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Abstract Details

Clinical Predictors of Survival in Probable Dementia with Lewy Bodies
Aging, Dementia, and Behavioral Neurology
P13 - Poster Session 13 (8:00 AM-9:00 AM)
7-006
To determine clinical predictors of survival from cognitive symptom onset in patients with clinically probable DLB.
Previous studies have shown a shorter survival in dementia with Lewy bodies (DLB) compared with other dementias. However, clinical predictors of survival in DLB are not well-understood.
We studied 488 patients who met criteria for probable DLB during their disease course and separately analyzed 175 of these individuals who had pathologically proven DLB at autopsy. Survival was estimated from time of cognitive symptom onset to death or last follow-up, with right censoring of those lost to follow-up. Predictors of survival were assessed with Cox-Proportional Hazards Models.
Average age of cognitive symptom onset was 69.6 ± 8.4 years, with a median survival of 8.6 years from cognitive symptom onset. Older age at cognitive symptom onset (HR 1.05, 95% CI, 1.04-1.06) and the presence of visual hallucinations (HR 1.6, 95% CI, 1.2-2.2) and cognitive fluctuations (HR 1.6, 95% CI, 1.3-2.1) at or before cognitive symptom onset was associated with shorter survival; sex, years of education, parkinsonism and REM sleep behavior disorder were not associated with survival. Further, a higher number of simultaneous core features at or before onset of cognitive symptoms predicted shorter survival (HR 1.2, 95% CI, 1.1-1.4). In the pathology-proven subgroup, only older age at cognitive symptom onset (HR 1.03. 95% CI, 1.00-1.05), cognitive fluctuations (HR 1.5, 95% CI, 1.01-2.1) and total number of core features (HR 1.3, 95% CI, 1.1-1.5) were associated with shorter survival. 
Older age at cognitive symptom onset, visual hallucinations, cognitive fluctuations, and higher number of core features at the onset of cognitive symptoms in probable DLB were associated with worse prognosis.  Similar associations were seen in pathology-confirmed DLB, with one exception: visual hallucinations were no longer associated with survival.
Authors/Disclosures
Stuart J. McCarter, MD (Mayo Clinic)
PRESENTER 		The institution of Dr. McCarter has received research support from NIH. The institution of Dr. McCarter has received research support from American Academy of Sleep Medicine Foundation.
Patrick S. Brennan Mr. Brennan has stock in Immuneering Corp.
Jeremiah Aakre, MPH Mr. Aakre has nothing to disclose.
David S. Knopman, MD, FAAN (Mayo Clinic) Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
Neill R. Graff-Radford, MD, FAAN (Mayo Clinic Jacksonville) The institution of Dr. Graff-Radford has received research support from Biogen. The institution of Dr. Graff-Radford has received research support from Lilly. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Biogen. Dr. Graff-Radford has received publishing royalties from a publication relating to health care.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF. The institution of Dr. Kantarci has received research support from Eisai. The institution of Dr. Kantarci has received research support from BioArctic.
Leah K. Forsberg, PhD (Mayo Clinic) Ms. Forsberg has nothing to disclose.
Julie A. Fields, PhD (Mayo Clinic) The institution of Dr. Fields has received research support from National Institutes of Health. The institution of Dr. Fields has received research support from Patient-Centered Outcomes Research Institute.
Gregory S. Day, MD, MSc, FAAN (Mayo Clinic) Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has or had stock in ANI Pharmaceuticals. The institution of Dr. Day has received research support from National Institutes of Health / NIA. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. The institution of Dr. Day has received research support from Amgen Pharmaceuticals. The institution of Dr. Day has received research support from AVID Radiopharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with 好色先生. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing 好色先生, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Ionis Pharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a 好色先生al Case Development + Presentation (video) with PeerDirect (P\S\L Group). Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development / Presentation (non-CME) with MJH Life Sciences (NeurologyLive). Dr. Day has a non-compensated relationship as a Clinical Director with Anti-NMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities.
Rodolfo Savica, MD, PhD, FAAN (Mayo Clinic) The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.
Hugo Botha, MD (Mayo School of Graduate Medical 好色先生, Rochester) Dr. Botha has received research support from NIH. An immediate family member of Dr. Botha has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH.
David T. Jones, MD (Mayo Clinic) Dr. Jones has stock in Cephlodyne Neurotechnologies, Inc.. Dr. Jones has received intellectual property interests from a discovery or technology relating to health care.
Vijay K. Ramanan, MD, PhD (Mayo Clinic) The institution of Dr. Ramanan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daridorexant trial for AD prevention (funded by Weston Family Foundation). The institution of Dr. Ramanan has received research support from the National Institutes of Health. The institution of Dr. Ramanan has received research support from the Mangurian Foundation for Lewy Body Disease Research. The institution of Dr. Ramanan has received research support from as part of clinical trials sponsored by the Alzheimer's Association, Eisai, the Alzheimer's Treatment and Research Institute at USC, and Transposon Therapeutics, Inc.. The institution of Dr. Ramanan has received research support from Medscape. The institution of Dr. Ramanan has received research support from Expert Perspectives in Medicine. The institution of Dr. Ramanan has received research support from Roche/ADLM. The institution of Dr. Ramanan has received research support from American College of Radiology. Dr. Ramanan has received personal compensation in the range of $500-$4,999 for serving as a Conference Speaker/Organizer (Honoraria) with AANI. Dr. Ramanan has received personal compensation in the range of $500-$4,999 for serving as a Speaker/CME Content with Clinical Care Options.
Christian Lachner Christian Lachner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PeerView. Christian Lachner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PSL Group Services.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.
Dennis W. Dickson, MD (Mayo Clinic) Dr. Dickson has nothing to disclose.
Ross Reichard Ross Reichard has nothing to disclose.
Bradley F. Boeve, MD, FAAN (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
Tanis J. Ferman, PhD (Mayo Clinic Jacksonville) Ms. Ferman has nothing to disclose.
Jonathan Graff-Radford, MD, FAAN Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Open evidence . The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as a Faculty Member with IMPACT AD .