Find-DLB: a naturalistic cohort of patients presenting with clinical features of dementia with Lewy bodies to a specialized cognitive clinic.

PURPOSE: Dementia with Lewy bodies (DLB) is a common neurodegenerative disorder, yet difficult to diagnose. Carefully selected research cohorts may not represent the clinical reality. We aimed to characterize a naturalistic cohort of patients with clinical features of DLB, reporting their final diagnosis, clinical features, and cognitive profile.

METHODS

Patients were recruited from a specialized cognitive clinic. Data from patient visits such as core clinical features, biomarkers, cognitive screening, and neuropsychological assessment were collected from health records. We used normative data to assess distribution of impairment in patients with DLB and Parkinson's disease (PD) with and without dementia.

RESULTS

A total of 143 patients were included in the cohort. Following specialized dementia evaluation, 88 patients fulfilled clinical criteria for DLB, 35 patients for PD with dementia (PDD), 14 had mild cognitive impairment (MCI), and the remaining 6 patients had other types of dementia. Parkinsonism was the most common core clinical feature (87%), followed by visual hallucinations (65%), cognitive fluctuations (52%) and, lastly, probable REM sleep behavior disorder (RBD, 47%). A majority of DLB patients had cognitive impairment on visuospatial constructive, attentional and executive tasks, and visual memory.

CONCLUSIONS

The differential diagnosis of DLB may be difficult within a clinical context because other cognitive disorders frequently present with core features of DLB. The cognitive profile and frequency of core clinical features in the DLB group were generally in line with previous reports. Probable RBD was lower than in other cohorts, which may reflect challenges in collecting this information in a clinical interview.