Major or Mild Neurocognitive Disorders with Lewy Bodies

  • Poh Choo How
  • Pachida Lo
  • Glen L. Xiong


Neurocognitive disorder (NCD) with Lewy bodies is a leading cause of non-Alzheimer disease-related NCDs. It is frequently underdiagnosed and misdiagnosed as other NCDs, Parkinson disease-related NCD, or major depressive disorder. It should be considered in the differential of new-onset cognitive impairment or parkinsonian symptoms in the older adults. It is marked by a combination of motor, sleep, and autonomic dysfunction and neurocognitive and neuropsychiatric symptoms. Definitive diagnosis can only be made on autopsy. However, the DSM-5 and the Lewy body NCD Consortium have developed a set of criteria for diagnosis based on core and suggestive features of the disease. Development of these symptoms within 1 year of each other strongly suggests a diagnosis of NCD with Lewy bodies. Treatment with cholinesterase inhibitors may help slow the progression of cognitive deterioration. Low-potency antipsychotics may be considered for treatment of hallucinations if benefits outweigh the risks of antipsychotic sensitivity.


Lewy body Alpha-synuclein Fluctuating cognition Parkinsonism Visual hallucinations Antipsychotic sensitivity REM sleep behavior disorder Cholinesterase inhibitors 


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Authors and Affiliations

  1. 1.University of California at Davis, Department of Psychiatry & Behavioral SciencesSacramentoUSA

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