Associations among education, age, and the dementia with Lewy bodies (DLB) metabolic pattern: A European-DLB consortium project

Alzheimers Dement. 2021 Aug;17(8):1277-1286. doi: 10.1002/alz.12294. Epub 2021 Feb 2.


Introduction: We assessed the influence of education as a proxy of cognitive reserve and age on the dementia with Lewy bodies (DLB) metabolic pattern.

Methods: Brain 18F-fluorodeoxyglucose positron emission tomography and clinical/demographic information were available in 169 probable DLB patients included in the European DLB-consortium database. Principal component analysis identified brain regions relevant to local data variance. A linear regression model was applied to generate age- and education-sensitive maps corrected for Mini-Mental State Examination score, sex (and either education or age).

Results: Age negatively covaried with metabolism in bilateral middle and superior frontal cortex, anterior and posterior cingulate, reducing the expression of the DLB-typical cingulate island sign (CIS). Education negatively covaried with metabolism in the left inferior parietal cortex and precuneus (making the CIS more prominent).

Discussion: These findings point out the importance of tailoring interpretation of DLB biomarkers considering the concomitant effect of individual, non-disease-related variables such as age and cognitive reserve.

Keywords: biomarkers; cognitive reserve; dementia with Lewy bodies; fluorodeoxyglucose positron emission tomography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Alzheimer Disease*
  • Brain / metabolism
  • Educational Status*
  • Europe
  • Fluorodeoxyglucose F18 / metabolism
  • Frontal Lobe / metabolism*
  • Gyrus Cinguli / metabolism*
  • Humans
  • Image Processing, Computer-Assisted / statistics & numerical data
  • Lewy Body Disease / metabolism*
  • Positron-Emission Tomography


  • Fluorodeoxyglucose F18