Journal Mobile Options
Table of Contents
Vol. 26, No. 5, 2008
Issue release date: November 2008
Dement Geriatr Cogn Disord 2008;26:445–452

Frequency and Case Identification of Dementia with Lewy Bodies Using the Revised Consensus Criteria

Aarsland D. · Rongve A. · Piepenstock Nore S. · Skogseth R. · Skulstad S. · Ehrt U. · Hoprekstad D. · Ballard C.
aDepartment of Old Age Psychiatry, and bGeriatric Medicine, Stavanger University Hospital, cDepartment of Old Age Psychiatry, Haugesund Hospital, dInstitute of Clinical Medicine, Faculty of Medicine, The University of Bergen, eDepartment of Geriatric Medicine, Haraldsplass Hospital, fOlaviken Hospital for Old Age Psychiatry and Department of Neurology, Haukeland University Hospital, Bergen, Norway; gWolfson Centre for Age Related Diseases, Kings College, London, UK

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Objective: To find the proportion of dementia with Lewy bodies (DLB) in a referral cohort of patients with a first-time diagnosis of mild dementia. Background: The proportion of DLB among the dementia sufferers is not known and the clinical consensus criteria have low sensitivity. We employed the revised DLB criteria to study the proportion with DLB in a community sample of patients with mild dementia. Methods: From March 2005 to March 2007, we included 196 patients from referrals to all geriatric medicine, old age psychiatry and neurology outpatient clinics in Rogaland and Hordaland counties in Western Norway. Standardized clinical instruments and diagnostic criteria were employed. Results: 65% had Alzheimer dementia, 20% DLB (16% probable DLB), 5.6% vascular dementia, 5.6% Parkinson disease with dementia, 2.0% frontotemporal dementia and 1.5% alcoholic dementia. There were no significant differences in the proportion with DLB according to age bands and dementia severity groups. The revised criteria for a clinical diagnosis of DLB increased the proportion of probable DLB by 25% compared to the previous criteria. Conclusion: DLB is common in patients with mild dementia, and is the second most common type of dementia. The introduction of new clinical criteria for DLB leads to an increase in the proportion diagnosed with probable DLB.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, Cummings J, Duda JE, Lippa C, Perry EK, Aarsland D, Arai H, Ballard CG, Boeve B, Burn DJ, Costa D, Del Ser T, Dubois B, Galasko D, Gauthier S, Goetz CG, Gomez-Tortosa E, Halliday G, Hansen LA, Hardy J, Iwatsubo T, Kalaria RN, Kaufer D, Kenny RA, Korczyn A, Kosako K, Lee VM, Lees A, Litvan I, Londos E, Lopez OL, Minoshima S, Mizuno Y, Molina JA, Mukaetove-Ladinska EB, Pasquier F, Perry RH, Schulz JB, Trojanowski JQ, Yamada M: Diagnosis and management of dementia with Lewy bodies. Third report of the DLB consortium. Neurology 2005;65:1863–1872.
  2. Bostrom F, Jonsson L, Minthon L, Londos E: Patients with Lewy body dementia use more resources than those with Alzheimer’s disease. Int J Geriatr Psychiatry 2007;22:713–719.
  3. Bostrom F, Jonsson L, Minthon L, Londos E: Patients with dementia with Lewy bodies have more impaired quality of life than patients with Alzheimer disease. Alzheimer Dis Assoc Disord 2007;21:150–154.
  4. McKeith IG, Rowan E, Askew K, Naidu A, Allan L, Barnett N, Lett D, Mosimann UP, Burn D, O’Brien JT: More severe functional impairment in dementia with lewy bodies than Alzheimer disease is related to extrapyramidal motor dysfunction. Am J Geriatr Psychiatry 2006;14:582–588.
  5. Williams MM, Xiong C, Morris JC, Galvin JE: Survival and mortality differences between dementia with Lewy bodies vs Alzheimer disease. Neurology 2006;67:1935–1941.
  6. Zaccai J, McCracken C, Brayne C: A systematic review of prevalence and incidence studies of dementia with Lewy bodies. Age Ageing 2005;34:561–566.
  7. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, Salmon DP, Lowe J, Mirra SS, Byrne EJ, Lennox G, Quinn NP, Edwardson JA, Ince PG, Bergeron C, Burns A, Miller BL, Lovestone S, Collerton D, Jansen EN, Ballard C, de Vos RA, Wilcock GK, Jellinger KA, Perry RH: Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47:1113–1124.
  8. McKeith IG, Ballard CG, Perry RH, Ince PG, O’Brien JT, Neill D, Lowery K, Jaros E, Barber R, Thompson P, Swann A, Fairbairn AF, Perry EK: Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology 2000;54:1050–1058.
  9. Barker WW, Luis CA, Kashuba A, Luis M, Harwood DG, Loewenstein D, Waters C, Jimison P, Shepherd E, Sevush S, Graff-Radford N, Newland D, Todd M, Miller B, Gold M, Heilman K, Doty L, Goodman I, Robinson B, Pearl G, Dickson D, Duara R: Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer Dis Assoc Disord 2002;16:203–212.
  10. Tiraboschi P, Salmon DP, Hansen LA, Hofstetter RC, Thal LJ, Corey-Bloom J: What best differentiates Lewy body from Alzheimer’s disease in early-stage dementia? Brain 2006;129:729–735.
  11. Ferman TJ, Smith GE, Boeve BF, Ivnik RJ, Petersen RC, Knopman D, Graff-Radford N, Parisi J, Dickson DW: DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology 2004;62:181–187.
  12. Lopez OL, Litvan I, Catt KE, Stowe R, Klunk W, Kaufer DI, Becker JT, DeKosky ST: Accuracy of four clinical diagnostic criteria for the diagnosis of neurodegenerative dementias. Neurology 1999;53:1292–1299.
  13. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
  14. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, et al: Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  15. Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, Broe GA, Cummings J, Dickson DW, Gauthier S, Goldman J, Goetz C, Korczyn A, Lees A, Levy R, Litvan I, McKeith I, Olanow W, Poewe W, Quinn N, Sampaio C, Tolosa E, Dubois B: Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 2007;22:1689–1707; quiz 1837.
  16. Clinical and neuropathological criteria for frontotemporal dementia. The Lund and Manchester Groups. J Neurol Neurosurg Psychiatry 1994;57:416–418.
  17. Jorm AF, Jacomb PA: The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med 1989;19:1015–1022.
  18. Morris JC: Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. Int Psychogeriatr 1997;9(suppl 1):173–176; discussion 177–178.
  19. Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, Russell RW, Symon L: Cerebral blood flow in dementia. Arch Neurol 1975;32:632–637.
  20. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
  21. Montgomery SA, Asberg M: A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382–389.
  22. Fahn S, Elton RL, Committee MotUD: Unified Parkinson’s Disease Rating Scale; in Fahn S, Marsden CD, Calne DM (eds): Recent Development in Parkinson’s Disease. Florham Park, MacMillan Health Care Information, 1987, pp 153–163.
  23. Aarsland D, Perry R, Larsen JP, McKeith IG, O’Brien JT, Perry EK, Burn D, Ballard CG: Neuroleptic sensitivity in Parkinson’s disease and parkinsonian dementias. J Clin Psychiatry 2005;66:633–637.
  24. Walker MP, Ayre GA, Cummings JL, Wesnes K, McKeith IG, O’Brien JT, Ballard CG: The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry 2000;177:252–256.
  25. AASM: International Classification of Sleep Disorders-2: Diagnostic and Coding Manual. Chicago, American Academy of Sleep Medicine, 2005.
  26. Linn MW, Linn BS: The rapid disability rating scale-2. J Am Geriatr Soc 1982;30:378–382.
  27. Delis D, Kramer J, Kaplan E, Ober B: California Verbal Learning Test: Adult Version Manual. San Antonio, The Psychological Corporation, 1987.
  28. Graves RE, Bezeau SC, Fogarty J, Blair R: Boston naming test short forms: a comparison of previous forms with new item response theory based forms. J Clin Exp Neuropsychol 2004;26:891–902.
  29. Warrington E, James M: The Visual Object and Space Perception Battery. Bury St. Edmunds, Thames Velley Test, 1991.
  30. Steinberg BA, Bieliauskas LA, Smith GE, Ivnik RJ: Mayo’s Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Trail-Making Test, the Stroop Test, and MAE Controlled Oral Word Association Test. Clin Neuropsychol 2005;19:329–377.
  31. Golden: Stroop Color and Word Test. Chicago, Stoelting, 1978.
  32. McKeith I, O’Brien J, Walker Z, Tatsch K, Booij J, Darcourt J, Padovani A, Giubbini R, Bonuccelli U, Volterrani D, Holmes C, Kemp P, Tabet N, Meyer I, Reininger C: Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007;6:305–313.
  33. Yoshita M, Taki J, Yokoyama K, Noguchi-Shinohara M, Matsumoto Y, Nakajima K, Yamada M: Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD. Neurology 2006;66:1850–1854.
  34. Gausdal M, Gjøra L: Samhandling om demensutredning. Oslo, Ullevål Universitetssykehus, 2007.
  35. Stevens T, Livingston G, Kitchen G, Manela M, Walker Z, Katona C: Islington study of dementia subtypes in the community. Br J Psychiatry 2002;180:270–276.
  36. Rahkonen T, Eloniemi-Sulkava U, Rissanen S, Vatanen A, Viramo P, Sulkava R: Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older. J Neurol Neurosurg Psychiatry 2003;74:720–724.
  37. Yamada T, Kadekaru H, Matsumoto S, Inada H, Tanabe M, Moriguchi EH, Moriguchi Y, Ishikawa P, Ishikawa AG, Taira K, Yamori Y: Prevalence of dementia in the older Japanese-Brazilian population. Psychiatry Clin Neurosci 2002;56:71–75.
  38. Mok W, Chow TW, Zheng L, Mack WJ, Miller C: Clinicopathological concordance of dementia diagnoses by community versus tertiary care clinicians. Am J Alzheimers Dis Other Demen 2004;19:161–165.
  39. Weisman D, Cho M, Taylor C, Adame A, Thal LJ, Hansen LA: In dementia with Lewy bodies, Braak stage determines phenotype, not Lewy body distribution. Neurology 2007;69:356–359.
  40. Erkinjuntti T, Ostbye T, Steenhuis R, Hachinski V: The effect of different diagnostic criteria on the prevalence of dementia. N Engl J Med 1997;337:1667–1674.
  41. Jellinger KA: The enigma of vascular cognitive disorder and vascular dementia. Acta Neuropathol (Berl) 2007;113:349–388.
  42. Londos E, Passant U, Risberg J, Gustafson L, Brun A: Contributions of other brain pathologies in dementia with Lewy bodies. Dement Geriatr Cogn Disord 2002;13:130–148.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50