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Dementia with Lewy bodies is one of the most common dementias in the elderly after Alzheimer’sdisease. It can be recognized on the basis of several clinical characteristics including progressivedementia with marked slowing and fluctuations, persistent visual hallucinations and an extrapyramidalsyndrome. Several other clinical and imaging features are highly suggestive such as the presenceof rapid eye movement sleep disorder, severe sensitivity to neuroleptics and specificneuroimaging abnormalities. Therapeutic strategies include prescription of L-dopa and cholinesteraseinhibitors such as rivastigmine, and avoidance of anticholinergic medications and neuroleptics.Physicians who care for older people should have a heightened awareness of this entity in orderto diagnose it early, avoid mistaking it for delirium and initiate appropriate treatment.
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