Background: Community-wide screening is not yet feasible to detect early cases of dementia or Parkinson's and as such current approaches need to focus on enriched cohorts. One potential population is those older adults who seek advice with Mild Cognitive Impairment (MCI), which represents an “at risk” state for Dementia. In addition, recent work has highlighted that the presence of Rapid Eye Movement sleep behavior disorder (RBD) where people act out their dreams is strong pre-clinical marker for DLB and Parkinson's. Indeed, the emergence of RBD increases the risk of developing these conditions by 140 fold. This study sought to explore the presence of RBD in people with memory concerns.
Methods: One hundred and forty-three consecutive community-dwelling volunteers with memory complaints underwent a comprehensive neuropsychological assessment and completed the RBD Questionnaire and the Geriatric Depression Scale.
Results: Of the 143 participants the presence of RBD was self-reported in 34 (24%) participants and MCI was confirmed in 24 (71%) of these RBD positive patients. Those with RBD were significantly more likely to have non-amnestic MCI (62%) than controls (29%) or amnestic MCI subjects (9%) (χ2 = 0.005). Finally, a higher level of depressive symptoms was observed in RBD positive cases compared to those not reporting this symptom (p = 0.042).
Conclusions: Results from the present study suggest that MCI patients with RBD were more likely to exhibit non-amnestic MCI rather than an amnestic phenotype, which was also associated with depressive symptoms. Such a cognitive and psychiatric profile is in keeping with patients who are ultimately diagnosed with DLB or Parkinson's and suggest that targeting such patients with additional biomarker testing (smell, colour vision and transcranial ultrasonography) may help predict these diseases at an early point allowing future disease modifying treatments to be used with greater benefits.
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We are currently performing detailed assessments and longitudinal follow up of these people who are at risk of developing DLB and Parkinson's. We are also collaborating internationally with the Dementia with Lewy Bodies Consortium and the International RBD Study Group.
Simon Lewis is an NHMRC-ARC Dementia Fellow who works as a Consultant Neurologist at the Royal Prince Alfred Hospital and is Professor of Cognitive Neuroscience at the University of Sydney. He is ...
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