{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T03:14:48Z","timestamp":1788146088105,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021071","name":"Faculty of Medicine and Health, University of Sydney","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["A&amp;amp;D Transl Res &amp;amp; Clin Interv"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Dementia with Lewy bodies (DLB) or Parkinson's disease dementia (PDD), collectively termed Lewy body dementia (LBD), show heterogenous progression across cognitive, motor, and neuropsychiatric symptom domains, yet disease\u2010specific endpoints are lacking. We evaluated whether a composite clinical endpoint using validated scales across different symptom domains could sensitively track disease progression and align with functional and caregiver outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>One hundred sixteen participants (DLB = 72; PDD = 44) were assessed at baseline, 3, and 6 months in a cluster\u2010randomized trial comparing usual care versus management informed by an evidence\u2010based toolkit. The Lewy Body Symptom Severity (LBSS) index was constructed by summing rescaled Mini\u2010Mental State Examination, Movement Disorder Society Unified Parkinson's Disease Rating Scale (Part III), Dementia Cognitive Fluctuations Scale, and Neuropsychiatric Inventory 4\u2010item subscore (including hallucinations). Linear mixed\u2010effects models tested change over time. Validity was examined against caregiver Clinical Rating of Change (CRC), Bristol Activities of Daily Living (ADL) Scale, and caregiver Zarit Burden Interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Over 6 months, LBSS increased significantly (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.0307;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0006). Simulation\u2010based power analyses indicated greater statistical efficiency for LBSS than for any individual component. LBSS also detected a significant intervention effect (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0365) not observed with single\u2010domain measures. LBSS correlated with caregiver burden (Zarit;\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.53,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), functional dependence (Bristol ADL;\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.57,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and CRC (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = \u22120.33,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002), permitting derivation of a minimal clinically important difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>A simple composite spanning cognition, parkinsonism, cognitive fluctuations, and neuropsychiatric symptoms sensitively detected short\u2010interval progression, with improved statistical efficiency over single\u2010domain measures, and was aligned with functional\/caregiver outcomes. These findings support composite endpoints for LBD trials and can inform the design of disease\u2010specific scales.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/trc2.70260","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:45:54Z","timestamp":1779335154000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The utility of a composite endpoint for tracking disease progression in Lewy body dementia"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-0488","authenticated-orcid":false,"given":"Elie","family":"Matar","sequence":"first","affiliation":[{"name":"Sydney Medical School Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Brain and Mind Centre Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Neurology Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Cambridge School of Clinical Medicine  Cambridge UK"},{"name":"MRC Biostatistics Unit University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John\u2010Paul","family":"Taylor","sequence":"additional","affiliation":[{"name":"Newcastle Translational and Clinical Research Institute Campus for Ageing and Vitality Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Thomas","sequence":"additional","affiliation":[{"name":"Newcastle Translational and Clinical Research Institute Campus for Ageing and Vitality Newcastle University  Newcastle upon Tyne 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