Brain Matters

DEMENTIA WITH LEWY BODIES - Diagnostic Criteria
From McKeith IG, Dickson DW, Lowe J, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium. Neurology 2005;65:1863

1. Central feature (essential for a diagnosis of possible or probable DLB)
* Dementia defined as progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational function
* Prominent or persistent memory impairment may not necessarily occur in the early stages but usually is evident with progression
* Deficits on tests of attention, executive function, and visuospatial ability may be especially prominent

2. Core features (two core features are sufficient for a diagnosis of probable DLB or one for possible DLB)
* Fluctuating cognition with pronounced variation in attention and alertness
* Recurrent visual hallucinations that typically are well formed and detailed
* Spontaneous features of parkinsonism

3. Suggestive features (If one or more of these is present in the presence of one or more core features, a diagnosis of probable DLB can be made. In the absence of any core features, one or more suggestive features is sufficient for possible DLB. Probable DLB should not be diagnosed on the basis of suggested features alone.)
* REM sleep behavior disorder (RBD)
* Severe neuroleptic sensitivity
* Low dopamine transporter uptake in the basal ganglia demonstrated by single photon emission CT or positron emission tomographic imaging

Some of these symptoms are described on the Lewy Body Dementia Association website:
http://www.lbda.org/category/3438/symptoms.htm

The Lewy Body Dementia Association has developed a chart comparing the diagnostic criteria of Dementia with Lewy Bodies (DLB) and Parkinson's Disease Dementia (PDD):

http://www.lbda.org/index.cfm?fuseaction=docs.download&category_ID=4117&download=1648