Treatment of Lewy-body dementias and psychopathology

Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) share similar clinical and neuropathological features, and together these Lewy-body-related dementias account for up to 20% of incident dementia cases. 1 Lippa CF Duda JE Grossman M et al. for the DLB/PDD Working GroupDLB and PDD boundary issues: diagnosis, treatment, molecular pathology, and biomarkers. Neurology. 2007; 68: 812-819 Crossref PubMed Scopus (452) Google Scholar Development of dementia confers substantial morbidity, with increased psychiatric comorbidities, nursing-home admissions, and health-care costs, and quality of life of the patient and caregiver is negatively affected. Definitive treatments for Lewy-body-related dementias are urgently needed. Previous studies show that cholinesterase inhibitors, which were originally developed to treat Alzheimer's disease, improve cognitive, neuropsychiatric, and functional symptoms in PDD and DLB. 2 Goldmann Gross R Siderowf A Hurtig HI Cognitive impairment in Parkinson's disease and dementia with lewy bodies: a spectrum of disease. Neurosignals. 2008; 16: 24-34 Crossref PubMed Scopus (33) Google Scholar However, not all patients benefit from cholinesterase inhibitors and no available treatments address the underlying disease processes. Memantine for patients with Parkinson's disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trialMemantine seems to improve global clinical status and behavioural symptoms of patients with mild to moderate DLB, and might be an option for treatment of these patients. Full-Text PDF