Dementia With Lewy Bodies

This article reviews the diagnosis of dementia with Lewy bodies, the prodromal phase of dementia with Lewy bodies, and management of the disease. The diagnostic criteria and characterization of syndromes for prodromal dementia with Lewy bodies facilitate earlier recognition of individuals at risk of Lewy body dementia. Earlier diagnosis may prevent iatrogenic complications, guide families to seek appropriate resources, and provide an opportunity for future therapeutic interventions in the clinical prodrome. Advances in biomarkers include the detection of phosphorylated α-synuclein in cutaneous nerve fibers and the CSF α-synuclein seed amplification assay. Dementia with Lewy bodies is a complex disease that requires an interdisciplinary approach to optimize diagnosis and management. Frequently occurring copathology, most commonly with Alzheimer disease, leads to greater cognitive decline, increased likelihood of admission to a long-term care facility, and a higher risk of mortality. Use of available biomarkers may better guide appropriate diagnosis and management.