Updated Guidelines for Lewy Body Dementia Diagnosis

Updated diagnosing guidelines for dementia with Lewy bodies (DLB) have been outlined in a recent Neurology article and aim to help physicians more confidently diagnose the disease, even in its early stages.

According to Ian McKeith, Newcastle University (UK), who led the guideline revision effort, experts now agree that certain symptoms, such as REM sleep behavior disorder and cardiac and brain imaging, are “highly predictive” of Lewy bodies in the brain (June 8, 2017. Lewy Body Dementia Association press release).
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DLB diagnosis is challenging due to its symptoms that are similar to Alzheimer and Parkinson disease as well as other neurological conditions. But the Lewy Body Dementia Association says, “for the first time, physicians can rely on both symptoms and ‘biomarkers’ to help make the diagnosis.”

The refined recommendations instruct physicians to consider dementia symptoms first and specifically look for visual hallucinations, REM sleep behavior disorder, or uncontrolled movements mimicking Parkinson disease.

The article also claims some tests are effective in detecting DLB, including brain imaging to detect structural changes, MIBG myocardial scintigraphy, and sleep studies to confirm whether a patient has REM sleep disorder (published online June 7, 2017; doi: 10.1212/WNL.0000000000004058).

These revised recommendations were established by researchers gathered at the 2015 International Dementia with Lewy Bodies Conference, who wanted to update the DLB diagnosis criteria, which had not been updated since 2005.—Amanda Del Signore