Lewy Body Disease/Dementia

Question 1

Lewy body

Answer 1

12-27% of all dementias

Question 2

Onset

Answer 2

Between 50-70
Earlier than AD and VaD

Question 3

Risk factors

Answer 3

Family members with DLB or Parkinson’s
Presence of other dementia pathologies

Question 4

Course

Answer 4

Slow and insidious
5-7 course from diagnosis (faster than AD)
Cognitive deficits predate motor deficits
Presentation punctuated by periods (hours to days) of fluctuation in mental status/orientation

Question 5

Pathology

Answer 5

Lewy bodies accumulate in the brain
Lewy bodies may be present in PD/AD, but more diffusely spread in LBD
Regions typically affected: brainstem, cortical areas, hippocampus, midbrain and basal ganglia
Two people can have different presentations based on location of lewy bodies

Question 6

Lewy body

Answer 6

Alpha-synuclein protein

Question 7

Behavioral presentation

Answer 7

Fluctuating attention/mental status - cognition/consciousness
Parkinsonian symptoms - falls, motor symptoms, rigidity
Recurrent visual hallucinations - typically non-bizarre
Sleep problems - REM sleep behavior disorder
Other - autonomic dysfunction, depression, apathy