From the Departments of Pathology (Neuropathology) (S.N., J.A.S.), Neurological Sciences (L.L.B., L.Y., A.S.B., D.A.B., J.A.S., R.S.W.), and Psychiatry and Behavioral Sciences (L.L.B., R.S.W.), Rush Alzheimer Disease Center and Rush University Medical Center, Chicago, IL.
Neurology. 2021 Aug 24;97(8):e825-e835. doi: 10.1212/WNL.0000000000012324. Epub 2021 Jun 4.
The associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested.
Black decedents (n = 81) were matched 2-to-1 by age, sex, years of education, and follow-up time in the study with White decedents (n = 154) from 4 longitudinal studies of dementia and aging. Participants underwent uniform clinical examination and cognitive, motor, and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism, and odds of dementia were determined using regression analyses.
The mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents; the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼25%), as was the frequency of LBs in individual brain regions, while the mean LB counts/mm were similar in all regions except the cingulate cortex, which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% confidence interval [CI] -3.45 to -1.01) and higher odds of dementia (odds ratio 3.0, 95% CI 1.10-8.17) in both racial groups; an association with parkinsonism was stronger in Black than White decedents.
The frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.
评估黑人和白人社区居住的老年人中路易体（LB）与嗅觉功能障碍、帕金森病和痴呆症更高几率的关联，并检验这些关联在不同种族间的差异。
在 4 项关于痴呆和衰老的纵向研究中，将黑人死者（n=81）按年龄、性别、受教育年限和研究随访时间与白人死者（n=154）进行 2:1 匹配。参与者接受了统一的临床检查以及认知、运动和嗅觉测试。通过α-突触核蛋白免疫组织化学检测了 7 个脑区的 LB，并使用回归分析确定了它们与嗅觉、帕金森病和痴呆症几率的关联在不同种族间的差异。
黑人死者的嗅觉测试、整体帕金森病体征和整体认知评分均低于白人死者；两组的痴呆症频率相似。黑人死者和白人死者的 LB 频率相似（约 25%），各脑区的 LB 频率也相似，除扣带回外，其他脑区的 LB 计数/mm 也相似，扣带回的 LB 计数较高。在回归分析中，LB 与嗅觉障碍（-2.23，95%置信区间[CI] -3.45 至 -1.01）和痴呆症几率升高（比值比 3.0，95%CI 1.10-8.17）相关，在两个种族群体中均如此；与帕金森病的关联在黑人死者中比在白人死者中更强。
黑人和白人老年人的 LB 频率、分布和临床表现相似。
