Association of Lewy Bodies With Age-Related Clinical Characteristics in Black and White Decedents

Neurology. 2021 Aug 24;97(8):e825-e835. doi: 10.1212/WNL.0000000000012324. Epub 2021 Jun 4.


Objective: The associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested.

Methods: Black decedents (n = 81) were matched 2-to-1 by age, sex, years of education, and follow-up time in the study with White decedents (n = 154) from 4 longitudinal studies of dementia and aging. Participants underwent uniform clinical examination and cognitive, motor, and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism, and odds of dementia were determined using regression analyses.

Results: The mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents; the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼25%), as was the frequency of LBs in individual brain regions, while the mean LB counts/mm2 were similar in all regions except the cingulate cortex, which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% confidence interval [CI] -3.45 to -1.01) and higher odds of dementia (odds ratio 3.0, 95% CI 1.10-8.17) in both racial groups; an association with parkinsonism was stronger in Black than White decedents.

Conclusions: The frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amygdala / pathology*
  • Autopsy
  • Black or African American / ethnology*
  • Cerebral Cortex / pathology*
  • Female
  • Humans
  • Lewy Bodies / pathology*
  • Lewy Body Disease / complications
  • Lewy Body Disease / ethnology*
  • Lewy Body Disease / pathology
  • Lewy Body Disease / physiopathology
  • Longitudinal Studies
  • Male
  • Olfaction Disorders / ethnology*
  • Olfaction Disorders / etiology
  • Olfaction Disorders / physiopathology
  • Severity of Illness Index
  • Substantia Nigra / pathology*
  • United States / ethnology
  • White People / ethnology*