• Yat-Fung Shea, Shui-Ching Lee, Alex Chun Keung Shum, Patrick Ka-Chun Chiu, Leung-Wing Chu, and Hon Wai Felix Chan.
• Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
• Singap Med J. 2020 Oct 1; 61 (10): 551-558.

IntroductionAlzheimer's disease (AD) and Lewy body dementia (LBD) are two common forms of dementia. There are still controversies regarding whether LBD patients have a worse clinical course than AD patients.MethodsWe retrospectively reviewed all biomarkers that supported AD and LBD patients presenting to the Memory Clinic of Queen Mary Hospital, Hong Kong, between 1 January 2008 and 30 December 2016. Diagnoses of AD and LBD were supported by clinical diagnostic criteria and biomarkers. LBD patients included those with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Baseline demographics, presenting clinical features, degree of cognitive impairment and specified clinical outcomes were compared.ResultsWe recruited 31 AD and 25 LBD patients (18 DLB, 7 PDD). When measured from disease onset, LBD patients were noted to have shorter overall survival (p = 0.02) with earlier occurrence of falls (p < 0.001), dysphagia (p < 0.001), pneumonia (p = 0.01), pressure injuries (p = 0.003) and institutionalisation (p = 0.03) than AD patients. Cox regression analyses showed that LBD predicted falls (hazard ratio [HR] 5.86, 95% confidence interval [CI] 2.29-15.01, p < 0.001), dysphagia (HR 10.06, 95% CI 2.50-40.44, p = 0.001), pressure injuries (HR 17.39, 95% CI 1.51-200.10, p = 0.02), institutionalisation (HR 2.72, 95% CI 1.12-6.60, p = 0.03) and death (HR 2.96, 95% CI 1.18-7.42, p = 0.02).ConclusionLBD patients had shorter overall survival with earlier occurrence of pre-specified long-term events compared with AD patients. LBD also independently predicted pre-specified long-term events.Copyright: © Singapore Medical Association.

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