Epidemiological Study on Dementia with Lewy Bodies

Study

No. in study

Age (years)

No. with dementia

No. of DLB

DLB/over 65 years, % (95 %CI)

DLB/all dementia, % (95 %CI)

Yamada (2001)

3715

142

0.11 (0.03–0.28)

0.28 (0.08–0.71)

Ikeda (2001)

1145

>65

0.09 (0.00–0.49)

1.67 (0.04–8.94)

Yamada (2002)

157

>70

0.00 (0.00–2.32)

0.00 (0.00–17.7)

Stevens (2002)

1085

>65

0.65 (0.26–1.32)

9.72 (4.0–19.0)

Herrera (2002)

1656

>65

118

0.12 (0.01–0.44)

1.69 (0.21–5.99)

de Silva (2003)

703

>65

0.14 (0.00–0.79)

3.57 (0.09–18.35)

Rahkonen (2003)

601

>75

137

4.99 (3.39–7.05)

21.9 (15.29–29.76)

Tognoni (2005)

1600

>65

0.19 (0.04–0.55)

3.03 (0.63–8.60)

Galasko (2007)

1984

>65

243

0.05 (0.00–0.28)

0.41 (0.01–2.27)

Molero (2007)

2438

>65

196

0.16 (0.04–0.42)

2.04 (0.56–5.14)

Fernandez Martinez (2008)

1931

>65

108

0.52 (0.25–0.95)

9.23 (4.53–16.37)

Gascon-Bayarri (2007)^a

1754

>65

165

0.86 (0.48–1.41)

9.09 (5.18–14.55)

Jhoo (2008)

714

>65

0.28 (0.03–1.01)

5.41 (0.66–18.2)

Gurvit (2008)

1019

>65

0.88 (0.04–1.67)

9.68 (4.52–17.58)

Arslantas (2009)

3100

>55

262

0.00 (0.00–0.12)

0.00 (0.00–1.4)

Kim (2011)

1673

>65

351

0.12 (0.01–0.43)

0.57 (0.07–2.04)

Yusuf (2011)

322

>65

0.00 (0.00–1.14)

0.00 (0.00–33.63)

Dimitrov (2012)^a

540

>65

0.37 (0.05–1.33)

5.13 (0.63–17.32)

Total

26137

2178

0.36 (0.29–0.44)

4.24 (3.44–5.17)

Van Jones et al. [6]

DLB dementia with Lewy bodies, CI confidence interval

^aUsed the revised 2005 criteria

Table 2.2

Population-based incidence studies

Study	No. in study	Age (years)	Dementia incidence (case/1000 person-years)	DLB incidence in whole population (cases/1000 person-years)	DLB incidence per dementia diagnosis (%)
Miech (2002)	5092	>65	36.3	0.57	3.2 (6/185)
Matsui (2009)^a	887	>65	32.3	1.40	4.4 (12/275)
Perez (2010)^a	3777	>65	26.9	1.12	4.5 (28/644)
Total				0.87	3.8 (3.39–4.15)

Van Jones et al. [6]

DLB dementia with Lewy bodies

^aUsed the revised 2005 criteria

2.2.2 Zaccai’s Review 2005 [5]

This is the first systematic review of epidemiological studies of DLB, which identified just six population prevalence studies and one incidence study [7–13]. All studies used the DSM-III-R or DSM-IV criteria to diagnose dementia. Five prevalence studies used the McKeith 1996 criteria [14] (Table 2.3), while one did a modified McKeith 1995 criteria [15]. with no restriction on duration of Parkinson’s disease.

Table 2.3

The 1996 original criteria for probable and possible DLB

1. The central feature required for a diagnosis of DLB is progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational function. Prominent or persistent memory impairment may not necessarily occur in the early stages but is usually evident with progression. Deficits on tests of attention and of fronto-subcortical skills and visuospatial ability may be especially prominent

2. Two of the following core features are essential for a diagnosis of probable DLB; one is essential for possible DlB:

(a) Fluctuating cognition with pronounced variations in attention and alertness

(b) Recurrent visual hallucinations which are typically well formed and detailed

3. Features supportive of the diagnosis are:

(a) Repeated falls

(b) Syncope

(d) Neuroleptic sensitivity

(e) Systematized delusions

(f) Hallucinations in other modalities

4. A diagnosis of DLB is less likely in the presence of:

(a) Stroke disease, evident as focal neurological signs or on brain imaging

(b) Evidence on physical examination and investigation of any physical illness, or other brain disorder, sufficient to account for the clinical picture

Consensus guidelines for the c1inical and pathological diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop (McKeith et al. [15])

Study results are as follows. Prevalence estimates for clinical DLB ranged from 0 to 5 % (median 0.1 %) with regard to the general population and from 0 to 30.5 % (median 6.6 %) of all dementia cases. The Cache County study provides the only incidence report, estimated at 0.1 % a year for the general population and 3.2 % a year for all new dementia cases. Six studies did not report on the sex of those diagnosed, while one reported that they were all men. The authors noted that the number of available studies was too small to hypothesize on the potential effect of age, sex, and genetic background on the results.

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