ArticleAlzheimer's & dementia (New York, N. Y.)
The utility of a composite endpoint for tracking disease progression in Lewy body dementia.
Article in Alzheimer's & dementia (New York, N. Y.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Defining and Measuring Cognitive Decline and Clinical Relevance.Neurology and therapy · 2026Review
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9 authors.
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Abstract
introductionDementia with Lewy bodies (DLB) or Parkinson's disease dementia (PDD), collectively termed Lewy body dementia (LBD), show heterogenous progression across cognitive, motor, and neuropsychiatric symptom domains, yet disease-specific endpoints are lacking. We evaluated whether a composite clinical endpoint using validated scales across different symptom domains could sensitively track disease progression and align with functional and caregiver outcomes.
methodsOne hundred sixteen participants (DLB = 72; PDD = 44) were assessed at baseline, 3, and 6 months in a cluster-randomized trial comparing usual care versus management informed by an evidence-based toolkit. The Lewy Body Symptom Severity (LBSS) index was constructed by summing rescaled Mini-Mental State Examination, Movement Disorder Society Unified Parkinson's Disease Rating Scale (Part III), Dementia Cognitive Fluctuations Scale, and Neuropsychiatric Inventory 4-item subscore (including hallucinations). Linear mixed-effects models tested change over time. Validity was examined against caregiver Clinical Rating of Change (CRC), Bristol Activities of Daily Living (ADL) Scale, and caregiver Zarit Burden Interview.
resultsOver 6 months, LBSS increased significantly ( DISCUSSION: A simple composite spanning cognition, parkinsonism, cognitive fluctuations, and neuropsychiatric symptoms sensitively detected short-interval progression, with improved statistical efficiency over single-domain measures, and was aligned with functional/caregiver outcomes. These findings support composite endpoints for LBD trials and can inform the design of disease-specific scales.
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