Clinical Diagnosis of Dementia with Lewy Bodies in a Japanese Dementia Registry

Abstract

We found 15 patients with dementia with Lewy bodies (DLB) and 232 patients with Alzheimer’s disease (AD) among 327 consecutive patients with mild to moderate dementia in a Japanese dementia registry, using the clinical criteria of the Consortium on DLB International Workshop. The percentage of females was significantly lower in DLB than in AD (p < 0.01), while age at examination, Mini-Mental State Examination score and duration of cognitive symptoms were comparable between the two diseases. Eight of the 15 DLB patients (53%) had spontaneous parkinsonism, which was observed in 6 of the 232 AD patients (2.6%). Visual hallucinations were reported by 11 of the 15 DLB patients (73%) and 8 of the 232 AD patients (3.4%). Cognitive fluctuation was positive in 13 of the 15 DLB patients (87%). We found two types of episodic cognitive deterioration: one was characterized by pronounced disturbances of attention and alertness (inattention type), and the other was characterized by marked and bizarre disturbances of orientation in time and places, and misidentification of persons (disorientation type). Systematized delusion was observed in 8 DLB patients, and 5 patients showed neuroleptic sensitivity. Patients with DLB have a unique dementia syndrome even in the stage of mild to moderate cognitive impairments. Further studies are recommended to establish diagnosis, treatment and management.

Deficit in sustained attention following selective cholinergic lesion of the pedunculopontine tegmental nucleus in rat, as measured with both post-mortem immunocytochemistry and in vivo PET imaging with [18F]fluoroethoxybenzovesamicol

“…Fluctuations of sustained attention, like those revealed in the current study by the increased variability of response latency, have also been described in humans with severe lesion of the PPTg cholinergic system, such as Parkinson's Disease (PD) or Dementia with Lewy Body (DLB) [53][54][55][56]. These attentional deficits were found to be alleviated following symptomatic treatment with cholinesterase inhibitors such as rivastigmine or donepezil [57].…”

The Role of ¹²³I-Metaiodobenzylguanidine Myocardial Scintigraphy in the Diagnosis of Lewy Body Disease in Patients with Dementia in a Memory Clinic

“…In contrast, the prevalence ratio of DLB in the Memory Clinic is relatively low. In some clinical studies from Japan, the prevalence of DLB was reported to be only a few percent of demented subjects [26,27] . These differences may partly reflect the underdiagnosis of patients with DLB in the clinical setting.…”

Accelerated hippocampal atrophy in Alzheimer's disease with apolipoprotein E ε4 allele

“…The clinical and investigative data collected prospectively in a standardized fashion were entered into the HI-ABCD Dementia Registry. 19 Requirements for inclusion in the present study included (1) meeting the criteria of the National Institute of Neurological Disease and Stroke/ Alzheimer's Disease and Related Disorders Association for probable AD 20 ; (2) age Ն60 and Ͻ80; (3) no complication of other neurological or mental disorders; and (4) no evidence of developmental abnormalities, significant neurological antecedents, or focal brain lesions on MRI. Patients excluded from the study were those who did not complete the entire procedure of the follow-up program and those whose MRIs were inadequate for image analysis because of motion artifacts or any other reason.…”