Enhancing Characterizations of Early Cognitive and Functional Changes in Lewy
Body Disease 
   Lead Investigator:    Lisa Graves
   Institution      :    VA San Diego Healthcare System, UC San Diego
   E-Mail           :    lvgraves@gmail.com
   Proposal ID      :    1325



   Proposal Description:
   Dementia with Lewy bodies (DLB) is the second most common form of progressive dementia after Alzheimer's disease (AD). While the cognitive and behavioral profiles that are characteristic of DLB are becoming increasingly well defined, early signs and symptoms are often mistaken for AD or a psychiatric condition, and efforts to characterize and differentiate the earliest cognitive and functional changes in individuals who go on to develop DLB have been quite limited.   Using clinical, cognitive/neuropsychological, and functional data from the National Alzheimer's Coordinating Center Uniform Data Set, Neuropathology Data Set, and Lewy Body Disease (LBD) module, along with the application of robust statistical techniques such as mixed effects modeling, we aim to: 1) identify individuals with LBD pathology who initially entered the database as  normal controls or with mild cognitive impairment (MCI), and to retrospectively examine and characterize profiles of cognitive and functional decline across the continuum of normal aging, MCI, and DLB, and 2) differentiate the nature and trajectory of cognitive and functional decline across the continuum of normal aging to dementia in individuals with (a) primarily LBD pathology, versus (b) primarily AD pathology, versus (c) mixed AD/LBD pathology. We hypothesize that, consistent with past research, while individuals who go on to develop AD dementia are likely to show early changes in memory, those who go on to develop DLB are likely to show early changes in visuospatial functioning and attention. Additionally, due to comorbid pathology, we hypothesize that overlapping cognitive characteristics will be observed in those who ultimately demonstrate mixed AD/LBD pathology. Moreover, early, subtle changes are likely to be more detectable on neuropsychological process indices, which reflect how one approaches completing a neuropsychological test (versus scores on core neuropsychological indices, which reflect overall performance on a t