Clinical and neurocognitive features of early Dementia with Lewy Bodies (DLB)

Abstract

Distinguishing between early Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) is important to facilitate early treatment, to prevent iatrogenic complications, to better understand the pathologic underpinnings of these conditions to develop new therapies, and to provide the patient and caregiver with appropriate support/guidance. The Mayo Clinic has a prospectively followed cohort of patients with DLB who have undergone formal sleep evaluation, neurocognitive assessment, neurologic exam, and pathologic examination. This discussion will highlight results from our studies that examine the early detection of DLB and differentiation from AD. This includes data on the predictive value of non-amnestic Mild Cognitive Impairment, REM sleep behavior disorder, excessive daytime sleepiness and the temporal onset of core DLB features relative to the eventual development of DLB. The relationship between clinical/cognitive patterns and the pathologic features of Lewy body distribution and concomitant Alzheimer's pathology will also be addressed. The recognition and understanding of the earliest stages of DLB has improved greatly in the past 2 decades, but much remains to be learned as we strive to understand and predict the pre-dementia stage of DLB.