Lookup NU author(s): Professor Ian McKeith
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Dementia with Lewy bodies (DLB) is the second most common cause of neurogenerative dementia in elderly people, accounting for 10–15% of all cases of dementia. It occupies part of a spectrum of disorders that includes Parkinson’s disease and primary autonomic failure, all of which share a neuritic pathology based on abnormal aggregation of the normally occurring synaptic protein α-synuclein. It is important to identify DLB patients accurately because they have specific symptoms, impairments and functional disabilities that differ from other common dementia syndromes, including Alzheimer’s disease, vascular cognitive impairment and fronto-temporal dementia. Recently revised clinical diagnostic criteria for DLB have been refined in an attempt to identify a substantial minority of cases with atypical presentations that are often due to the presence of mixed pathology. Newly developed rating scales for the core features of DLB (fluctuation, visual hallucinations and Parkinsonism) promise to improve clinical diagnostic accuracy, as does the use of structural and functional neuroimaging, particularly of dopamine transporter activity in the basal ganglia. DLB patients frequently have severe neuroleptic sensitivity reactions, which are associated with significantly increased morbidity and mortality. Cholinesterase inhibitor treatment is usually well tolerated and substantially improves cognitive and neuropsychiatric symptoms. Virtually unrecognized 20 years ago, DLB may, within this decade, be one of the most treatable neurodegenerative disorders of late life.
Author(s): McKeith I
Publication type: Article
Publication status: Published
ISSN (print): 0838-7982
Publisher: MPI Medical Publishing Inc.
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