Aims
Neuropsychiatric symptoms are a prominent feature of dementia with Lewy bodies (DLB). Visual hallucinations are well described and part of the clinical diagnostic criteria. However, there are limited data on the prevalence and significance of other neuropsychiatric symptoms in DLB, particularly within an Australian context. We aimed to describe neuropsychiatric symptoms and their clinical associations in an Australian DLB cohort.
Methods
Individuals with DLB and their caregivers underwent clinical, cognitive and neuropsychiatric assessments. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory (NPI). Median regression was used to estimate the association between neuropsychiatric symptoms and dementia severity (CDR), cognition (MMSE), function (Bristol ADL), quality of life (Dementia QOL), caregiver quality of life (Euroqol 5D) and caregiving burden (Zarit Burden Interview).
Results
Fifty participants (44 male, age 73.8 ± 5.6 years, median MMSE 26 (IQR 23 - 27)) were included. Neuropsychiatric symptoms were present in 48 participants, median NPI score 15 (IQR 5.5 – 29.5). Affective symptoms were most common (apathy 70%, anxiety 56%, depression 54%) followed by sleep disorders (48%). Total NPI score was associated with dementia severity (β = 0.03, 95%CI 0.003–0.06, p = 0.03), functional impairment (β = 0.18, 95%CI 0.04–0.31, p = 0.01), quality of life (β = -0.3, 95%CI -0.57– -0.02, p = 0.04) and caregiving burden (β = 0.33, 95%CI 0.07–0.59, p = 0.01).
Conclusion
Neuropsychiatric symptoms, particularly affective and sleep symptoms, are common in DLB and associated with important clinical outcomes. Careful assessment of these symptoms is essential in the management of DLB.