Mirza Saira Saeed, Saeed Usman, Ramirez Joel, Herrmann Nathan, Stuss Donald T, Black Sandra E, Masellis Mario
Division of Neurology, Department of Medicine University of Toronto Toronto Ontario Canada.
Hurvitz Brain Sciences Research Program Sunnybrook Research Institute University of Toronto Toronto Ontario Canada.
Alzheimers Dement (Amst). 2022 May 2;14(1):e12306. doi: 10.1002/dad2.12306. eCollection 2022.
Disability is common across Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). White matter hyperintensities (WMHs) are prevalent in both diagnoses and associated with disability; both diagnoses show neuropsychiatric symptoms (NPS) and impaired cognition.
In AD and DLB, we examined if WMHs, NPS, and cognition associate with basic and/or instrumental activities of daily living (BADLs and/or IADLs) cross-sectionally, and longitudinally over ≈1.4 years.
Across both diagnoses, NPS were not only associated with greater disability in performing both BADLs and IADLs, but were also associated with a decline in the ability to perform BADLs in the AD group. In the DLB group only, higher WMH volume was associated with greater disability in performing both BADLs and IADLs, and was associated with a decline in the ability to perform BADL over time.
Management of NPS and WMHs, particularly in DLB, might help maintain functionality in dementia patients for longer.
残疾在阿尔茨海默病（AD）和路易体痴呆（DLB）中很常见。白质高信号（WMH）在这两种疾病中都很普遍，并且与残疾相关；这两种疾病都表现出神经精神症状（NPS）和认知障碍。
在AD和DLB中，我们横断面地以及在约1.4年的时间里纵向研究了WMH、NPS和认知与基本和/或工具性日常生活活动（BADL和/或IADL）之间的关联。
在这两种疾病中，NPS不仅与BADL和IADL执行能力的更大残疾相关，而且在AD组中还与BADL执行能力的下降相关。仅在DLB组中，更高的WMH体积与BADL和IADL执行能力的更大残疾相关，并且与随着时间推移BADL执行能力的下降相关。
NPS和WMH的管理，特别是在DLB中，可能有助于痴呆患者更长时间地维持功能。
