with MCI-AD, and also in DLB compared with AD. Hyposmia, tremor, slowness and autonomic symptoms were not specific to Lewy body disease. REM sleep behaviour disorder and hyposmia were reported to develop several years prior to the onset of cognitive symptoms in Lewy body disease. A 10-point symptom scale differentiated between MCI-LB and MCI-AD with a sensitivity of 83% and a specificity of 100%.
Conclusions:
Drooling, misjudging objects and symptoms related to parkinsonism, fluctuating cognition and RBD may be the most characteristic symptoms of MCI-LB. Slowness, tremor, autonomic symptoms and hyposmia are all common in MCI-LB but are not specific to the disease. Copyright © 2017 John Wiley & Sons, Ltd.
Insights
Early diagnosis of Lewy body disease in mild cognitive impairment (MCI) may be aided by specific symptoms. Fluctuations, confusion, and parkinsonian signs are key indicators for MCI-LB.
Area of Science:
- Neurology
- Cognitive Science
- Geriatrics
Background:
- Dementia with Lewy bodies (DLB) presents with diverse cognitive and non-cognitive symptoms.
- Distinguishing DLB from Alzheimer's disease (AD) is crucial for appropriate management.
- Mild cognitive impairment (MCI) can be an early stage of neurodegenerative diseases like DLB and AD.
Purpose of the Study:
- To identify symptoms indicative of Lewy body disease in individuals with mild cognitive impairment (MCI).
- To differentiate MCI due to Lewy bodies (MCI-LB) from MCI due to Alzheimer's disease (MCI-AD).
- To develop a symptom-based scale for early detection of MCI-LB.
Main Methods:
- Recruited participants with MCI-LB, MCI-AD, DLB, AD, and controls.
- Utilized an interview-based questionnaire administered to participants and/or their carers.
- Compared the prevalence of Lewy body-associated symptoms between diagnostic groups.
Main Results:
- Symptoms like fluctuating attention, confusion, rigidity, handwriting changes, falls, drooling, and REM sleep behavior disorder (RBD) were more prevalent in MCI-LB and DLB.
- Hyposmia, tremor, slowness, and autonomic symptoms were not specific to Lewy body disease.
- A 10-point symptom scale achieved 83% sensitivity and 100% specificity in differentiating MCI-LB from MCI-AD.
Conclusions:
- Drooling, misjudging objects, parkinsonism, fluctuating cognition, and RBD symptoms are characteristic of MCI-LB.
- Slowness, tremor, autonomic dysfunction, and hyposmia are common but not specific to MCI-LB.
- These findings support the use of specific symptom clusters for early MCI-LB diagnosis.
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