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路易体痴呆的风险因素和预测因素:一项系统综述。

Risk factors and predictors for Lewy body dementia: a systematic review.

作者信息

Ratnavel Ahalya, Dino Francesca R, Jiang Celina, Azmy Sarah, Wyman-Chick Kathryn A, Bayram Ece

机构信息

Department of Molecular, Cellular, and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA USA.

Department of Neurology, University of Colorado Anschutz, Aurora, CO USA.

出版信息

NPJ Dement. 2025;1(1):20. doi: 10.1038/s44400-025-00022-2. Epub 2025 Aug 4.

Abstract

Lewy body dementia (LBD), including Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), is a common and burdensome dementia. Determining risk factors and predictors can provide insights into pathogenesis and guide treatment efforts. In this systematic review, we searched PubMed, Embase, and Web of Science for longitudinal studies assessing risk/prodromal factors; including participants without dementia at baseline; with LBD as the outcome; with good/high quality based on the Newcastle-Ottawa Quality Assessment Scale. Across 167 included studies, more consistently reported factors were older age, male sex, , , changes in cognition, mood, behavior, sleep, gait/posture, speech, parkinsonism, smell loss, autonomic dysfunction, white matter disease on MRI, lower CSF amyloid β42 and higher CSF/blood neurofilament light chain. The majority focused on clinical factors preceding PDD with cohorts from North America and Europe, limiting generalizability. Further efforts with more representative cohorts are needed to better identify people at risk for LBD.

摘要

路易体痴呆(LBD),包括帕金森病痴呆(PDD)和路易体痴呆(DLB),是一种常见且负担沉重的痴呆症。确定风险因素和预测指标有助于深入了解发病机制并指导治疗工作。在这项系统评价中,我们检索了PubMed、Embase和科学网,以查找评估风险/前驱因素的纵向研究;包括基线时无痴呆的参与者;以LBD为结局;根据纽卡斯尔-渥太华质量评估量表评定为高质量。在纳入的167项研究中,更一致报告的因素有年龄较大、男性、认知、情绪、行为、睡眠、步态/姿势、言语、帕金森症、嗅觉丧失、自主神经功能障碍、MRI显示的白质病变、脑脊液淀粉样β42降低以及脑脊液/血液神经丝轻链升高。大多数研究聚焦于来自北美和欧洲队列的PDD之前的临床因素,限制了普遍性。需要通过更具代表性的队列做进一步努力,以更好地识别LBD风险人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82bc/12321581/7af055122a8b/44400_2025_22_Fig1_HTML.jpg

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