Abstract

Background: The prevalence of dementia with Lewy bodies (DLB) in geriatric wards and nursing homes is poorly understood. The aim of this study was to investigate the prevalence of core symptoms of DLB in a geriatric setting.

Methods: Patients were recruited prospectively at the Robertsau Geriatric University Hospital (PrevaLewy study). Patients with two core symptoms of DLB among hallucinations, fluctuations, REM sleep behaviour disorders and parkinsonism were included in the Lewy group, and those with one or no core symptoms in the control group. The two groups were compared in terms of overall cognition (MMSE), neurovegetative and neurosensory symptoms, diagnosis of previous neurodegenerative diseases, and drug treatments.

Results: 165 patients were included, 105 of whom were in the Lewy group (63.6%) and 60 in the control group. In the Lewy group, 30.5% had RBD, 39.0% had hallucinations, 65.7% had fluctuations, and 85.7% had parkinsonism. The MMSE score was lower in the Lewy group (18.8/30) compared to the control group (21.8/30; P=.047).  The Lewy group had more autonomic and neurosensory disorders (P<.001), wore more diapers and urinary protection (P=.002), and took more melatonin drug (P=.016) than the control group.

Conclusions: This study shows for the first time a very high prevalence of DLB clinically defined in a geriatric setting. The associated symptoms and treatments are consistent with such a diagnosis. The next step is to search for DLB biomarkers in geriatric patients.

 

Keywords: Dementia with Lewy bodies, Lewy body disease, Geriatrics, Nursing Home, Aging