Objective To compare cognitive ,behavioral ,and psychological symptoms observed in Alzheimer's disease (AD ) and dementia with Lewy body (DLB ) in order to provide helpful information for differential diagnosis. Methods We selected 215 patients with AD (AD group)and 66 patients with DLB(DLB group)to retrospectively analyzed their general information ,family history , and disease history.The Mini-Mental State Examination(MMSE scale)was used to evaluate cognitive abilities and Neuropsychiatric Inventory ( NPI scale ) was used for analysis of behavioral and psychological symptoms of dementia in both groups. Results The prevalence of hypertension was higher in the AD group(52.6%,n＝113)than in the DLB group(40%,n＝24)(P＜0.05).The DLB group showed better general cognitive scores ,disorientation scores ,immediate recall scores ,and delayed recall scores than the AD group. Fluctuating cognitive deficiencies and Parkinson's symptoms were more prevalent in the DLB group than in the AD group with 2 patients (0.9%) showing fluctuating cognitive deficiencies in the AD group ,and 19(28.8%)in the DLB group(χ2＝8.580 ,P＝0.003) ;with 26 patients(12.1%)showing Parkinson's symptoms in the AD group and 25(37.9%)in the DLB group(χ2＝ 22.602 ,P＝ 0.000).As to behavioral and psychological symptoms ,the DLB group had higher scores in total NPI ,hallucinations and nighttime abnormal behaviors with 32 patients (14.9%)showing hallucinations and 64 (29.8%)showing nighttime abnormal behaviors in the AD group ;30(46.2%)showing hallucinations and 30 (46.2%)showing nighttime abnormal behaviors in the DLB group (all P ＜ 0.05 ) . Conclusions Hypertension is more prevalent in AD patients. Fluctuating cognitive deficiencies ,Parkinson's symptoms ,hallucinations ,and nighttime abnormal behaviors are prominent manifestations in DLB patients.

Objective To investigate the frequency and location of cerebral microbleeds(CMB) in dementia with Lewy bodies(DLB)versus in Alzheimer's disease(AD).Methods This retrospective study included three groups of probable AD patients (n =156),dementia with Lewy bodies (n =67) and normal controls(n=172).Frequencies and location of CMBs in the three groups were calculated and recorded.The foci of MRI signal for CMB were confirmed by two radiologists at moments of unknowingness about diagnosis.The correlations of cerebral small vessel disease and cerebral amyloid angiopathy with the development of cognitive decline in AD were analyzed.Results The incidence rate of CMBs was higher in patients with groups of DLB(22.4 ％,15/67) and AD(19.8 ％,31/156) than in normal controls (8.2 ％,14/172) (P =0.002 and 0.002),while there was no significant difference in incidence rate of CMBs between DLB and AD groups(P＞0.05).The MRI signal intensity of CMBs was the highest in the occipital lobe of the DLB group,and was higher in the deep temporal lobe or temporal lobe in the AD group.Conclusions The frequency of CMB is higher in patients with DLB or AD than in normal controls and there is no significant difference in frequency of CMB between DLB and AD groups,which suggests that the pathophysiological mechanisms of CMB may be similar between AD and DLB.

Dementia with Lewy bodies(DLB)is the second most common neurodegenerative dementia after Alzheimer's Disease(AD). This article will mainly elaborate the relationship between DLB and blood-brain barrier(BBB)from the following five aspects: (1)The structure and function of BBB; (2)In vivo assessment methods for the blood-brain barrier damage; (3)Evidence for the damage of blood-brain barrier in DLB; (4)The relationship between α-synuclein and the blood-brain barrier; (5)The relationship between APOE and the blood-brain barrier.Future research should focus on the pathogenesis of BBB damage in DLB patients, by which new drug targets for disease diagnosis and treatment may be found.

Objective:To assess the practical value of visual scores of magnetic resonance imaging(MRI)features in the diagnosis and classification of dementia with Lewy bodies(DLB).Methods:In this study, 102 DLB patients were prospectively recruited, with 102 cognitively normal elderly people as the normal control group(NC).All included subjects underwent MRI examinations and neuropsychological assessments.Based on the clinical dementia rating(CDR)scale, DLB patients were divided into a mild(CDR=1.0), a moderate(CDR=2.0)and a severe(CDR=3.0)group.The results of MRI were scored visually and the rating scales included medial temporal lobe atrophy(MTA), global cortical atrophy-frontal subscale(GCA-F), posterior cortical atrophy(PCA), white matter lesions(the Fazekas scale), cerebral microbleeds(CMBs), and the Evans Index(EI).Statistical differences were compared between the DLB and NC groups and between DLB patients with different degrees of cognitive impairment.Results:In terms of neuropsychology, the Mini-Mental State Examination(MMSE) score of the DLB group[16.0(11.0, 21.0)]was statistically significantly lower than that of the NC group[29.0(28.0, 30.0)]( Z=-12.31, P<0.001), the Montreal Cognitive Assessment(MoCA)score of the DLB group[9.5(6.0, 15.0)]was statistically significantly lower than that of the NC group[28.0(27.0, 29.0)]( Z=-12.40, P<0.001), and the Activities of Daily Living(ADL)score of the DLB group[32.0(23.8, 40.0)]was statistically significantly higher than that of the NC group[20.0(20.0, 20.0)]( Z=-11.98, P<0.001).The scores of all MRI visual assessment scales in DLB patients were statistically significantly higher than those in the NC group( P<0.001).There were significant differences in MTA scores between DLB patients with different degrees of cognitive impairment( P0<0.001).The MTA score of the mild group[1.0(1.0, 1.0)]was statistically significantly lower than that of the moderate group[2.0(1.0, 2.0)]( P1<0.001, P2<0.001); The MTA score of the moderate group[2.0(1.0, 2.0)]was statistically significantly lower than that of the severe group[2.0(2.0, 3.0)]( P1=0.003, P2=0.010). Conclusions:This study has for the first time after comprehensively evaluated the value of various visual scores in DLB diagnosis, MTA can be used to help diagnose DLB and distinguish the severity of DLB, providing a new supplemental tool for clinical diagnosis.

Objective: To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. Methods: By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. Results: A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.

Neurofibrillary tangle-predominant dementia(NFTPD)is one type of late-onset dementia, with memory disorders as the main clinical manifestation.The pathological feature is the presence of a large number of neurofibrillary tangle(NFT)in the hippocampus with no or little amyloid deposition in the brain.In recent years, primary age-related tauopathy(PART)has been proposed as a new pathological term, which means that NFT appears in the medial temporal lobe with aging, but no amyloid deposits, and NFTPD is one type of dementia associated with the progression of PART.