Lewy Body Dementia: Pathogenesis and Clinical Findings

Lewy Body Dementia is a sub-category of major or mild neurocognitive disorders depending on severity of disease. Dementia should occur before or concurrently with onset of Parkinsonism. Clinical manifestations have been organized into a hierarchy of diagnostic specificity.



Central feature (required for diagnosis):

 • Progressive and prominent cognitive impairment, particularly affecting memory, executive and visuospatial function

Core features:

 • Fluctuating cognition with pronounced variations in attention and alertness

 • Recurrent visual hallucinations (well-formed and detailed)

 • Spontaneous features of parkinsonism

Suggestive features:

 • Rapid eye movement sleep behavior disorder

 • Neuroleptic sensitivity

 • Low dopamine transporter uptake seen on SPECT/PET

Supportive features:

 • Repeated falls

 • Systematized delusions

 • Depression

 • Hallucinations in other modalities



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