Long-Term Cognitive Decline in Dementia with Lewy Bodies in a Large Multicenter, International Cohort

Milica G. Kramberger, Bjørn Auestad, Sara Garcia-Ptacek, Carla Abdelnour, Josep Garre Olmo, Zuzana Walker, Afina W. Lemstra, Elisabet Londos, Frederic Blanc, Laura Bonanni, Ian McKeith, Bengt Winblad, Frank Jan De Jong, Flavio Nobili, Elka Stefanova, Maria Petrova, Cristian Falup-Pecurariu, Irena Rektorova, Sevasti Bostantjopoulou, Roberta BiundoDaniel Weintraub, Dag Aarsland

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Background/Objective: The aim of this study was to describe the rate and clinical predictors of cognitive decline in dementia with Lewy bodies (DLB), and compare the findings with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) patients. Methods: Longitudinal scores for the Mini-Mental State Examination (MMSE) in 1,290 patients (835 DLB, 198 PDD, and 257 AD) were available from 18 centers with up to three years longitudinal data. Linear mixed effects analyses with appropriate covariates were used to model MMSE decline over time. Several subgroup analyses were performed, defined by anti-dementia medication use, baseline MMSE score, and DLB core features. Results: The mean annual decline in MMSE score was 2.1 points in DLB, compared to 1.6 in AD (p=0.07 compared to DLB) and 1.8 in PDD (p=0.19). Rates of decline were significantly higher in DLB compared to AD and PDD when baseline MMSE score was included as a covariate, and when only those DLB patients with an abnormal dopamine transporter SPECT scan were included. Decline was not predicted by sex, baseline MMSE score, or presence of specific DLB core features. Conclusions: The average annual decline in MMSE score in DLB is approximately two points. Although in the overall analyses there were no differences in the rate of decline between the three neurodegenerative disorders, there were indications of a more rapid decline in DLB than in AD and PDD. Further studies are needed to understand the predictors and mechanisms of cognitive decline in DLB.

Original languageEnglish
Pages (from-to)787-795
Number of pages9
JournalJournal of Alzheimer's Disease
Issue number3
Publication statusPublished - 2017


  • Dementia with Lewy bodies
  • international cohort
  • long-term cognitive decline
  • multicenter study

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