Objective: The study aim is to outline the Lewy body dementia (DLB) phenotypes as presenting symptoms and its correlation with cognitive profiles and clinical evolution of disease.

Background: DLB is the second most common cause of dementia in the elderly. DLB is clinically and pathologically related to Parkinson’s disease (PD) and PD dementia, and the three disorders can be viewed as existing on a spectrum of Lewy body disease. Sleep disturbances as REM and NREM parasonnia are mostly represented in early DLB as in advanced phases of disease. The pattern of neuropsychological deficits seen in DLB is different to those of Alzheimer disease, with less marked memory impairment and more severe impairments of visuo-spatial, attentional and frontal-executive functions.

Methods: Seventy- one out patients with DLB have been collected from 2011 since 2014 among patients referring to the Parkinson’s disease and Movement Disorders Unit, Sleep Medicine Unit and Alzheimer Unit at the IRCCS C. Mondino National Institute of Neurology Foundation in Pavia, Italy. All the patients underwent to neurological and neuropsychological assessment.

Results: We divided the patients in three groups on the basis of presenting symptoms: twenty-four patients referred psychiatric/behavioural symptoms (that include REM behaviour disorders, confusional arousal, visual hallucinations, delirium and depression) as presenting symptom (group 1- G1); thirty-five patients referred parkinsonism (group 2-G2); twelve patients referred cognitive impairment (group 3- G3). The three groups differed in impairment of amnestic domain : 40% of G1 patients show amnestic impairment, 41% in G2 and 66% in G3. The G3 patients show a shorter disease duration than G1 and G2 patients .

Conclusions: The presenting features of DLB can be broadly placed in three categories: psychiatric/behavioural symptoms, parkinsonism and cognitive impairment. The presenting symptoms don’t configure a different phenotype of disease. The patient that initially present cognitive impairment have earlier diagnosis and show, at the moment of diagnosis, more cognitive impairment in amnestic domain than the patients that initially present with non cognitive symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/presenting-symptoms-and-cognitive-profile-in-lewy-body-dementia-a-series-of-cases/