New evidence on the management of Lewy body dementia

John-Paul Taylor; Ian G McKeith; David J Burn; Brad F Boeve; Daniel Weintraub; Claire Bamford; Louise M Allan; Alan J Thomas; John T O'Brien

doi:10.1016/S1474-4422(19)30153-X

New evidence on the management of Lewy body dementia

Lancet Neurol. 2020 Feb;19(2):157-169. doi: 10.1016/S1474-4422(19)30153-X. Epub 2019 Sep 10.

Authors

John-Paul Taylor¹, Ian G McKeith², David J Burn², Brad F Boeve³, Daniel Weintraub⁴, Claire Bamford⁵, Louise M Allan⁶, Alan J Thomas², John T O'Brien⁷

Affiliations

¹ Institute of Neuroscience, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. Electronic address: [email protected].
² Institute of Neuroscience, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
³ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
⁴ Department of Psychiatry and Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; Parkinson's Disease and Mental Illness Research, Education and Clinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
⁵ Institute of Health and Society, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
⁶ University of Exeter Medical School, University of Exeter, Exeter, UK.
⁷ Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.

Abstract

Dementia with Lewy bodies and Parkinson's disease dementia, jointly known as Lewy body dementia, are common neurodegenerative conditions. Patients with Lewy body dementia present with a wide range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. Presentation varies between patients and can vary over time within an individual. Treatments can address one symptom but worsen another, which makes disease management difficult. Symptoms are often managed in isolation and by different specialists, which makes high-quality care difficult to accomplish. Clinical trials and meta-analyses now provide an evidence base for the treatment of cognitive, neuropsychiatric, and motor symptoms in patients with Lewy body dementia. Furthermore, consensus opinion from experts supports the application of treatments for related conditions, such as Parkinson's disease, for the management of common symptoms (eg, autonomic dysfunction) in patients with Lewy body dementia. However, evidence gaps remain and future clinical trials need to focus on the treatment of symptoms specific to patients with Lewy body dementia.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Dementia / diagnosis
Dementia / therapy
Humans
Lewy Bodies
Lewy Body Disease / diagnosis*
Lewy Body Disease / therapy*
Neurodegenerative Diseases / diagnosis
Neurodegenerative Diseases / therapy*
Parkinson Disease / diagnosis
Parkinson Disease / therapy

Abstract

Publication types

MeSH terms

Grants and funding