Dementia with Lewy bodies.
Dementia with Lewy bodies (DLB) is the second commonest cause of neurodegenerative dementia in older people. It is part of the range of clinical presentations that share a neuritic pathology based on abnormal aggregation of the synaptic protein alpha-synuclein. DLB has many of the clinical and pathological characteristics of the dementia that occurs during the course of Parkinson's disease. Here we review the current state of scientific knowledge on DLB. Accurate identification of patients is important because they have specific symptoms, impairments, and functional disabilities that differ from those of other common types of dementia. Severe neuroleptic sensitivity reactions are associated with significantly increased morbidity and mortality. Treatment with cholinesterase inhibitors is well tolerated by most patients and substantially improves cognitive and neuropsychiatric symptoms. Clear guidance on the management of DLB is urgently needed. Virtually unrecognised 20 years ago, DLB could within this decade be one of the most treatable neurodegenerative disorders of late life.
McKeith
Ian
I
Institute for Ageing and Health, University of Newcastle, Newcastle upon Tyne, UK. i.g.mckeith@ncl.ac.uk
Mintzer
Jacobo
J
Aarsland
Dag
D
Burn
David
D
Chiu
Helen
H
Cohen-Mansfield
Jiska
J
Dickson
Dennis
D
Dubois
Bruno
B
Duda
John E
JE
Feldman
Howard
H
Gauthier
Serge
S
Halliday
Glenda
G
Lawlor
Brian
B
Lippa
Carol
C
Lopez
Oscar L
OL
Carlos Machado
João
J
O'Brien
John
J
Playfer
Jeremy
J
Reid
Wayne
W
D000544:Alzheimer Disease / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology; D011859:Radiography; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome