Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: beyond cognition

Joanne M Hamilton; David P Salmon; Rema Raman; Lawrence A Hansen; Eliezer Masliah; Guerry M Peavy; Douglas Galasko

doi:10.1016/j.jalz.2013.04.003

Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: beyond cognition

Alzheimers Dement. 2014 Mar;10(2):171-8. doi: 10.1016/j.jalz.2013.04.003. Epub 2013 Jul 11.

Authors

Joanne M Hamilton¹, David P Salmon², Rema Raman³, Lawrence A Hansen⁴, Eliezer Masliah⁴, Guerry M Peavy², Douglas Galasko⁵

Affiliations

¹ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA. Electronic address: jhamilton@anhsocal.com.
² Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
³ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
⁴ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Pathology, University of California, San Diego, La Jolla, CA, USA.
⁵ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Neurology Service, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA.

Abstract

Background: The relative contributions of cognitive, motor, and behavioral deficits to the impairment of physical or instrumental activities of daily living (ADLs) may differ in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).

Methods: Multiple linear regression analyses were used to identify the amount of variability in physical self-maintenance and instrumental ADL ratings predicted by cognitive, motor, and behavioral indices separately for patients with autopsy-diagnosed DLB (n = 39) or AD (n = 39).

Results: Motor dysfunction accounted for significant variance in physical ADLs in DLB (R(2) change = 0.17), whereas behavioral (R(2) change = 0.23) and motor dysfunction (R(2) change = 0.13) accounted for significant variance in AD. Motor (R(2) change = 0.32) and cognitive (R(2) change = 0.10) dysfunction accounted for significant variance in instrumental ADLs in DLB, whereas cognitive (R(2) change = 0.36) and behavioral (R(2) change = 0.12) dysfunction accounted for significant variance in AD.

Conclusions: Cognitive, motor, and behavioral deficits contribute differently to ADL changes in DLB and AD. Thus, treatments designed to ameliorate a certain aspect of AD or DLB (e.g., cognitive dysfunction) may have a larger impact on everyday functioning in one disorder than the other.

Keywords: Activities of daily living; Alzheimer's disease; Behavior; Cognition; Dementia with Lewy bodies; Motor function.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Alzheimer Disease / complications*
Behavioral Symptoms / etiology*
Cognition Disorders / diagnosis
Cognition Disorders / etiology*
Female
Humans
Lewy Body Disease / complications*
Male
Middle Aged
Movement Disorders / diagnosis
Movement Disorders / etiology*
Neuropsychological Tests
Regression Analysis

Abstract

Publication types

MeSH terms

Grants and funding