The Dementia with Lewy Bodies (DLB) Consortium has updated diagnostic criteria to improve detection and management, emphasizing clearer distinctions between DLB and Alzheimer’s disease (AD). While retaining the core structure of the 2005 criteria, the revisions better separate clinical features from biomarkers, now classified as indicative or supportive to enhance diagnostic precision. DLB’s key symptoms include cognitive fluctuations, visual hallucinations, parkinsonism, and REM sleep behavior disorder (RBD). Mixed pathologies, such as DLB with significant AD-like plaques, continue to complicate diagnosis.

Managing DLB requires a multifaceted approach due to its complex symptoms. Nonpharmacologic strategies, including exercise and cognitive training, help improve quality of life, while pharmacologic treatments like cholinesterase inhibitors address cognitive symptoms, and selective antipsychotics target psychiatric issues. Dopaminergic therapies, though less effective than in Parkinson’s disease, may worsen psychiatric symptoms. Future research will focus on refining diagnostics, exploring genetic and biomarker distinctions, and developing targeted treatments.

Reference: McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017 Jul 4;89(1):88-100. doi: 10.1212/WNL.0000000000004058. Epub 2017 Jun 7. PMID: 28592453; PMCID: PMC5496518.