DEFINITION

• Dementia with Lewy bodies (DLB) is a primary neurodegenerative disorder affecting cognitive function and movement.
  • Early symptoms include prominent deficits in attention, as well as visuospatial and executive dysfunction.
  • Parkinsonism, hallucinations, cognitive fluctuations, and REM sleep behavior disorder are commonly present.
• DLB is one of the three major α-synucleinopathies, along with Parkinson disease (PD) and multiple system atrophy but is more likely to be misdiagnosed as Alzheimer disease (AD).
  • α-synuclein protein aggregation in cytoplasmic neuronal inclusions (Lewy bodies) is a pathological hallmark of both DLB and PD.
  • Classically, DLB pathology features heavy neocortical Lewy body burden with low AD pathology Aβ or tau pathology, but co-pathology is frequent and may contribute to heterogeneity of disease [1][2][3].
• Compared with AD, DLB has a shorter mean survival time after diagnosis (~4 years vs. ~6 years) [4] and generally places more significant financial burdens on patients and their families/caretakers [5].
• Cognitive impairment due to Lewy bodies is classified under the neurocognitive disorders (NCDs) section of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) [6].