Differences in clinical course between dementia with Lewy bodies and Alzheimer's disease

Eur J Neurol. 2009 Feb;16(2):212-7. doi: 10.1111/j.1468-1331.2008.02388.x.


Background and purpose: To investigate whether there may be differences in the clinical course and changes in cognitive progression between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).

Methods: We compared the time from the first visit to endpoints (discontinuation of visits because of admission, death, or institutionalization) between 56 patients with DLB and 111 patients with AD. Mini-Mental State Examination (MMSE) scores of patients were every 12 months examined up to 60 months.

Results: Dementia with Lewy bodies had a significantly shorter time to reaching endpoints than those with AD (median time; 40 months vs. 52 months, P < 0.0001). The proportion of admission (or death) was significantly higher in DLB than in AD (30% vs. 14%, P < 0.05), while the difference in institutionalization in nursing homes did not reach statistical significance (25% vs. 17%). Rates of longitudinal MMSE score decline for DLB and AD groups were equivalent.

Conclusion: Dementia with Lewy bodies had a greater risk of admission (or death) because of most commonly fall-related injuries and bronchopneumonia than AD, but the two groups did not differ in rate of cognitive decline.

MeSH terms

  • Aged
  • Alzheimer Disease / complications
  • Alzheimer Disease / mortality
  • Alzheimer Disease / physiopathology*
  • Cognition Disorders / etiology
  • Cognition Disorders / physiopathology*
  • Disease Progression*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Institutionalization / statistics & numerical data
  • Kaplan-Meier Estimate
  • Lewy Body Disease / complications
  • Lewy Body Disease / mortality
  • Lewy Body Disease / physiopathology*
  • Male
  • Neuropsychological Tests