β-Amyloid and tau biomarkers and clinical phenotype in dementia with Lewy bodies
Ferreira D, Przybelski SA, Lesnick TG, Lemstra AW, Londos E, Blanc F, Nedelska Z, Schwarz CG et al.. Neurology, 2020-09-28
Topic: Amyloid, tau and blood-test diagnosis
Objective In a multicenter cohort of probable dementia with Lewy bodies (DLB), we tested the hypothesis that β-amyloid and tau biomarker positivity increases with age, which is modified by APOE genotype and sex, and that there are isolated and synergistic associations with the clinical phenotype. Methods We included 417 patients with DLB (age 45-93 years, 31% women). Positivity on β-amyloid (A+) and tau (T+) biomarkers was determined by CSF β-amyloid 1-42 and phosphorylated tau in the European cohort and by Pittsburgh compound B and AV-1451 PET in the Mayo Clinic cohort. Patients were stratified into 4 groups: A-T-, A+T-, A-T+, and A+T+. Results A-T- was the largest group (39%), followed by A+T- (32%), A+T+ (15%), and A-T+ (13%). The percentage of A-T- decreased with age, and A+ and T+ increased with age in both women and men. A+ increased more in APOE ε4 carriers with age than in noncarriers. A+ was the main predictor of lower cognitive performance when considered together with T+. T+ was associated with a lower frequency of parkinsonism and probable REM sleep behavior disorder. There were no significant interactions between A+ and T+ in relation to the clinical phenotype. Conclusions Alzheimer disease pathologic changes are common in DLB and are associated with the clinical phenotype. β-Amyloid is associated with cognitive impairment, and tau pathology is associated with lower frequency of clinical features of DLB. These findings have important implications for diagnosis, prognosis, and disease monitoring, as well as for clinical trials targeting disease-specific proteins in DLB. Classification of evidence This study provides Class II evidence that in patients with probable DLB, β-amyloid is associated with lower cognitive performance and tau pathology is associated with lower frequency of clinical features of DLB.
Key findings
- Results A-T- was the largest group (39%), followed by A+T- (32%), A+T+ (15%), and A-T+ (13%).
- T+ was associated with a lower frequency of parkinsonism and probable REM sleep behavior disorder.
- There were no significant interactions between A+ and T+ in relation to the clinical phenotype.
- Conclusions Alzheimer disease pathologic changes are common in DLB and are associated with the clinical phenotype. β-Amyloid is associated with cognitive impairment, and tau pathology is associated with lower frequency of clinical features of DLB.
- These findings have important implications for diagnosis, prognosis, and disease monitoring, as well as for clinical trials targeting disease-specific proteins in DLB.
Why it matters
In people with dementia with Lewy bodies, amyloid and tau biomarker positivity increased with age, and amyloid was the main predictor of lower cognitive performance when considered with tau. Tau positivity was linked to a lower frequency of parkinsonism and probable REM sleep behavior disorder, with no significant interaction between amyloid and tau.
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Study details
- Participants417
- Evidence strengthModerate
How this study scored 60/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 417 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 132 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.5 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 4 / 6 | Cited 10.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 3 / 4 | Cited 65 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Kejal Kantarci: h-index 103 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32989106) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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Read the original
- DOI: 10.1212/wnl.0000000000010943
- PubMed: 32989106
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Ferreira, D., Przybelski, S. A., Lesnick, T. G., Lemstra, A. W., Londos, E., Blanc, F., et al. (2020). β-Amyloid and tau biomarkers and clinical phenotype in dementia with Lewy bodies. Neurology. https://doi.org/10.1212/wnl.0000000000010943
Vancouver
Ferreira D, Przybelski SA, Lesnick TG, Lemstra AW, Londos E, Blanc F, et al. β-Amyloid and tau biomarkers and clinical phenotype in dementia with Lewy bodies. Neurology. 2020. doi:10.1212/wnl.0000000000010943. PMID: 32989106.
BibTeX
@article{ferreira2020-32989106,
author = {Ferreira, D. and Przybelski, S. A. and Lesnick, T. G. and Lemstra, A. W. and Londos, E. and Blanc, F. and Nedelska, Z. and Schwarz, C. G. and others},
title = {{β-Amyloid and tau biomarkers and clinical phenotype in dementia with Lewy bodies}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000010943},
pmid = {32989106},
url = {https://doi.org/10.1212/wnl.0000000000010943}
}
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