Nervi Angela, Reitz Christiane, Tang Ming-Xin, Santana Vincent, Piriz Angel, Reyes-Dumeyer Dolly, Lantigua Rafael, Medrano Martin, Jiménez-Velázquez Ivonne Z, Lee Joseph H, Mayeux Richard
Gertrude H. Sergievsky Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th St, Columbia University, New York, NY 10032, USA.
Arch Neurol. 2008 Dec;65(12):1634-9. doi: 10.1001/archneur.65.12.1634.
The clinical delineation of dementia with Lewy bodies (DLB) from Alzheimer disease (AD) remains unclear.
To compare neuropsychological profiles in DLB and AD among Caribbean Hispanic family members and participants in a population-based epidemiologic sample using extended neuropsychological test batteries and to explore whether these differences were related to heritable factors.
Cross-sectional study.
Clinics in northern Manhattan (New York City), the Dominican Republic, and Puerto Rico.
We compared measures of memory, orientation, language, and executive and visuospatial functioning between patients with DLB vs AD in 2 Caribbean Hispanic cohorts, including a family sample (89 patients with DLB and 118 patients with AD) and an epidemiologic sample (70 patients with DLB and 157 patients with AD). Patients with DLB in the family sample were further categorized as patients having at least 2 family members with DLB or as patients having 1 family member with DLB.
To determine whether observed differences in cognitive profiles were driven by heritable factors, we repeated analyses in the epidemiologic sample after excluding familial cases. We applied general linear models adjusted for age, sex, educational level, disease duration, and apolipoprotein E epsilon4 (OMIM 104310) genotype.
Patients with DLB in both samples were more severely impaired in orientation, visuoconstruction, and nonverbal reasoning after controlling for potential confounders. Patients having at least 2 family members with DLB had the most severe impairment in memory, followed by patients having 1 family member with DLB, and then by patients with AD. After excluding familial AD and DLB cases in the epidemiologic sample, the differences between the groups persisted but were attenuated.
Compared with patients having AD, patients having DLB are more severely impaired in various cognitive domains, particularly orientation and visuospatial functioning. The difference seems stronger in familial DLB than in sporadic DLB. Whether this divergence in cognitive functions is caused by gene-gene or gene-environmental interactions remains unclear.
路易体痴呆（DLB）与阿尔茨海默病（AD）在临床上的区分仍不明确。
使用扩展神经心理测试电池，比较加勒比西班牙裔家庭成员以及基于人群的流行病学样本中的DLB和AD患者的神经心理特征，并探讨这些差异是否与遗传因素有关。
横断面研究。
纽约市曼哈顿北部、多米尼加共和国和波多黎各的诊所。
我们比较了两个加勒比西班牙裔队列中DLB患者与AD患者在记忆、定向、语言、执行功能和视觉空间功能方面的测量结果，这两个队列包括一个家族样本（89例DLB患者和118例AD患者）和一个流行病学样本（70例DLB患者和157例AD患者）。家族样本中的DLB患者进一步分为至少有2名家庭成员患有DLB的患者和有1名家庭成员患有DLB的患者。
为了确定观察到的认知特征差异是否由遗传因素驱动，我们在排除家族性病例后，在流行病学样本中重复进行分析。我们应用了针对年龄、性别、教育水平、疾病持续时间和载脂蛋白E ε4（OMIM 104310）基因型进行调整的一般线性模型。
在控制潜在混杂因素后，两个样本中的DLB患者在定向、视觉构建和非言语推理方面受损更严重。至少有2名家庭成员患有DLB的患者在记忆方面受损最严重，其次是有1名家庭成员患有DLB的患者，然后是AD患者。在流行病学样本中排除家族性AD和DLB病例后，组间差异仍然存在但有所减弱。
与AD患者相比，DLB患者在各个认知领域受损更严重，尤其是定向和视觉空间功能。家族性DLB中的差异似乎比散发性DLB中的更强。这种认知功能差异是否由基因-基因或基因-环境相互作用引起仍不清楚。
