Objective: We sought to characterize the prevalence of color vision impairment in DLB patients and investigate how color vision impairment in DLB patients was associated with other features of the disease.

Background: Dementia with Lewy Bodies (DLB) is frequently misdiagnosed for other dementias such as Alzheimer dementia, especially in its earlier stages. Therefore identification of novel and distinguishing features of this disease can improve accuracy of early diagnosis. We characterized color vision impairment (CVI) in DLB patients to better understand its diagnostic utility.

Methods: We retrospectively reviewed charts of patients with DLB patients and patients with mild cognitive impairment suspected to be in the prodromal phase of DLB (pro-DLB). All patients underwent an online 15-hue color vision arrangement test. Furthermore we reviewed DaT-SCAN SPECT and volumetric MRIs (available in 62% and 44% of patients, respectively).

Results: Sixty-six subjects (17 pro-DLB and 49 DLB) were included in this study with a median age of 75 years and 45% were female. In the entire cohort, the symptom prevalence was: visual hallucinations (82%), abnormal DaT-SCAN (76%), tremor (74%), anosmia (71%), possible REM-behavior disorder (61%), bradykinesia (53%), and rigidity (45%). After the excluding patients who reported having color vision impairment from a young age (n=2), the rate of CVI in the cohort was 64% (n=41). No significant differences in gender, age, or DaT-SCAN results existed between patients with CVI vs. without CVI. Finally, we performed a multivariate stepwise logistic regression to predict which factors were significantly associated with CVI in our cohort. Overall three factors (lower MOCA total score (p=0.007), postural tremor (p=0.03), and anosmia (p=0.03)) were independently associated with CVI.

Conclusions: Color vision impairment in DLB patients occurred with similar prevalence to the core features of DLB (~70%) and was present in about half of patients with the prodromal form. Further studies are needed to determine relationships between CVI and volumetric changes on MRI and prospectively validate its diagnostic utility.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/characterization-of-color-vision-impairment-in-lewy-body-diseases/