Case Report: Depression × dementia with Lewy bodies in the elderly: The importance of differential diagnosis

Abstract

BackgroundDementia is a clinical syndrome which is more common in elderly people. Dementia with Lewy bodies (LBD) is not so rare in elderly people, with cognitive impairment in about 30% over age 65. The clinical picture is characterized by fluctuation in cognitive functions, recurrent, well-formed, detailed visual hallucinations, and Parkinsonism, with rigidity, tremor, bradykinesia, and slurred speech.Case presentationWe present a case report of LBD in a 73-year-old retired teacher, which a initial wrong diagnosis of refractory depression for at least 3 years. We also conduct a review of recent works on theme.ConclusionLBD diagnosis can be neglected for years, with a legal and clinical issues to patients and their families. Detailed medical research, including differential diagnosis, are very necessary on those cases, specially when they are called refractory. We encourage new research and adequate clinical training to prevent damage.

Differentiating Prodromal Dementia with Lewy Bodies from Prodromal Alzheimer’s Disease: A Pragmatic Review for Clinicians

“…There are several case reports of an initial primary psychiatric presentation of DLB, including depression, psychosis, anxiety, and catatonia [12][13][14][15]. While cognitive symptoms may also be present, there may be a lag between the onset of psychiatric symptoms and cognitive decline in DLB [16].…”