Results:The cortical LB (CLB) burden was the only independent predictor of dementia (OR: 4.12, p<0.001). The total cortical Aβ plaque burden was an independent predictor of a shorter latency to dementia from onset of motor signs (p=0.001). DLB cases had a higher LB burden in the parietal and temporal cortex, compared to PDD. Carrying at least one APOE ϵ4 allele was associated with a higher cortical LB burden (p=0.02), particularly in the neocortical frontal, parietal, and temporal regions. Conclusions:High CLB burden is a key neuropathological substrate of dementia in LBD.Elevated cortical LB pathology and Aβ plaques are both correlated with a faster progression to dementia. The higher LB load in the temporal and parietal regions, which distinguishes DLB cases, could have a role in the shorter latency to dementia and may be mediated by the APOE ϵ4 allele.

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