COGNITIVE PROFILES OF AUTOPSY-CONFIRMED LEWY BODY VARIANT VS PURE ALZHEIMER-DISEASE

Objective: To compare the cognitive profiles of patients with autopsy- confirmed Alzheimer disease (AD), with or without concomitant Levy bod ies, on 2 dementia screening measures. Methods: Profiles on subtests o f the Mattis Dementia Rating Scale (range, 105-125) and of component i tems of the Mini-Mental State Examination were compared between 23 pat ients with uncomplicated AD and 23 patients with concomitant AD and Le wy body pathology (Lewy body variant [LBV]). Results: Although the gro ups did not differ significantly regarding age, years of education, to tal Mini-Mental State Er;amination score, or total Mattis Dementia Rat ing Scale score, the AD group performed significantly worse than the L BV group on the Mattis Dementia Rating Scale Memory subscale (P<.0.05) . In contrast, the LBV group demonstrated poorer performance than the pure AD group on the Initiation/Perseveration subscale (P<.02). The gr oups did not differ significantly on the Attention, Construction or Co nceptualization subscales. The same overall pattern of results was obt ained when subgroups with mild to moderate and moderate to severe deme ntia were examined separately, with the additional finding that in the mild-to-moderate range patients with dementia and IBV performed worse than patients with pure AD on the Construction subscale. Conclusions: Tthe difference in pattern of cognitive deficits among patients with pure AD vs those with AD and LBV is similar to that seen between AD an d more subcortical/frontal dementias leg, Huntington disease) This sug gests that the concomitant Lewy body pathology significantly contribut es to the presentation of the cognitive dysfunction in individuals wit h LBV.