Feature Article

Dementia with Lewy bodies: a common disorder easily missed

Sid Williams



A recently recognised and often partially remediable disorder, dementia with Lewy bodies may be responsible for 15 to 25% of all dementia presentations. The clinical features and some practical advice on diagnosis and management of this disorder are reviewed here.

Key Points

  • Dementia with Lewy bodies (DLB) is a relatively common disorder that may present as mild cognitive impairment, established dementia, visual hallucinations, delirium, psychosis or combinations of these.
  • Symptoms of the disorder may respond, sometimes dramatically, to the cholinesterase inhibitors donepezil, galantamine or rivastigmine.
  • Antipsychotic drugs may produce severe parkinsonian and other adverse effects in patients with DLB. Risks are lower but still present when the ‘atypical’ antipsychotic drugs are used.
  • Clinical features of DLB, relatively recently delineated, are not widely known or recognised.