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Differences in clinical course between dementia with Lewy bodies and Alzheimer's disease
Authors:H. Hanyu  T. Sato  K. Hirao  H. Kanetaka  H. Sakurai   T. Iwamoto
Affiliation:Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
Abstract: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.
Keywords:dementia with Lewy bodies    Alzheimer's disease    progression    clinical course
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