Abstract Details

Title Cognitive correlates of ADL impairment in Lewy body dementia

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-005

Objective Investigate the relationship between cognition and activities of daily living (ADLs) in Lewy body dementia (LBD).

Background Understanding the specific cognitive domains associated with ADL impairment in LBD may help identify patients who require additional support and who would benefit from targeted therapeutic interventions.

Design/Methods We analyzed neuropsychological test data for 207 LBD patients (including dementia with Lewy bodies (n=48) and Parkinson disease dementia (n=159)) in a clinical neuropsychological registry. All patients were evaluated for impairment in 8 ADLs. Patients were categorized as having either mild (<6 ADLs impaired), moderate (6 or 7 ADLs impaired), or severe (all 8 ADLs impaired). Neuropsychological test scores were compared between the ADL impairment groups using one-way ANOVA or Kruskal-Wallis H tests as appropriate.

Results Neuropsychological test performances differed significantly between the three groups (mild, moderate, and severe ADL impairment, respectively) on tests of global cognition [DRS-2 total scaled score: 5.5 (IQR=3-8) vs 6 (IQR=3-8) vs 3.5 (IQR=2-5), p=.0021]; speeded visuospatial processing [Trailmaking Part A T-score: 31 (IQR=19-40) vs 29 (IQR=21-36.5) vs 22 (IQR=18-29), p=.0012)]; speeded executive functioning [Trailmaking Part B T-score: 27 (IQR=16-34) vs 22 (IQR=18-39) vs 19 (IQR=16-23), p=.0057)]; and psychomotor processing speed [composite z-score: -1.9 (SD=1.1) vs -1.8 (SD=1.1) vs -2.9 (SD=1.2), p<.0001)]. Post-hoc comparisons revealed that the severely impaired ADL group performed significantly worse on these measures than the other ADL groups (p<.05). Impairments in driving and self-care were associated with worse performances on Trailmaking Part A, Trailmaking Part B, and psychomotor processing speed compared to patients without impairment in those activities (p<.05).

Conclusions

Among patients with LBD, impairments in speeded tasks of visual processing and executive functioning are associated with impairment in ADLs, particularly driving and self-care. Processing speed performance may be useful in predicting limitations in ADLs in LBD.

Authors/Disclosures
Nidhi Desai PRESENTER	Miss Desai has nothing to disclose.
	No disclosure on file
Nitai Mukhopadhyay (Virginia Commonwealth University)	Nitai Mukhopadhyay has nothing to disclose.
Kathryn Wyman-Chick, Psyd (HealthPartners Neuroscience Center/Neuropsychology)	Dr. Wyman-Chick has received research support from NIH/NIA.
Sarah Lageman (Virginia Commonwealth University)	Sarah Lageman has received personal compensation in the range of $0-$499 for serving as a Content Validator of online materials with CurePSP.
Matthew J. Barrett, MD, FAAN (Virginia Commonwealth University)	The institution of Dr. Barrett has received research support from Kyowa Kirin. The institution of Dr. Barrett has received research support from NIH.

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