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Prodromal dementia with Lewy bodies

Lookup NU author(s): Dr Paul Donaghy, Professor John O'Brien, Professor Alan ThomasORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background The clinical condition of dementia is now recognised as a diagnosis that can only be applied too late in the disease process to be useful for therapeutic approaches centring on disease modification. As a result, in recent years increasing attention has been given to mild cognitive impairment (MCI) and the diagnosis of prodromal dementia. This paper reviews the evidence for the clinical presentation of prodromal dementia with Lewy bodies (DLB). Methods A MEDLINE search was carried out to identify papers with original data on the prodromal presentation of DLB. Results In MCI cohorts that progress to dementia, the proportion diagnosed with DLB is similar to that reported in dementia cohorts. Prodromal DLB may present as any MCI subtype, though visuospatial and executive domains may be most commonly affected. REM sleep behaviour disorder (RBD), autonomic symptoms, hyposmia, hallucinations and motor symptoms appear to be more common in prodromal DLB than prodromal Alzheimer’s disease. Some of these symptoms can precede the diagnosis of DLB by several years. There has been little research into the use of biomarkers in prodromal DLB, though in RBD cohorts clinical and imaging biomarkers have been associated with the development of DLB. ConclusionsThe evidence available suggests that prodromal DLB may be differentiated from other dementia prodromes in most cases. Further research is needed to confirm this, and to assess the utility of biomarkers such as 123I-FP-CIT and 131I-MIBG imaging.

Publication metadata

Author(s): Donaghy PC, O'Brien JT, Thomas AJ

Publication type: Review

Publication status: Published

Journal: Psychological Medicine

Year: 2015

Volume: 45

Issue: 2

Pages: 259-268

Print publication date: 01/01/2015

Online publication date: 03/04/2014

Acceptance date: 04/03/2014

ISSN (print): 0033-2917

ISSN (electronic): 1469-8978


DOI: 10.1017/S0033291714000816

PubMed id: 25690399