Predicting Survival in Dementia With Lewy Bodies With Hippocampal Volumetry
Year: 2016
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The clinical course of dementia with Lewy bodies patients is heterogeneous. The ability to more accurately prognosticate survival is important. OBJECTIVE: The objective of this study was to investigate hippocampal volume as a predictor of survival in dementia with Lewy bodies patients. METHODS: Survival analysis for time from onset of cognitive symptoms to death was carried out using Cox proportional hazards models. Given their age and total intracranial volume, patients were dichotomized into low/medium (0%-66.7%) and high (66. 7%-100%) hippocampal volume categories. The models using these categories to predict survival were adjusted for field strength, APOE ε4 status, and estimated onset age of cognitive problems. RESULTS: We investigated 167 consecutive patients with dementia with Lewy bodies. The median age at MRI was 72 years (interquartile range 67-76), and 80% were male. The median time from estimated first cognitive symptom to death was 7.4 years (interquartile range:5.7-10.2). Lower hippocampal volumes were significantly associated with higher risk of death (hazard ratio 1.28; 95% confidence interval 1.04-1.58; P = .024). The predicted median survival for participants with onset of cognitive symptoms at age 68 was 10.63 years (95% confidence interval 8.66-14.54) for APOE ε4 negative, high hippocampal volume participants; 8.89 years (95% confidence interval 7.56-12.36) for APOE ε4 positive, high hippocampal volume participants; 8.10 years (95% confidence interval 7.34-11.08) for APOE ε4 negative, low/medium hippocampal volume participants; and 7.38 (95% confidence interval 6.74-9.29) years for APOE ε4 positive, low/medium hippocampal volume participants. CONCLUSIONS: Among patients with clinically diagnosed dementia with Lewy bodies, those with neuroimaging evidence of hippocampal atrophy have shorter survival times. © 2016 International Parkinson and Movement Disorder Society.
Source: Movement Disorders
DOI: 10.1002/mds.26666
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Effects of estrogen on brain morphology and neuronal integrity in early menopause, Sex-specific Risk for Vascular Dysfunction and Cognitive Decline, 1H MRS markers of MCI syndromes and common dementias, Pathological basis of MRS and DTI changes in neurodegenerative dementia, Alzheimers Disease Patient Registry, Einstein Aging Study, Pathobiology of Neurodegeneration in C9ORF72 repeat expansion, Evaluating and Extending Our Hypothetical Model of Alzheimer's Biomarkers, Epidemiology of Familial Late-Onset Alzheimer's Disease, The Frontotemporal Lobar Degeneration Neuroimaging Initiative, EXTRAMURAL RESEARCH FACILITIES IMPROVEMENT PROGRAM, Genetics and Molecular Biology of Parkinsonism, Brain Aging and Alzheimer's Biomarker Classification Using Amyloid PET, tau PET, and Neurodegeneration on MRI: Developing the ATN system, G9000171383, Mayo Alzheimer's Disease Research Center
OpenAlex ID: W2398530838