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Abstract Details

White Matter Hyperintensities Relate to Activities of Daily Living More Strongly in Dementia with Lewy Bodies than in Alzheimer’s disease-The Sunnybrook Dementia Study
Aging, Dementia, and Behavioral Neurology
P3 - Poster Session 3 (12:00 PM-1:00 PM)
10-008

We investigated if WMHs differentially associate with, and/or predict activities of daily living (ADLs) in patients with Alzheimer’s Disease (AD) or Dementia with Lewy Bodies (DLB).

Loss of functional independence is a common feature across all dementia diagnoses, including AD and DLB—the two most common neurodegenerative dementias. White matter hyperintensities (WMHs) on T2-weighted MRI are prevalent in both diagnoses, and also associate with disability, but this association has mostly been studied in AD. We investigated if WMHs differentially associate with, and/or predict ADLs in patients with AD or DLB

We examined if WMHs are associated with Basic and/or Instrumental ADLs (BADL and IADL) cross-sectionally in 263 patients (AD=214; DLB=49), and longitudinally in 154 patients (AD=129; DLB=25) over ~1.5 years, using multiple linear regression models. All patients underwent volumetric MRI, ADL and neuropsychiatric assessment. Total WMH volumes were quantified by semiautomatic segmentation and ADLs assessed using the Disability Assessment for Dementia scale. We also tested which ADL components, i.e. planning, initiation, or effective performance drive the associations.

Compared to AD, DLB patients were younger, had better MMSE and lower WMH volume, but higher neuropsychiatric symptoms and disability at baseline. In AD, WMHs did not associate with or predict disability on BADL or IADL. In DLB, higher WMH volume was associated with a significant decline in both BADL (decline per SD(β):-13.88, 95% CI: -26.48, -1.29) and IADL (decline per SD(β):-15.13, 95% CI: -27.02, -3.25) over time. In DLB, association of WMHs with BADL was driven by disability in planning and effective performance whereas that for IADL was driven by disability in planning.
Despite the lower burden of WMHs in DLB than AD, WMHs more strongly predicted ADLs in DLB. WMHs might interact with DLB pathology differently than with AD pathology consequently influencing functional performance.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
Donald Stuss No disclosure on file
Sandra E. Black, MD, FAAN (Sunnybrook Health Science Center) Dr. Black has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Hoffmann-La Roche. Dr. Black has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Black has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffmann-La Roche. Dr. Black has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Black has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai Limited . Dr. Black has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Black has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Black has received research support from Hoffmann-La Roche. The institution of Dr. Black has received research support from Biogen. The institution of Dr. Black has received research support from GE Healthcare. The institution of Dr. Black has received research support from Eli Lilly. The institution of Dr. Black has received research support from Genentech. The institution of Dr. Black has received research support from NovoNordisk. The institution of Dr. Black has received research support from UCB Biopharma. The institution of Dr. Black has received research support from Alkahest Inc. The institution of Dr. Black has received research support from University of Southern California - AHEAD 3-45 Study.
Mario Masellis, MD (Sunnybrook Health Sciences Centre) Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arkuda Therapeutics. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alector. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wave Life Sciences. The institution of Dr. Masellis has received research support from Canadian Institutes of Health Research. The institution of Dr. Masellis has received research support from Ontario Brain Institute. The institution of Dr. Masellis has received research support from Weston Brain Institute. The institution of Dr. Masellis has received research support from Washington University. The institution of Dr. Masellis has received research support from Alector. Dr. Masellis has received publishing royalties from a publication relating to health care.