NEW ORLEANS—Two years after disease onset, patients with dementia with Lewy bodies (DLB) have a significantly worse quality of life than do patients with Alzheimer’s disease or Huntington’s disease, reported researchers at the 64th Annual Meeting of the American Academy of Neurology.
Patients with DLB scored 33.3 on the SF-12 Physical Health Summary, compared with 42.7 for patients with Huntington’s disease and 42 for patients with Alzheimer’s disease. Patients with DLB scored 41 on the SF-12 Mental Health Summary, compared with 46.1 for patients with Huntington’s disease and 45.6 for patients with Alzheimer’s disease.
Disability also was greater among patients with DLB, who scored 38.3 on the Older Americans Resource and Services Disability Subscale, compared with 27.5 for patients with Huntington’s disease and 32.2 for those with Alzheimer’s disease. Patients with DLB also reported more medical comorbidities and greater depression than did patients with either Huntington’s or Alzheimer’s disease.
Renzo Figari, MD, Movement Disorders Fellow at the University of Maryland School of Medicine in Baltimore, and his colleagues compared the level of motor and cognitive impairment, disability, and quality of life in 39 patients with Huntington’s disease, 46 with Alzheimer’s disease, and 23 with DLB. Patients completed five tests, including the Mini-Mental State Examination (MMSE), Brief Symptoms Inventory (BSI-18), and the Cumulative Illness Rating Scale. All patients had had dementia for at least two years. Mean ages were 75 for patients with Alzheimer’s disease, 72.5 for patients with DLB, and 54 for patients with Huntington’s disease.
Patients with Alzheimer’s disease scored 17.8 on the MMSE, compared with 24.3 for patients with Huntington’s disease and 22.1 for patients with DLB. No differences were found among the patient groups on the Somatization or Anxiety symptom scales of BSI-18. When adjusted for age, cognition, comorbidity, and depression, patients with DLB had the worst quality of life and disability ratings, but the differences between groups were no longer significant.
The findings for patients with DLB may reflect the combination of physical, cognitive, and psychiatric impairments associated with the disease. “Clinically, this suggests the need for optimal management of DLB, including a combination of antiparkinsonian drugs, antipsychotics, antidepressants, and drugs for dementia, as needed,” Dr. Figari told Neurology Reviews. “We also need a better understanding of how to assess patient-reported outcomes, including quality of life and disability, in people with cognitive and psychiatric impairments.”
—Erik Greb