neurologic disorders
Dementia with Lewy Bodies and Parkinson Disease Dementia
Key Points
Because Lewy bodies occur in dementia with Lewy bodies and in Parkinson disease, some experts hypothesize that the 2 disorders are part of the same synucleinopathy affecting the central and peripheral nervous systems. Suspect dementia with Lewy bodies if dementia develops nearly simultaneously with parkinsonian features and when dementia is accompanied by fluctuations in cognition, loss of attention, vivid dreams, psychiatric symptoms (eg, visual hallucinations; complex, bizarre delusions), and autonomic dysfunction. Suspect Parkinson disease dementia if dementia begins years after parkinsonian features, particularly if executive dysfunction occurs early. Consider use ofrivastigmineand sometimes other cholinesterase inhibitors to try to improve cognition in patients who have dementia with Lewy bodies or Parkinson disease dementia. 