Congratulations to Drs. Melissa Armstrong, Erin Monari, Leonardo Almeida, Nikolaus McFarland, Irene Malaty, and Michael Okun, on the publication of “Initial Patterns and Correlates of Quality of Life in Dementia with Lewy Bodies.”
April 5, 2016 vol. 86 no. 16 Supplement P6.234.Neurology
Objective: To identify patterns and correlates of quality of life (QoL) in Dementia with Lewy Bodies (DLB) at initial movement disorders center encounters.
Background: Few published studies investigate contributions to QoL in DLB. Methods: We enrolled DLB patients participating in the UF-INFORM database. Baseline demographics and disease-related measures at initial encounter were analyzed. Correlations were assessed between QoL (PDQ-39) and motor function (UPDRS-III), ability to complete ADLs (UPDRS ADL total), depression (BDI), anxiety (STAI-trait), apathy (AS), and cognition (MMSE). Missing data was handled by reporting the “n” for each analysis. Results: The cohort included 64 DLB patients (67[percnt] male, mean age 71.9, SD 6.6). Baseline characteristics included MMSE (mean 18.9, SD 7.5, n=29), “off” UPDRS-III (mean 41.7, SD 14.3, n=33), “on” UPDRS-III (mean 37.2, SD 11.1, n=18), UPDRS ADL subscale (mean 18.0, SD 7.1, n=49), BDI (mean 16.1, SD 8.9, n=64), STAI-trait (mean 45.4, SD 12.8, n=16) and AS (mean 19.5, SD 7.0, n=32). Mobility was the most impaired PDQ domain (mean 69.1, SD 28.2), followed by ADL (mean 53.2, SD 32.0), cognition (mean 51.3, SD 28.7), communication (mean 40.1, SD 27.8), emotional well-being (mean 39.0, SD 24.1), bodily discomfort (mean 34.8, SD 23.1), stigma (mean 25.0, SD 23.3) and social support (mean 15.2, SD 19.2) (>50 patients for all subdomains). QoL correlated most strongly with depression (r=0.77, p<0.01), apathy (r=0.69, p<0.01), ability to perform ADLs (r=0.67, p<0.01), anxiety (r=0.60, p=0.02), and cognition (r=0.55, p<0.01). It correlated less strongly with total “off” UPDRS-III (r=0.45, p<0.01) and did not correlate with total “on” UPDRS-III (r=0.04, p=0.89) or age (r=0.126, p=0.37). Conclusions: While mobility is the most impaired PDQ domain, QoL has stronger correlations with neuropsychiatric/behavioral features than motor function in DLB, consistent with descriptions in other parkinsonisms. These findings support an increasing focus on addressing neurobehavioral symptoms in DLB.