Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
J Alzheimers Dis. 2023;94(3):861-878. doi: 10.3233/JAD-230207.
Lewy body dementia is the third most common and costliest type of dementia. It is an umbrella term for dementia with Lewy bodies and Parkinson's disease dementia, both of which place a substantial burden on the person and society. Recent findings outline ethnoracial differences in dementia risk. Delayed and misdiagnosis across ethnoracial groups contribute to higher levels of burden. In this context, we aimed to summarize current knowledge, gaps, and unmet needs relating to race and ethnicity in Lewy body dementia. In this narrative review, we provide an overview of studies on Lewy body dementia focusing on differences across ethnoracial groups and outline several recommendations for future studies. The majority of the findings comparing different ethnoracial groups were from North American sites. There were no differences in clinical prevalence and progression across ethnoracial groups. Compared to people identifying as non-Hispanic White, co-pathologies were more common and clinical diagnostic accuracy was lower for people identifying as Black. Co-morbidities (e.g., diabetes, hypertension) were more common and medication use rates (e.g., antidepressants, antiparkinsonian agents) were lower for people identifying as Black or Hispanic compared to people identifying as White. More than 90% of clinical trial participants identified as non-Hispanic White. Despite increasing efforts to overcome disparities in Alzheimer's disease and related dementias, inclusion of individuals from minoritized communities in Lewy body dementia studies continues to be limited and the findings are inconclusive. Representation of diverse populations is crucial to improve the diagnostic and therapeutic efforts in Lewy body dementia.
路易体痴呆是第三常见且最昂贵的痴呆症类型。它是一个涵盖性术语，包括路易体痴呆和帕金森病痴呆，这两种疾病都给个人和社会带来了巨大的负担。最近的研究结果概述了痴呆症风险在不同种族群体之间的差异。在不同种族群体中存在的延迟诊断和误诊导致负担水平更高。在这种情况下，我们旨在总结与路易体痴呆相关的种族和民族方面的现有知识、差距和未满足的需求。在这篇叙述性综述中，我们提供了关于路易体痴呆的研究概述，重点介绍了不同种族群体之间的差异，并概述了未来研究的几项建议。比较不同种族群体的大多数研究结果都来自北美地区的研究。在种族群体之间，临床患病率和进展没有差异。与非西班牙裔白人相比，黑人的共病更为常见，临床诊断准确性较低。与白人相比，黑人或西班牙裔的共病（如糖尿病、高血压）更为常见，而药物使用率（如抗抑郁药、抗帕金森药物）较低。超过 90%的临床试验参与者是非西班牙裔白人。尽管在阿尔茨海默病和相关痴呆症方面做出了越来越多的努力来克服差异，但在路易体痴呆研究中纳入少数族裔社区的个人仍然有限，而且研究结果也不确定。代表性多样化的人群对于改善路易体痴呆的诊断和治疗努力至关重要。
