Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies.
Int J Geriatr Psychiatry
; 37(4)2022 04.
Article
in En
| MEDLINE
| ID: mdl-35302677
ABSTRACT
OBJECTIVES:
Autonomic symptoms are a common feature of the synucleinopathies, and may be a distinguishing feature of prodromal Lewy body disease. We aimed to assess whether the cognitive prodrome of dementia with Lewy bodies, mild cognitive impairment (MCI) with Lewy bodies (MCI-LB), would have more severe reported autonomic symptoms than cognitively healthy older adults, with MCI due to Alzheimer's disease (MCI-AD) also included for comparison. We also aimed to assess the utility of an autonomic symptom scale in differentiating MCI-LB from MCI-AD.METHODS:
Ninety-three individuals with MCI and 33 healthy controls were assessed with the Composite Autonomic Symptom Score 31-item scale (COMPASS). Mild cognitive impairment patients also underwent detailed clinical assessment and differential classification of MCI-AD or MCI-LB according to current consensus criteria. Differences in overall COMPASS score and individual symptom sub-scales were assessed, controlling for age.RESULTS:
Age-adjusted severity of overall autonomic symptomatology was greater in MCI-LB (Ratio = 2.01, 95% CI 1.37-2.96), with higher orthostatic intolerance and urinary symptom severity than controls, and greater risk of gastrointestinal and secretomotor symptoms. MCI-AD did not have significantly higher autonomic symptom severity than controls overall. A cut-off of 4/5 on the COMPASS was sensitive to MCI-LB (92%) but not specific to this (42% specificity vs. MCI-AD and 52% vs. healthy controls).CONCLUSIONS:
Mild cognitive impairment with Lewy bodies had greater autonomic symptom severity than normal ageing and MCI-AD, but such autonomic symptoms are not a specific finding. The COMPASS-31 may therefore have value as a sensitive screening test for early-stage Lewy body disease.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Lewy Body Disease
/
Alzheimer Disease
/
Cognitive Dysfunction
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Aged
/
Humans
Language:
En
Journal:
Int J Geriatr Psychiatry
Journal subject:
GERIATRIA
/
PSIQUIATRIA
Year:
2022
Document type:
Article
Affiliation country: