National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA 98105, USA.
Alzheimer Dis Assoc Disord. 2011 Jan-Mar;25(1):17-23. doi: 10.1097/WAD.0b013e3182037edf.
We examined the risk of 1-year decline in 4 everyday activities in patients with dementia with Lewy bodies (DLB), relative to patients with Alzheimer disease (AD). Data were from the National Alzheimer's Coordinating Center, gathered from 32 Alzheimer's Disease Centers. Participants (n=1880) were: aged 60+ years, demented with a primary clinical diagnosis of probable AD or DLB, and had a global Clinical Dementia Rating of 0.5 to 2. The activities were measured with the Functional Activities Questionnaire. In modified Poisson regression models adjusted for demographics, baseline activity, years from symptom onset, cognitive impairment, and comorbidities; DLB participants aged 67 to 81 years had 1.5 to 2 times increased risk of decline in performing basic kitchen tasks, engaging in games/hobbies, and paying attention/understanding, relative to AD participants of the same age (P<0.05). There was no significant difference between AD and DLB participants beyond this age range. For decline in ability to go shopping alone, there was also no significant difference between AD and DLB participants. In summary, the functional course of DLB, relative to AD, may depend on the age of the patient. These findings may provide anticipatory guidance to families and healthcare providers, which may be useful in the planning of care strategies.
我们研究了与阿尔茨海默病（AD）患者相比，路易体痴呆（DLB）患者在一年内日常四项活动能力下降的风险。数据来自国家阿尔茨海默病协调中心，收集自 32 个阿尔茨海默病中心。参与者（n=1880）为：年龄 60 岁以上，患有痴呆症，主要临床诊断为可能的 AD 或 DLB，且全球临床痴呆评分（CDR）为 0.5 至 2。这些活动通过功能性活动问卷进行测量。在调整了人口统计学、基线活动、症状出现后年限、认知障碍和合并症的改良泊松回归模型中；67 至 81 岁的 DLB 参与者在执行基本厨房任务、参与游戏/爱好和注意力/理解方面下降的风险是相同年龄 AD 参与者的 1.5 至 2 倍（P<0.05）。在此年龄范围之外，AD 和 DLB 参与者之间没有显著差异。对于独自购物能力下降，AD 和 DLB 参与者之间也没有显著差异。总之，与 AD 相比，DLB 的功能病程可能取决于患者的年龄。这些发现可能为患者家属和医疗保健提供者提供预期指导，这可能对制定护理策略有用。
