Abstract：
BACKGROUND: Geriatric symptoms are common in dementia cases, while few studies have focused on these symptoms in Lewy body dementia (LBD). The purpose of this study is to investigate the distributions of Apolipoprotein E (APOE) ε4 and geriatric symptoms, and explore their associaitons in Dementia with Lewy bodies (DLB) and Parkinson\'s disease dementia (PDD).
METHODS: A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4.
RESULTS: DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082-11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079-8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups.
CONCLUSIONS: The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.
METHODS: A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4.
RESULTS: DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082-11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079-8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups.
CONCLUSIONS: The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.
摘要：
背景：老年病症状在痴呆病例中很常见，虽然很少有研究关注路易体痴呆（LBD）的这些症状。这项研究的目的是调查载脂蛋白E（APOE）ε4的分布和老年症状，并探讨它们在路易体痴呆（DLB）和帕金森病痴呆（PDD）中的关联。
方法：对185例轻-中度可能的DLB（n=93）和PDD（n=92）患者进行回顾性研究。人口统计学和临床特征，神经心理学评估，并记录APOE基因型。Description,使用相关和逻辑回归模型分析老年症状主诉的存在及其与APOEε4的关联。
结果：DLB患者表现出更多的波动认知频率，视觉幻觉,快速眼动睡眠行为障碍，妄想,抑郁症,焦虑,冷漠,食欲不振,而PDD病例有便秘，害怕跌倒，失眠更频繁。APOEε4等位基因在DLB中比PDD更常见(29.9%vs.7.0%,p<0.001)，与PDDAPOEε4（）相比，DLBAPOEε4（）患者的妄想（p=0.005）和冷漠（p=0.007）更多。我们还发现APOEε4等位基因与多汗症(OR=3.472,95CI:1.082-11.144,p=0.036)和抑郁(OR=3.002,95CI:1.079-8.353,p=0.035)显著相关,虽然APOEε4等位基因与就诊年龄之间没有显着关联，发病年龄，MDS-UPDRSIII的分数，H&Y舞台,ADL,MMSE,MOCA和NPI,以及波动认知的存在，VH,两组的帕金森病和RBD。
结论：在轻度-中度LBD患者中，老年症状的存在和共同发生是常见的。APOEε4等位基因的存在与多汗症和抑郁症有关，但不是全球认知，日常生活的活动，DLB的运动功能和其他神经精神症状。这些发现提高了人们对老年症状的认识，并有助于轻-中度DLB和PDD的医疗管理。
方法：对185例轻-中度可能的DLB（n=93）和PDD（n=92）患者进行回顾性研究。人口统计学和临床特征，神经心理学评估，并记录APOE基因型。Description,使用相关和逻辑回归模型分析老年症状主诉的存在及其与APOEε4的关联。
结果：DLB患者表现出更多的波动认知频率，视觉幻觉,快速眼动睡眠行为障碍，妄想,抑郁症,焦虑,冷漠,食欲不振,而PDD病例有便秘，害怕跌倒，失眠更频繁。APOEε4等位基因在DLB中比PDD更常见(29.9%vs.7.0%,p<0.001)，与PDDAPOEε4（）相比，DLBAPOEε4（）患者的妄想（p=0.005）和冷漠（p=0.007）更多。我们还发现APOEε4等位基因与多汗症(OR=3.472,95CI:1.082-11.144,p=0.036)和抑郁(OR=3.002,95CI:1.079-8.353,p=0.035)显著相关,虽然APOEε4等位基因与就诊年龄之间没有显着关联，发病年龄，MDS-UPDRSIII的分数，H&Y舞台,ADL,MMSE,MOCA和NPI,以及波动认知的存在，VH,两组的帕金森病和RBD。
结论：在轻度-中度LBD患者中，老年症状的存在和共同发生是常见的。APOEε4等位基因的存在与多汗症和抑郁症有关，但不是全球认知，日常生活的活动，DLB的运动功能和其他神经精神症状。这些发现提高了人们对老年症状的认识，并有助于轻-中度DLB和PDD的医疗管理。
