Demencja ciałek lewy’ego
Rokowania, prognozy i postęp choroby

Demencja ciałek Lewy’ego (LBD) stanowi drugą najczęstszą neurodegeneracyjną demencję, charakteryzującą się postępującym spadkiem funkcji poznawczych, krótszym średnim czasem przeżycia wynoszącym około 4,1 lat od diagnozy (zakres 5-8 lat) oraz wyższym ryzykiem hospitalizacji i instytucjonalizacji w porównaniu z chorobą Alzheimera. Rokowanie jest mniej korzystne, zwłaszcza przy wczesnym wystąpieniu halucynacji wzrokowych, zaburzeń chodu i zmienności funkcji poznawczych. Patologia ciałek Lewy’ego niezależnie przyspiesza spadek funkcji globalnych, uwagi, pamięci i funkcji wzrokowo-przestrzennych, a obecność allelu APOE lub współistnienie patologii choroby Alzheimera pogarsza przebieg. Najczęstsze przyczyny zgonu to wyniszczenie organizmu, zachłystowe zapalenie płuc, choroby sercowo-naczyniowe oraz sepsa. Wczesne planowanie opieki i włączenie opieki paliatywnej są kluczowe, zważywszy na trudności diagnostyczne i zmienność przebiegu choroby.

  1. Rokowanie w demencji ciałek Lewy’ego – przegląd ogólny
    1. Zmienność w rokowaniu
  2. Czynniki wpływające na rokowanie
    1. Czynniki kliniczne
    2. Współchorobowość
  3. Oczekiwana długość życia
  4. Jakość życia i obciążenie opiekunów
  5. Planowanie opieki medycznej
  6. Specyfika leczenia a rokowanie
  7. Trudności diagnostyczne a rokowanie
    1. Kolejne rozdziały

Rokowanie w demencji ciałek Lewy’ego – przegląd ogólny

Demencja ciałek Lewy’ego (Lewy body dementia, LBD) jest drugą najczęstszą formą demencji neurodegeneracyjnej, jednak dostępne są ograniczone dane dotyczące jej rokowania i przebiegu naturalnego, które mają kluczowe znaczenie dla praktyki klinicznej i badań naukowych. Pacjenci z demencją ciałek Lewy’ego mogą mieć mniej korzystne rokowanie, z przyspieszonym spadkiem funkcji poznawczych, krótszym czasem przeżycia oraz zwiększonym ryzykiem umieszczenia w ośrodkach opieki w porównaniu z pacjentami z chorobą Alzheimera.1

Demencja ciałek Lewy’ego jest chorobą postępującą, co oznacza, że objawy zaczynają się powoli i pogarszają się z czasem. Rokowanie w przypadku LBD jest ogólnie określane jako dość niekorzystne ze względu na postępujący charakter choroby.2 Co istotne, koszty opieki zdrowotnej, a także obciążenie opiekunów są wyższe w przypadku demencji ciałek Lewy’ego niż w chorobie Alzheimera.3

Zmienność w rokowaniu

Przebieg demencji ciałek Lewy’ego może być różny dla każdej osoby i może zależeć od ogólnego stanu zdrowia pacjenta lub współistniejących chorób. Ponieważ LBD postępuje w różnym tempie u poszczególnych osób, nie jest możliwe dokładne określenie, jak długo dana osoba może żyć z tą chorobą.4 Badania sugerują, że większość osób żyje od 5 do 8 lat od momentu diagnozy LBD.5

Istnieje duża zmienność w czasie przeżycia, gdyż demencja ciałek Lewy’ego może postępować szybko lub wolno.6 Średni czas przeżycia po diagnozie wynosi około 4,1 lat, co wskazuje, że przeżycie w LBD jest o 1,6 roku krótsze niż po diagnozie choroby Alzheimera.7 Przegląd z 2017 roku wykazał, że przeżycie od początku choroby wynosi między 5,5 a 7,7 roku, a przeżycie od diagnozy między 1,9 a 6,3 roku.8

Czynniki wpływające na rokowanie

Czynniki kliniczne

Krótszy czas przeżycia jest bardziej prawdopodobny, gdy we wczesnej fazie choroby występują halucynacje wzrokowe, nieprawidłowy chód i zmienne funkcje poznawcze.9 W badaniach wykazano, że patologia ciałek Lewy’ego jest związana z szybszym spadkiem wszystkich badanych funkcji poznawczych, niezależnie od patologii amyloidu-β i tau, stadium poznawczego oraz wyjściowej diagnozy demencji z ciałkami Lewy’ego/choroby Parkinsona.10

Patologia ciałek Lewy’ego ma również niezależny wpływ na szybszy spadek funkcji globalnych, uwagi/wykonawczych, pamięci i funkcji wzrokowo-przestrzennych w czasie.11 Spadek może być szybszy, gdy obecny jest gen APOE lub gdy występuje również choroba Alzheimera lub jej biomarkery.12

Współchorobowość

Upadki spowodowane wieloma czynnikami, w tym parkinsonizmem, dysautonomią i kruchością, zwiększają chorobowość i śmiertelność.13 W późnej fazie choroby osoby mogą być niezdolne do samodzielnej opieki.14 Zwiększona częstość hospitalizacji w porównaniu z chorobą Alzheimera jest najczęściej związana z halucynacjami i dezorientacją, a następnie z upadkami i infekcjami.15

Do najczęstszych przyczyn zgonu wśród osób z demencją ciałek Lewy’ego należą:

  • Wyniszczenie organizmu (failure to thrive)16
  • Zachłystowe zapalenie płuc, powikłanie dysfagii (trudności w połykaniu) wynikające z dysautonomii17
  • Choroby układu sercowo-naczyniowego18
  • Sepsa19

Oczekiwana długość życia

Średnia oczekiwana długość życia po diagnozie demencji ciałek Lewy’ego wynosi około 5-8 lat, ale może wynosić nawet 20 lat.2021 Według Narodowego Instytutu Starzenia się i Narodowej Biblioteki Medycznej (NLM), średni czas od diagnozy do śmierci u osób z LBD wynosi od 5 do 7 lat.22

Osoby z 3 i 4 stopniem progresji LBD mają zazwyczaj krótszą oczekiwaną długość życia niż osoby w innych stadiach.23 Krótka średnia oczekiwana długość życia może być spowodowana brakiem wiedzy na temat LBD wśród pracowników służby zdrowia i populacji oraz trudnościami w odróżnieniu jej od innych podobnych schorzeń. Często prowadzi to do opóźnienia diagnozy, co opóźnia rozpoczęcie odpowiedniej terapii.24

Warto zauważyć, że przeżycie można definiować od momentu wystąpienia choroby lub od momentu diagnozy.25 Różnica w przeżyciu między chorobą Alzheimera a demencją ciałek Lewy’ego może wynikać z faktu, że LBD jest trudniejsza do zdiagnozowania i może być diagnozowana później w przebiegu choroby.26

Jakość życia i obciążenie opiekunów

W porównaniu z chorobą Alzheimera i innymi demencjami, demencja ciałek Lewy’ego prowadzi generalnie do wyższych wskaźników niepełnosprawności, hospitalizacji i instytucjonalizacji, a także niższej oczekiwanej długości życia i jakości życia, przy zwiększonych kosztach opieki.27

Występuje więcej objawów neuropsychiatrycznych w LBD niż w chorobie Alzheimera, a mogą one pojawić się wcześniej, więc osoby z LBD mogą mieć mniej korzystne rokowanie, z szybszym pogorszeniem funkcji poznawczych, częstszym umieszczaniem w ośrodkach opieki oraz krótszą oczekiwaną długością życia.28

Prawdopodobnie czynnikami przyczyniającymi się do tego mniej korzystnego rokowania są zwiększona częstość występowania i wczesne pojawienie się objawów neuropsychiatrycznych u pacjentów z demencją ciałek Lewy’ego oraz trudności z dokładną diagnozą.29

Planowanie opieki medycznej

Badania pokazują, jak ważne jest, aby lekarze inicjowali rozmowy na temat planowania opieki we wczesnych stadiach demencji ciałek Lewy’ego. Konieczne są również badania informujące klinicystów o tym, kiedy może zbliżać się koniec życia, takie jak badanie PACE-DLB (Predicting ACcurately End-of-Life in Dementia with Lewy Bodies and Promoting Quality End-of-Life Experiences).30

Badania wykazały, że lekarze często nie poruszają tematów związanych z końcem życia. Jeśli masz pytania na ten temat, upewnij się, że je zadasz.31 Chociaż usługi hospicyjne w Stanach Zjednoczonych są przeznaczone do wspierania ostatnich 6 miesięcy życia, opieka paliatywna jest odpowiednia na każdym etapie LBD. Opieka paliatywna to specjalistyczna opieka medyczna, która koncentruje się na jakości życia osób z poważnymi chorobami i ich rodzin.32

Specyfika leczenia a rokowanie

Demencja ciałek Lewy’ego korzystnie reaguje na inhibitory acetylocholinesterazy, nawet bardziej niż choroba Alzheimera.33 W przeciwieństwie do choroby Parkinsona, demencja ciałek Lewy’ego słabiej reaguje na L-dopę i może również powodować ciężkie reakcje nadwrażliwości na leki neuroleptyczne, takie jak sztywność, zmniejszenie świadomości, gorączka, upadki, hipotensja ortostatyczna i zapaść.34

Badania wykazały, że status patologii ciałek Lewy’ego zapewnia lepsze podejście do medycyny precyzyjnej w przewidywaniu trajektorii klinicznych, niezależnie od biomarkerów choroby Alzheimera i diagnozy klinicznej, co może mieć implikacje dla postępowania klinicznego w zaburzeniach poznawczych i projektowania badań leków na chorobę Alzheimera i demencję ciałek Lewy’ego.35

Analiza patologii ciałek Lewy’ego in vivo może zapewnić lepsze podejście do medycyny precyzyjnej w postępowaniu klinicznym u pacjentów z zaburzeniami poznawczymi oraz w projektowaniu badań leków u uczestników z chorobą Alzheimera i demencją z ciałkami Lewy’ego.36

Trudności diagnostyczne a rokowanie

Trajektoria pogorszenia poznawczego w demencji ciałek Lewy’ego jest trudna do ustalenia ze względu na wysoki wskaźnik przegapionych diagnoz; typowe opóźnienie w diagnozie LBD wynoszące rok w USA i 1,2 roku w Wielkiej Brytanii oznacza, że często brakuje punktu odniesienia, od którego można mierzyć pogorszenie.37

W porównaniu z lepiej zbadaną chorobą Alzheimera, uważa się, że pamięć utrzymuje się dłużej, podczas gdy płynność werbalna może być tracona szybciej, ale najczęściej stosowane narzędzia oceny funkcji poznawczych mogą pomijać najczęstsze deficyty poznawcze w LBD, a potrzebne są lepsze badania.38

Obecność zarówno patologii choroby Alzheimera, jak i ciałek Lewy’ego (AD+/LB+) wydaje się trudniejsza do klinicznej identyfikacji, ponieważ tylko 9% osób w tej grupie spełniało kryteria LBD/PD na początku badania (16% podczas obserwacji) w porównaniu z 31% (46% podczas obserwacji) w grupie AD-/LB+.39

Badania podkreślają potencjalną korzyść z włączenia biomarkera ciałek Lewy’ego do oceny klinicznej pacjenta z zaburzeniami poznawczymi, co ma istotne implikacje diagnostyczne i prognostyczne.40

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 11.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 The prognosis of dementia with Lewy bodies – PubMed
    https://pubmed.ncbi.nlm.nih.gov/28342649/
    Dementia with Lewy bodies is the second most common form of neurodegenerative dementia, yet scarce evidence is available about its prognosis and natural history, which are crucial to inform clinical practice and research. […] Patients with dementia with Lewy bodies might have a less favourable prognosis, with accelerated cognitive decline, shorter lifespan, and increased admission to residential care than patients with Alzheimer’s disease. […] Health-care costs and, importantly, caregiver burden, are also reported to be higher in dementia with Lewy bodies than in Alzheimer’s disease. […] It is probable that causative factors for this less favourable prognosis are the increased prevalence and early emergence of neuropsychiatric symptoms in patients with dementia with Lewy bodies, and the challenge of accurate diagnosis.
  • #2 Lewy Body Dementia (LBD): What It Is, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17815-lewy-body-dementia
    Lewy body dementia is a progressive disease, meaning symptoms start slowly and get worse over time. […] The prognosis (outlook) of LBD is generally fair to poor because it gets worse over time. […] Each persons experience with Lewy body dementia (LBD) is unique to them. How slowly or quickly the disease progresses is impossible to know, but may be influenced by your general health and any existing conditions you may have. […] The average life expectancy of Lewy body dementia is five to eight years after the initial diagnosis. But some people with LBD live up to 20 years after their diagnosis. […] This short average life expectancy could be due to a lack of knowledge regarding LBD among healthcare providers and the population and difficulty in distinguishing it from other similar conditions. This often leads to a delay in diagnosis, which delays the onset of specific therapy.
  • #3 The prognosis of dementia with Lewy bodies – PubMed
    https://pubmed.ncbi.nlm.nih.gov/28342649/
    Dementia with Lewy bodies is the second most common form of neurodegenerative dementia, yet scarce evidence is available about its prognosis and natural history, which are crucial to inform clinical practice and research. […] Patients with dementia with Lewy bodies might have a less favourable prognosis, with accelerated cognitive decline, shorter lifespan, and increased admission to residential care than patients with Alzheimer’s disease. […] Health-care costs and, importantly, caregiver burden, are also reported to be higher in dementia with Lewy bodies than in Alzheimer’s disease. […] It is probable that causative factors for this less favourable prognosis are the increased prevalence and early emergence of neuropsychiatric symptoms in patients with dementia with Lewy bodies, and the challenge of accurate diagnosis.
  • #4 Diagnosis and Prognosis – Lewy Body Dementia Association
    https://www.lbda.org/diagnosis-and-prognosis/
    What is the long-term prognosis for someone with LBD? The prognosis is different for each person and may be affected by their general health or the existence of unrelated illnesses. Because LBD progresses at varying rates for each individual, it is not possible to determine how long someone may live with the disease. Research suggests most people live five to eight years with LBD.
  • #5 Diagnosis and Prognosis – Lewy Body Dementia Association
    https://www.lbda.org/diagnosis-and-prognosis/
    What is the long-term prognosis for someone with LBD? The prognosis is different for each person and may be affected by their general health or the existence of unrelated illnesses. Because LBD progresses at varying rates for each individual, it is not possible to determine how long someone may live with the disease. Research suggests most people live five to eight years with LBD.
  • #6 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #7 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #8 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #9 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #10 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    There is poor knowledge about the clinical effects of Lewy body (LB) pathology in patients with cognitive impairment, especially when coexisting with Alzheimers disease (AD) pathology (amyloid- and tau). […] LB pathology was also associated with faster longitudinal decline in all examined cognitive functions, independent of amyloid-, tau, cognitive stage and a baseline diagnosis of dementia with Lewy bodies/Parkinsons disease. […] LB status provides a better precision-medicine approach to predict clinical trajectories independent of AD biomarkers and a clinical diagnosis, which could have implications for the clinical management of cognitive impairment and the design of AD and LB drug trials. […] The results show that LB pathology had effects on the clinical profile independent of A and tau pathologies with cross-sectional impairment in attention/executive, visuospatial and motor functions.
  • #11 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    LB pathology also had independent associations with a faster decline over time in global, attention/executive, memory and visuospatial functions. […] In particular, the presence of both pathologies (AD+/LB+) seems more difficult to identify clinically as only 9% in this group fulfilled the criteria for DLB/PD at baseline (16% during follow-up) versus 31% (46% during follow-up) in the AD/LB+ group. […] This study has highlighted the potential improvement of including an LB biomarker in the clinical assessment of a patient with cognitive impairment, with substantial diagnostic and prognostic implications. […] Analyzing LB pathology in vivo could provide a better precision-medicine approach for the clinical management of patients with cognitive impairment and for designing drug trials of participants with AD and LBD.
  • #12 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Prognosis Variable; average survival 4 years from diagnosis. […] DLB typically begins after the age of fifty, and people with the disease have an average life expectancy, with wide variability, of about four years after diagnosis. […] The prognosis for DLB has not been well studied; early studies had methodological limitations, such as small sample size and selection bias. […] Relative to Alzheimer’s disease (AD) and other dementias, DLB generally leads to higher rates of disability, hospitalization and institutionalization, and lower life expectancy and quality of life, with increased costs of care. […] Decline may be more rapid when the APOE gene is present, or when AD or its biomarkers is also present. […] The trajectory of cognitive decline in DLB is difficult to establish because of the high rate of missed diagnoses; the typical delay of a year in the US, and 1.2 years in the UK, for diagnosis of DLB mean that a baseline from which deterioration can be measured is often absent.
  • #13 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #14 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #15 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Compared to AD, which is better studied, memory is thought to be retained longer, while verbal fluency may be lost faster, but the most common tools used to assess cognition may miss the most common cognitive deficits in DLB, and better studies are needed. […] There are more neuropsychiatric symptoms in DLB than AD, and they may emerge earlier, so those with DLB may have a less favorable prognosis, with more rapid cognitive decline, more admissions to residential care, and a lower life expectancy. […] An increased rate of hospitalization compared to AD is most commonly related to hallucinations and confusion, followed by falls and infection. […] Life expectancy is difficult to predict, and limited study data are available. […] Survival may be defined from the point of disease onset, or from the point of diagnosis.
  • #16 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #17 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #18 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #19 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #20 Is Lewy body dementia fatal? Life expectancy and treatment
    https://www.medicalnewstoday.com/articles/is-lewy-body-dementia-fatal
    Lewy body dementia (LBD) is a progressive condition. The average life expectancy is around 5 to 8 years following a diagnosis, but it can be up to 20 years. […] The average life expectancy following an LBD diagnosis can vary greatly, from months to 20 years. […] The National Institute on Aging and the National Library of Medicine (NLM) state that the average time from diagnosis to death for people with LBD is between 5 and 7 years. […] People with stage 3 and 4 LBD progression typically have a shorter life expectancy than those at other stages. […] LBD is a progressive disease with no cure. The average life expectancy ranges from 2 to 20 years, but most people live for 5 to 7 years after receiving a diagnosis.
  • #21 Lewy Body Dementia (LBD): What It Is, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17815-lewy-body-dementia
    Lewy body dementia is a progressive disease, meaning symptoms start slowly and get worse over time. […] The prognosis (outlook) of LBD is generally fair to poor because it gets worse over time. […] Each persons experience with Lewy body dementia (LBD) is unique to them. How slowly or quickly the disease progresses is impossible to know, but may be influenced by your general health and any existing conditions you may have. […] The average life expectancy of Lewy body dementia is five to eight years after the initial diagnosis. But some people with LBD live up to 20 years after their diagnosis. […] This short average life expectancy could be due to a lack of knowledge regarding LBD among healthcare providers and the population and difficulty in distinguishing it from other similar conditions. This often leads to a delay in diagnosis, which delays the onset of specific therapy.
  • #22 Is Lewy body dementia fatal? Life expectancy and treatment
    https://www.medicalnewstoday.com/articles/is-lewy-body-dementia-fatal
    Lewy body dementia (LBD) is a progressive condition. The average life expectancy is around 5 to 8 years following a diagnosis, but it can be up to 20 years. […] The average life expectancy following an LBD diagnosis can vary greatly, from months to 20 years. […] The National Institute on Aging and the National Library of Medicine (NLM) state that the average time from diagnosis to death for people with LBD is between 5 and 7 years. […] People with stage 3 and 4 LBD progression typically have a shorter life expectancy than those at other stages. […] LBD is a progressive disease with no cure. The average life expectancy ranges from 2 to 20 years, but most people live for 5 to 7 years after receiving a diagnosis.
  • #23 Is Lewy body dementia fatal? Life expectancy and treatment
    https://www.medicalnewstoday.com/articles/is-lewy-body-dementia-fatal
    Lewy body dementia (LBD) is a progressive condition. The average life expectancy is around 5 to 8 years following a diagnosis, but it can be up to 20 years. […] The average life expectancy following an LBD diagnosis can vary greatly, from months to 20 years. […] The National Institute on Aging and the National Library of Medicine (NLM) state that the average time from diagnosis to death for people with LBD is between 5 and 7 years. […] People with stage 3 and 4 LBD progression typically have a shorter life expectancy than those at other stages. […] LBD is a progressive disease with no cure. The average life expectancy ranges from 2 to 20 years, but most people live for 5 to 7 years after receiving a diagnosis.
  • #24 Lewy Body Dementia (LBD): What It Is, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17815-lewy-body-dementia
    Lewy body dementia is a progressive disease, meaning symptoms start slowly and get worse over time. […] The prognosis (outlook) of LBD is generally fair to poor because it gets worse over time. […] Each persons experience with Lewy body dementia (LBD) is unique to them. How slowly or quickly the disease progresses is impossible to know, but may be influenced by your general health and any existing conditions you may have. […] The average life expectancy of Lewy body dementia is five to eight years after the initial diagnosis. But some people with LBD live up to 20 years after their diagnosis. […] This short average life expectancy could be due to a lack of knowledge regarding LBD among healthcare providers and the population and difficulty in distinguishing it from other similar conditions. This often leads to a delay in diagnosis, which delays the onset of specific therapy.
  • #25 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Compared to AD, which is better studied, memory is thought to be retained longer, while verbal fluency may be lost faster, but the most common tools used to assess cognition may miss the most common cognitive deficits in DLB, and better studies are needed. […] There are more neuropsychiatric symptoms in DLB than AD, and they may emerge earlier, so those with DLB may have a less favorable prognosis, with more rapid cognitive decline, more admissions to residential care, and a lower life expectancy. […] An increased rate of hospitalization compared to AD is most commonly related to hallucinations and confusion, followed by falls and infection. […] Life expectancy is difficult to predict, and limited study data are available. […] Survival may be defined from the point of disease onset, or from the point of diagnosis.
  • #26 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    There is wide variability in survival times, as DLB may be rapidly or slowly progressing. […] A 2019 meta-analysis found an average survival time after diagnosis of 4.1 years indicating survival in DLB 1.6 years less than after a diagnosis of Alzheimer’s disease. […] A 2017 review found survival from disease onset between 5.5 and 7.7 years, and survival from diagnosis between 1.9 and 6.3 years. […] The difference in survival between AD and DLB could be because DLB is harder to diagnose, and may be diagnosed later in the course of the disease. […] Shorter life expectancy is more likely when visual hallucinations, abnormal gait, and variable cognition are present early on. […] In the late phase of the disease, people may be unable to care for themselves. […] Falls caused by many factors including parkinsonism, dysautonomia, and frailness increase morbidity and mortality. […] Failure to thrive and aspiration pneumonia, a complication of dysphagia (difficulty swallowing) that results from dysautonomia, commonly cause death among people with the Lewy body dementias. […] Cardiovascular disease and sepsis are also common causes of death.
  • #27 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Prognosis Variable; average survival 4 years from diagnosis. […] DLB typically begins after the age of fifty, and people with the disease have an average life expectancy, with wide variability, of about four years after diagnosis. […] The prognosis for DLB has not been well studied; early studies had methodological limitations, such as small sample size and selection bias. […] Relative to Alzheimer’s disease (AD) and other dementias, DLB generally leads to higher rates of disability, hospitalization and institutionalization, and lower life expectancy and quality of life, with increased costs of care. […] Decline may be more rapid when the APOE gene is present, or when AD or its biomarkers is also present. […] The trajectory of cognitive decline in DLB is difficult to establish because of the high rate of missed diagnoses; the typical delay of a year in the US, and 1.2 years in the UK, for diagnosis of DLB mean that a baseline from which deterioration can be measured is often absent.
  • #28 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Compared to AD, which is better studied, memory is thought to be retained longer, while verbal fluency may be lost faster, but the most common tools used to assess cognition may miss the most common cognitive deficits in DLB, and better studies are needed. […] There are more neuropsychiatric symptoms in DLB than AD, and they may emerge earlier, so those with DLB may have a less favorable prognosis, with more rapid cognitive decline, more admissions to residential care, and a lower life expectancy. […] An increased rate of hospitalization compared to AD is most commonly related to hallucinations and confusion, followed by falls and infection. […] Life expectancy is difficult to predict, and limited study data are available. […] Survival may be defined from the point of disease onset, or from the point of diagnosis.
  • #29 The prognosis of dementia with Lewy bodies – PubMed
    https://pubmed.ncbi.nlm.nih.gov/28342649/
    Dementia with Lewy bodies is the second most common form of neurodegenerative dementia, yet scarce evidence is available about its prognosis and natural history, which are crucial to inform clinical practice and research. […] Patients with dementia with Lewy bodies might have a less favourable prognosis, with accelerated cognitive decline, shorter lifespan, and increased admission to residential care than patients with Alzheimer’s disease. […] Health-care costs and, importantly, caregiver burden, are also reported to be higher in dementia with Lewy bodies than in Alzheimer’s disease. […] It is probable that causative factors for this less favourable prognosis are the increased prevalence and early emergence of neuropsychiatric symptoms in patients with dementia with Lewy bodies, and the challenge of accurate diagnosis.
  • #30 Preparing Families with LBD for End of Life – Lewy Body Dementia Association
    https://www.lbda.org/blog/preparing-families-with-lbd-for-end-of-life/
    Its a well-known fact that Lewy body dementia (LBD) has different end of life factors than Alzheimers disease. In fact, while people with Alzheimers disease typically have an eight to ten-year lifespan after onset of the disease, those with LBD average five to seven years from onset of Lewy body dementia symptoms until the end of life. […] This study shows just how important it is for physicians to initiate advance care planning discussions with people in the early Lewy body dementia stages. Research is also needed to inform clinicians of when end of life may be approaching, such as the Predicting ACcurately End-of-Life in Dementia with Lewy Bodies and Promoting Quality End-of-Life Experiences (PACE-DLB) Study. […] The survey found that physicians often dont raise topics relating to end of life. If you have questions about this, make sure to ask. […] While hospice services in the United States are intended to support the last 6 months of life, palliative care is appropriate at any stage of LBD. Palliative care is specialized medical care that focuses on quality of life for people with serious illnesses and their families.
  • #31 Preparing Families with LBD for End of Life – Lewy Body Dementia Association
    https://www.lbda.org/blog/preparing-families-with-lbd-for-end-of-life/
    Its a well-known fact that Lewy body dementia (LBD) has different end of life factors than Alzheimers disease. In fact, while people with Alzheimers disease typically have an eight to ten-year lifespan after onset of the disease, those with LBD average five to seven years from onset of Lewy body dementia symptoms until the end of life. […] This study shows just how important it is for physicians to initiate advance care planning discussions with people in the early Lewy body dementia stages. Research is also needed to inform clinicians of when end of life may be approaching, such as the Predicting ACcurately End-of-Life in Dementia with Lewy Bodies and Promoting Quality End-of-Life Experiences (PACE-DLB) Study. […] The survey found that physicians often dont raise topics relating to end of life. If you have questions about this, make sure to ask. […] While hospice services in the United States are intended to support the last 6 months of life, palliative care is appropriate at any stage of LBD. Palliative care is specialized medical care that focuses on quality of life for people with serious illnesses and their families.
  • #32 Preparing Families with LBD for End of Life – Lewy Body Dementia Association
    https://www.lbda.org/blog/preparing-families-with-lbd-for-end-of-life/
    Its a well-known fact that Lewy body dementia (LBD) has different end of life factors than Alzheimers disease. In fact, while people with Alzheimers disease typically have an eight to ten-year lifespan after onset of the disease, those with LBD average five to seven years from onset of Lewy body dementia symptoms until the end of life. […] This study shows just how important it is for physicians to initiate advance care planning discussions with people in the early Lewy body dementia stages. Research is also needed to inform clinicians of when end of life may be approaching, such as the Predicting ACcurately End-of-Life in Dementia with Lewy Bodies and Promoting Quality End-of-Life Experiences (PACE-DLB) Study. […] The survey found that physicians often dont raise topics relating to end of life. If you have questions about this, make sure to ask. […] While hospice services in the United States are intended to support the last 6 months of life, palliative care is appropriate at any stage of LBD. Palliative care is specialized medical care that focuses on quality of life for people with serious illnesses and their families.
  • #33 Dementia with Lewy bodies | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/dementia-with-lewy-bodies?lang=us
    Dementia with Lewy bodies also responds favourably to acetylcholinesterase inhibitors, even more so than Alzheimer disease. […] Unlike Parkinson disease, dementia with Lewy bodies respond less readily to L-dopa and also may have severe sensitivity reactions to neuroleptic drugs, such as rigidity, reduced consciousness, pyrexia, falling, postural hypotension and collapse.
  • #34 Dementia with Lewy bodies | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/dementia-with-lewy-bodies?lang=us
    Dementia with Lewy bodies also responds favourably to acetylcholinesterase inhibitors, even more so than Alzheimer disease. […] Unlike Parkinson disease, dementia with Lewy bodies respond less readily to L-dopa and also may have severe sensitivity reactions to neuroleptic drugs, such as rigidity, reduced consciousness, pyrexia, falling, postural hypotension and collapse.
  • #35 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    There is poor knowledge about the clinical effects of Lewy body (LB) pathology in patients with cognitive impairment, especially when coexisting with Alzheimers disease (AD) pathology (amyloid- and tau). […] LB pathology was also associated with faster longitudinal decline in all examined cognitive functions, independent of amyloid-, tau, cognitive stage and a baseline diagnosis of dementia with Lewy bodies/Parkinsons disease. […] LB status provides a better precision-medicine approach to predict clinical trajectories independent of AD biomarkers and a clinical diagnosis, which could have implications for the clinical management of cognitive impairment and the design of AD and LB drug trials. […] The results show that LB pathology had effects on the clinical profile independent of A and tau pathologies with cross-sectional impairment in attention/executive, visuospatial and motor functions.
  • #36 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    LB pathology also had independent associations with a faster decline over time in global, attention/executive, memory and visuospatial functions. […] In particular, the presence of both pathologies (AD+/LB+) seems more difficult to identify clinically as only 9% in this group fulfilled the criteria for DLB/PD at baseline (16% during follow-up) versus 31% (46% during follow-up) in the AD/LB+ group. […] This study has highlighted the potential improvement of including an LB biomarker in the clinical assessment of a patient with cognitive impairment, with substantial diagnostic and prognostic implications. […] Analyzing LB pathology in vivo could provide a better precision-medicine approach for the clinical management of patients with cognitive impairment and for designing drug trials of participants with AD and LBD.
  • #37 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Prognosis Variable; average survival 4 years from diagnosis. […] DLB typically begins after the age of fifty, and people with the disease have an average life expectancy, with wide variability, of about four years after diagnosis. […] The prognosis for DLB has not been well studied; early studies had methodological limitations, such as small sample size and selection bias. […] Relative to Alzheimer’s disease (AD) and other dementias, DLB generally leads to higher rates of disability, hospitalization and institutionalization, and lower life expectancy and quality of life, with increased costs of care. […] Decline may be more rapid when the APOE gene is present, or when AD or its biomarkers is also present. […] The trajectory of cognitive decline in DLB is difficult to establish because of the high rate of missed diagnoses; the typical delay of a year in the US, and 1.2 years in the UK, for diagnosis of DLB mean that a baseline from which deterioration can be measured is often absent.
  • #38 Dementia with Lewy bodies – Wikipedia
    https://en.wikipedia.org/wiki/Dementia_with_Lewy_bodies
    Compared to AD, which is better studied, memory is thought to be retained longer, while verbal fluency may be lost faster, but the most common tools used to assess cognition may miss the most common cognitive deficits in DLB, and better studies are needed. […] There are more neuropsychiatric symptoms in DLB than AD, and they may emerge earlier, so those with DLB may have a less favorable prognosis, with more rapid cognitive decline, more admissions to residential care, and a lower life expectancy. […] An increased rate of hospitalization compared to AD is most commonly related to hallucinations and confusion, followed by falls and infection. […] Life expectancy is difficult to predict, and limited study data are available. […] Survival may be defined from the point of disease onset, or from the point of diagnosis.
  • #39 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    LB pathology also had independent associations with a faster decline over time in global, attention/executive, memory and visuospatial functions. […] In particular, the presence of both pathologies (AD+/LB+) seems more difficult to identify clinically as only 9% in this group fulfilled the criteria for DLB/PD at baseline (16% during follow-up) versus 31% (46% during follow-up) in the AD/LB+ group. […] This study has highlighted the potential improvement of including an LB biomarker in the clinical assessment of a patient with cognitive impairment, with substantial diagnostic and prognostic implications. […] Analyzing LB pathology in vivo could provide a better precision-medicine approach for the clinical management of patients with cognitive impairment and for designing drug trials of participants with AD and LBD.
  • #40 Clinical effects of Lewy body pathology in cognitively impaired individuals | Nature Medicine
    https://www.nature.com/articles/s41591-023-02449-7
    LB pathology also had independent associations with a faster decline over time in global, attention/executive, memory and visuospatial functions. […] In particular, the presence of both pathologies (AD+/LB+) seems more difficult to identify clinically as only 9% in this group fulfilled the criteria for DLB/PD at baseline (16% during follow-up) versus 31% (46% during follow-up) in the AD/LB+ group. […] This study has highlighted the potential improvement of including an LB biomarker in the clinical assessment of a patient with cognitive impairment, with substantial diagnostic and prognostic implications. […] Analyzing LB pathology in vivo could provide a better precision-medicine approach for the clinical management of patients with cognitive impairment and for designing drug trials of participants with AD and LBD.

Zobacz więcej

zaburzenia poznawcze lewodopa halucynacje wzrokowe gen APOE zaburzenia chodu nadwrażliwość hipotensja ortostatyczna dysautonomia zaburzenia funkcji poznawczych inhibitor acetylocholinesterazy sepsa lek neuroleptyczny upadek dysfagia parkinsonizm demencja ciałek Lewy'ego choroba Alzheimera opieka paliatywna zachłystowe zapalenie płuc choroba układu sercowo-naczyniowego objawy neuropsychiatryczne biomarker choroba Parkinsona