Dementia with Lewy bodies in first-generation immigrants in a European memory clinic
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ORIGINAL ARTICLE
Dementia with Lewy bodies in first‑generation immigrants in a European memory clinic Kurt Segers1 · Florence Benoit2 · Jean‑Marie Meyts2 · Gérald Glibert1 · Sophie Levy2 · Murielle Surquin2 Received: 12 May 2020 / Accepted: 4 September 2020 © Belgian Neurological Society 2020
Abstract We wanted to explore possible differences in disease presentation, frequency, and age of onset of dementia with Lewy bodies (DLB) between first-generation immigrants (FGI) and patients born in Belgium (PBIB). We conducted a retrospective study on all patients of our Memory Clinic between June 1, 2010 and January 31, 2020. A synucleinopathy was diagnosed in 150 of 2702 patients (5.5%): 91 received a diagnosis of DLB (3.4%). FGI were two times more likely to receive a diagnosis of DLB, due to a higher prevalence in North-Africans and Latin-Americans. Visual hallucinations were less frequent in NorthAfricans than in other immigrants. FGI were younger than PBIB and reported more often parasomnia. Our data suggest a higher risk for DLB in certain immigrant groups. Especially for North-African patients, a genetic factor can be suspected, namely mutations in Leucine-rich repeat kinase 2 (LRRK2). Memory clinics with a high rate of FGI may provide interesting data and insights into the prevalence of DLB, genetic and environmental differences. Keywords Lewy body dementia · Dementia with Lewy bodies · Immigrants
Introduction Dementia with Lewy bodies (DLB) is, after Alzheimer’s disease, the second most common neurodegenerative cause of dementia. Its pathological hallmark is the presence of Lewy bodies, which contain, amongst other molecules, misfolded α-synuclein, a characteristic it shares with Parkinson’s disease (PD) and multiple system atrophy (MSA), the so-called synucleinopathies. It is believed that DLB and PD are two entities of the same spectrum, since both clinical syndromes share symptoms, risk factors and underlying pathology [1]. Diagnosing DLB can be difficult [2], as can diagnosing cognitive disorders in immigrants [3]. We wanted to explore the differences between DLB in first-generation immigrants (FGI) as compared to patients who were born in Belgium (PBIB). More precisely, we wanted to explore possible differences in disease presentation, frequency, and age of onset. Literature about dementia in immigrants is scarce [3]. To our * Kurt Segers Kurt.segers@chu‑brugmann.be 1
Neurology Department, Brugmann University Hospital, Van Gehuchtenplein 4, 1020 Brussels, Belgium
Geriatrics Department, Brugmann University Hospital, Brussels, Belgium
2
knowledge, this is the first study that has focused on DLB in immigrants.
Materials and methods In the database of our memory clinic in Brussels, Belgium, we searched all patients with a first contact between June 1, 2010 and January 31, 2020. We identified all patients with a clinical diagnosis of DLB or other synucleinopathies. The diagnosis of probable DLB was based on the third or fourth consensus criteria [4, 5], while the diagnosis of PD and MSA was purel
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