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- Title
Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies.
- Authors
Hamilton, Calum A.; Frith, James; Donaghy, Paul C.; Barker, Sally A. H.; Durcan, Rory; Lawley, Sarah; Barnett, Nicola; Firbank, Michael; Roberts, Gemma; Taylor, John‐Paul; Allan, Louise M.; O'Brien, John; Yarnall, Alison J.; Thomas, Alan J.; Taylor, John-Paul
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
MILD cognitive impairment; ORTHOSTATIC intolerance; LEWY body dementia; ALZHEIMER'S disease; SYMPTOMS; OLDER people
- Publication
International Journal of Geriatric Psychiatry, 2022, Vol 37, Issue 4, p1
- ISSN
0885-6230
- Publication type
journal article
- DOI
10.1002/gps.5703