Prodromal dementia with Lewy bodies: a case series of the 3 prodromal types from clinical practice

Abstract

Prodromal dementia with Lewy bodies (DLB) refers to a state prior to the onset of dementia with clinical signs or symptoms that may indicate the future development of DLB. Prodromal symptoms can include not only cognitive deficits but also a mix of clinical features including sleep disorders, autonomic dysfunction, and neuro-psychiatric disturbances. While diagnostic criteria for the subtypes of prodromal DLB were recently published, they are largely for use in the research setting. However, these diagnostic criteria have important implications for clinical practice. Helping clinicians to recognize prodromal stages of DLB can lead to identifying deficits sooner, improved patient and family counseling, and advance care planning. This case series presents examples of the 3 subtypes of prodromal DLB – mild cognitive impairment-onset, delirium-onset, and psychiatric-onset – to help clinicians identify individuals who may be on a trajectory to develop DLB.