Dementia with Lewy bodies
The 2017 DLB Consortium criteria (core features, indicative biomarkers, the one-year rule), DaT imaging, severe antipsychotic sensitivity, cholinesterase inhibitors, and managing parkinsonism, REM sleep behaviour disorder and autonomic failure in older people.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- The second commonest neurodegenerative dementia after Alzheimer disease, about 5 to 10% of clinical diagnoses and more at autopsy. Many patients are labelled Alzheimer disease or delirium first.
- Alpha-synuclein Lewy bodies in cortex and brainstem, usually with coexisting Alzheimer pathology.
- Think DLB when dementia comes with fluctuation, visual hallucinations, REM sleep behaviour disorder (RBD) or parkinsonism, and when attention and visuospatial skills fail before memory.
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Sources
- Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium (McKeith IG et al. Neurology 2017;89:88-100)Neurology, 2017
- Research criteria for the diagnosis of prodromal dementia with Lewy bodies (McKeith IG et al. Neurology 2020;94:743-55)Neurology, 2020
- Clinical Practice Guidelines and Principles of Care for People with DementiaAU/NZNHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People (Cognitive Decline Partnership Centre), University of Sydney, 2016 (Monash-led update consulted on 11 May to 6 July 2026; final not yet released)
- Updating the Clinical Practice Guidelines and Principles of Care for People with DementiaAU/NZMonash University, 2026 draft
- Therapeutic Guidelines: Neurology and Psychotropic (eTG complete)AU/NZTherapeutic Guidelines Limited, topic version not verified
- A biological classification of Parkinson's disease: the SynNeurGe research diagnostic criteria (Hoglinger GU et al. Lancet Neurol 2024;23:191-204)The Lancet Neurology, 2024
- Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study (McKeith I et al. Lancet 2000;356:2031-6)The Lancet, 2000
- Dementia: assessment, management and support for people living with dementia and their carers (NG97)National Institute for Health and Care Excellence, 2018
- Pharmaceutical Benefits Scheme (cholinesterase inhibitor listings)AU/NZAustralian Government Department of Health, Disability and Ageing
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback