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Major or Mild Neurocognitive Disorders with Lewy Bodies

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Geriatric Psychiatry

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Abstract

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.

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Notes

  1. 1.

    AD-NCD, neurocognitive disorder due to Alzheimer disease; LB-NCD, neurocognitive disorder with Lewy bodies; PD-NCD, neurocognitive disorder due to Parkinson disease.

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  1. University of California at Davis, Department of Psychiatry & Behavioral Sciences, Sacramento, CA, USA

    Poh Choo How, Pachida Lo & Glen L. Xiong MD

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  1. Poh Choo How
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  2. Pachida Lo
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Correspondence to Glen L. Xiong MD .

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  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

    Ana Hategan

  2. Baylor Scott and White Department of Psychiatry, Texas A&M University College of Medicine, Temple, Texas, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California Davis Medical Center, Sacramento, California, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, California, USA

    Caroline Giroux

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How, P.C., Lo, P., Xiong, G.L. (2018). Major or Mild Neurocognitive Disorders with Lewy Bodies. In: Hategan, A., Bourgeois, J., Hirsch, C., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-67555-8_20

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