Longitudinal motor decline in dementia with Lewy bodies and Parkinson’s disease dementia in a community autopsy cohort

Abstract Background Although parkinsonism is a core feature of Parkinson’s Disease Dementia (PDD) and with Lewy bodies (DLB), its evolution less delineated. We aimed to assess differences in severity progression parkinsonian motor symptoms signs community autopsy cohort clinicopathologic diagnosis DLB, PDD or Alzheimer’s (AD). Method Data included were from 194 participants the Arizona study Aging Neurodegenerative Disorders DLB (n=48), (n=98) (±AD co‐pathology) pure AD at least two movement exams performed by disorders subspecialists who classified PD according MDS‐UPDRS criteria. was subgrouped presence absence final exam (DLB+Park DLB–Park). Between group trajectory UPDRS‐II UPDRS‐III scores explored using piecewise‐linear non‐linear MMRM multivariate analysis. Result Over 1435 participant‐years longitudinal data analyses (Figure 1). Mean±SD age baseline death 76.0±7.5 83.4±6.8 years, respectively. At baseline, most did not have dementia substantial abnormalities (except PDD). (73.9%) (69.2%) groups had more males than (33.3%). Parkinsonism present 65.6% last exam. Piecewise‐linear analysis showed highest (p<0.001) for (mean±SE: 14.3±0.78 27.4±1.64), followed DLB+Park (5.0±1.05 17.4±3.10), DLB‐Park (3.7±2.54 3.8±1.35) (3.2±0.88 8.0±1.94). Annual rate increase greatest (1.44±0.20) (1.04±0.08), (0.89±0.18) (0.30±0.11). (2.12±0.20 vs 2.64±0.42), (1.31 ± 0.38 0.64 0.22). Preliminary models 2) further supported between group/subgroup trajectories, DLB‐Park. Conclusion These preliminary results large, well‐characterized clinicopathological community‐based support that experience comparable, greater, PDD. Future modeling/sensitivity will better delineate expected trajectories add prognostication value clinic design clinical trials.