Neuropsychiatric, cognitive, and imaging profile of patients with dementia with Lewy body: A tertiary care center experience

Abstract

Abstract Background: Dementia with Lewy body is a neurodegenerative disorder and is the second most common cause of dementia after Alzheimer’s disease. We aimed to study the demographic, clinical, neuropsychological, and imaging characteristics of these patients. Methods: The current study is a retrospective chart review of 37 patients who met the diagnostic criteria of probable dementia with Lewy body. The relevant demographic data and clinical details including detailed history, examination, clinical scales (unified Parkinson’s disease rating scale scores in OFF and ON states), mini mental status examination scores, and neuropsychological and imaging findings were retrieved from the medical records. Results: There were 33 men in the study. The mean age was 67.08 ± 9.27 years, mean age of disease onset was 63.76 ± 8.67 years, and mean duration of illness was 3.32 ± 2.2 years. In most of the patients, rapid eye movement sleep behavior disorder preceded the illness by 5.5 ± 6.88 years. The patients had good response to levodopa with significant improvement in the unified Parkinson’s disease rating scale part III score (P = 0.0018). The mean mini mental status examination score was 16.97 ± 5.96. Brain magnetic resonance imaging showed diffuse cerebral atrophy (42.4%) as the most common finding. Fluorodeoxyglucose–positron emission tomography (n = 8) showed hypometabolism in the occipital lobes with sparing of the posterior cingulate gyrus. Neuropsychological assessment showed impairment in mental speed, focused and sustained attention, verbal fluency, working memory, planning, set shifting, response inhibition, verbal learning and memory, and visuospatial construction. Conclusions: There was early cognitive impairment with multiple domains affected. In most of the patients, brain magnetic resonance imaging showed atrophy and occipital lobe hypometabolism on fluorodeoxyglucose–positron emission tomography.