Isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) is a powerful early predictor of dementia with Lewy bodies (DLB) and Parkinson’s disease (PD). This provides an opportunity to directly observe the evolution of prodromal DLB and to identify which cognitive variables are the strongest predictors of evolving dementia.
IRBD participants (n = 754) from 10 centers of the International RBD Study Group underwent annual neuropsychological assessment. Competing risk regression analysis determined optimal predictors of dementia. Linear mixed-effect models determined the annual progression of neuropsychological testing.
Reduced attention and executive function, particularly performance on the Trail Making Test Part B, were the strongest identifiers of early DLB. In phenoconverters, the onset of cognitive decline began up to 10 years prior to phenoconversion. Changes in verbal memory best differentiated between DLB and PD subtypes.
In iRBD, attention and executive dysfunction strongly predict dementia and begin declining several years prior to phenoconversion.

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This post is Copyright: Stephen Joza,
Michele T. Hu,
Ki‐Young Jung,
Dieter Kunz,
Dario Arnaldi,
Jee‐Young Lee,
Luigi Ferini‐Strambi,
Elena Antelmi,
Friederike Sixel‐Döring,
Valérie Cochen De Cock,
Jacques Y. Montplaisir,
Jessica Welch,
Han‐Joon Kim,
Frederik Bes,
Pietro Mattioli,
Kyung Ah Woo,
Sara Marelli,
Giuseppe Plazzi,
Brit Mollenhauer,
Amelie Pelletier,
Jamil Razzaque,
Jun‐Sang Sunwoo,
Nicola Girtler,
Claudia Trenkwalder,
Jean‐François Gagnon,
Ronald B. Postuma,
for the International REM Sleep Behavior Disorder Study Group | July 18, 2023

Wiley: Alzheimer’s & Dementia: Table of Contents