Dementia with Lewy bodies

Abstract

Dementia with Lewy bodies (DLB) is a clinicopathological syndrome, which account for up to 20% of all elderly cases of dementia reaching autopsy, with a clinical presentation primarily characterized by cognitive decline leading to dementia, accompanied in majority of cases by extrapyramidal motor features and additional neuropsychiatric features. It is considered a part of a larger spectrum of LB disease that exhibit diverse clinical presentations, including Parkinson's disease (PD0, primary autonomic failure, and REM sleep behavior disorder (RBD). The central characteristic of DLB is a progressive dementia with marked impairments in visuoperceptual, attentional, and executive functions reflecting a combination of cortical and subcortical damage. Fluctuating cognition, recurrent visual hallucinations (VHs) and extrapyramidal motor symptoms are the core features by which DLB can be clinically recognized. At autopsy DLB is neuropathologically indistinguishable from dementia occurring late in the course of Parkinson's disease (PDD). ChEIs offer the greatest benefits for symptomatic improvement in both psychotic and cognitive features of DLB without significant compromise of motor function.