Collin Marie, Bonnet-Chateau Justine, Gilles Victor, Dautricourt Sophie, Gilbert Thomas, Makaroff Zaza, Coste Marie-Hélène, Dauphinot Virginie, Garnier-Crussard Antoine
Clinical and Research Memory Centre of Lyon, Department of Geriatric Medicine, Lyon Institute for Aging, Charpennes Hospital, Clinical Research Center Aging-Brain-Frailty, Hospices Civils de Lyon, Villeurbanne, France.
Clinical and Research Memory Centre of Lyon, Department of Geriatric Medicine, Lyon Institute for Aging, Charpennes Hospital, Clinical Research Center Aging-Brain-Frailty, Hospices Civils de Lyon, Villeurbanne, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Neuropresage Team, Cyceron, 14000 Caen, France.
J Nutr Health Aging. 2025 Jun;29(6):100541. doi: 10.1016/j.jnha.2025.100541. Epub 2025 Mar 23.
OBJECTIVES: Intrinsic capacity (IC), the composite of all the physical and mental capacities of an individual, has never been studied in patients with dementia with Lewy bodies (DLB). As IC decline is associated with the risk of frailty, functional decline and disability and is potentially reversible after targeted interventions, a monitoring and specific management of IC decline in patients with DLB could promote healthy aging in this population. The aim of this cross-sectional study was to describe the frequency of IC decline in DLB and to compare it with AD. DESIGN: A single-center cross-sectional study. SETTING: This study was carried out in a memory clinic between 2015 and 2023 based on the MEMORA cohort. PARTICIPANTS: Patients with a diagnosis of AD or probable DLB and a comprehensive geriatric assessment. MEASUREMENTS: IC was assessed according to the WHO model in 4 domains: vitality assessed by the Mini Nutritional Assessment (MNA), locomotion assessed by the Short Physical Performance Battery (SPPB), psychology assessed by the Geriatric Depression Scale 4-items (GDS-4 items), and hearing assessed by the Hearing, Vision, Equilibrium and Cognition (HVEC) scale. RESULTS: A total of 798 patients (154 with probable DLB and 644 with AD) were included, and the mean age was 81.4 years (SD 6.33). Compared with AD patients, DLB patients had significantly more impaired IC in all domains, with greater risks of impaired vitality (odds ratio (OR) 2.43, 95% confidence interval (CI) 1.60-3.72), locomotion (OR 3.50, 95% CI 2.15-5.90), psychology (OR 2.60, 95% CI 1.73-3.92) and hearing (OR 2.30, 95% CI 1.53-3.49), according to the adjusted models. Similarly, when IC domains were considered linear variables, IC across all domains was significantly lower in the DLB group than in the AD group. CONCLUSION: This study revealed that DLB patients presented a greater decrease in IC than did AD patients across all domains. In memory clinics, DLB patients could be offered systematic and early IC monitoring and personalized interventions.
目的：内在能力（IC）是个体所有身体和心理能力的综合体现，此前从未在路易体痴呆（DLB）患者中进行过研究。由于IC下降与衰弱、功能衰退和残疾风险相关，且在针对性干预后可能可逆，因此对DLB患者的IC下降进行监测和特殊管理有助于促进该人群的健康老龄化。这项横断面研究的目的是描述DLB患者IC下降的频率，并将其与阿尔茨海默病（AD）患者进行比较。 设计：单中心横断面研究。 背景：本研究于2015年至2023年在一家记忆诊所基于MEMORA队列开展。 参与者：诊断为AD或可能患有DLB的患者，并进行了全面的老年综合评估。 测量方法：根据世界卫生组织模型，从四个领域评估IC：通过微型营养评定法（MNA）评估活力，通过简短体能状况量表（SPPB）评估运动能力，通过老年抑郁量表4项（GDS-4项）评估心理状态，通过听力、视力、平衡和认知（HVEC）量表评估听力。 结果：共纳入798例患者（154例可能患有DLB，644例患有AD），平均年龄为81.4岁（标准差6.33）。与AD患者相比，DLB患者在所有领域的IC受损程度均显著更高，根据校正模型，活力受损风险更大（比值比（OR）2.43，95%置信区间（CI）1.60 - 3.72）、运动能力受损风险更大（OR 3.50，95% CI 2.15 - 5.90）、心理状态受损风险更大（OR 2.60，95% CI 1.73 - 3.92）以及听力受损风险更大（OR 2.30，95% CI 1.53 - 3.49）。同样，当将IC领域视为线性变量时，DLB组所有领域的IC均显著低于AD组。 结论：本研究表明，DLB患者在所有领域的IC下降幅度均大于AD患者。在记忆诊所中，可为DLB患者提供系统的早期IC监测和个性化干预。
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