Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
Neuropsychiatr Dis Treat. 2013;9:927-35. doi: 10.2147/NDT.S45840. Epub 2013 Jun 28.
Whether dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) should be considered as one entity or two distinct conditions is a matter of controversy. The aim of this study was to compare the characteristics of DLB and PDD patients using data from the Swedish Dementia Quality Registry (SveDem).
SveDem is a national Web-based quality registry initiated to improve the quality of diagnostic workup, treatment, and care of patients with dementia across Sweden. Patients with newly diagnosed dementia of various types were registered in SveDem during the years 2007-2011. The current cross-sectional report is based on DLB (n = 487) and PDD (n = 297) patients. Demographic characteristics, diagnostic workup, Mini-Mental State Examination (MMSE) score, and medications were compared between DLB and PDD groups.
No gender differences were observed between the two study groups (P = 0.706). PDD patients were significantly younger than DLB patients at the time of diagnosis (74.8 versus 76.8 years, respectively; P < 0.001). A significantly higher prevalence of patients with MMSE score ≤24 were found in the PDD group (75.2% versus 67.6%; P = 0.030). The mean number of performed diagnostic modalities was significantly higher in the DLB group (4.9 ± 1.7) than in the PDD group (4.1 ± 1.6; P < 0.001). DLB patients were more likely than PDD patients to be treated with cholinesterase inhibitors (odds ratio = 2.5, 95% confidence interval = 1.8-3.5), whereas the use of memantine, antidepressants, and antipsychotics did not differ between the groups.
This study demonstrates several differences in the dementia work-up between DLB and PDD. The onset of dementia was significantly earlier in PDD, while treatment with cholinesterase inhibitors was more common in DLB patients. Severe cognitive impairment (MMSE score ≤24) was more frequent in the PDD group, whereas more diagnostic tests were used to confirm a DLB diagnosis. Some similarities also were found, such as gender distribution and use of memantine, antidepressants, and antipsychotics drugs. Further follow-up cost-effectiveness studies are needed to provide more evidence for workup and treatment guidelines of DLB and PDD.
路易体痴呆（DLB）和帕金森病伴痴呆（PDD）是否应被视为同一实体或两种不同的疾病仍存在争议。本研究旨在使用瑞典痴呆质量登记处（SveDem）的数据来比较 DLB 和 PDD 患者的特征。
SveDem 是一个全国性的基于网络的质量登记处，旨在提高瑞典各地痴呆患者的诊断工作、治疗和护理质量。2007-2011 年间，各种类型新发痴呆的患者在 SveDem 中进行登记。本横断面报告基于 DLB（n=487）和 PDD（n=297）患者。比较了 DLB 和 PDD 组之间的人口统计学特征、诊断检查、简易精神状态检查（MMSE）评分和药物治疗情况。
两组患者之间无性别差异（P=0.706）。与 DLB 患者相比，PDD 患者的诊断时年龄明显更小（分别为 74.8 岁和 76.8 岁；P＜0.001）。PDD 组 MMSE 评分≤24 的患者比例显著更高（75.2%与 67.6%；P=0.030）。DLB 组进行的诊断方式数量明显多于 PDD 组（4.9±1.7 与 4.1±1.6；P＜0.001）。与 PDD 患者相比，DLB 患者更可能接受胆碱酯酶抑制剂治疗（比值比=2.5，95%置信区间=1.8-3.5），而两组之间使用美金刚、抗抑郁药和抗精神病药的情况没有差异。
本研究表明 DLB 和 PDD 之间的痴呆症检查存在一些差异。PDD 的痴呆发病年龄明显更早，而 DLB 患者更常接受胆碱酯酶抑制剂治疗。PDD 组认知功能严重受损（MMSE 评分≤24）更为常见，而使用更多的诊断测试来确认 DLB 诊断。也发现了一些相似之处，如性别分布以及美金刚、抗抑郁药和抗精神病药物的使用。需要进一步的随访成本效益研究，为 DLB 和 PDD 的检查和治疗指南提供更多证据。
