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. 2018 Feb 15;10(1):19.
doi: 10.1186/s13195-018-0350-6.

Clinical prevalence of Lewy body dementia

Joseph P M Kane  1 , Ajenthan Surendranathan  2 , Allison Bentley  2 , Sally A H Barker  1 , John-Paul Taylor  1 , Alan J Thomas  1 , Louise M Allan  1 , Richard J McNally  3 , Peter W James  3 , Ian G McKeith  1 , David J Burn  1 , John T O'Brien  4   5
Affiliations

Clinical prevalence of Lewy body dementia

Joseph P M Kane et al. Alzheimers Res Ther. .

Abstract

Background: The prevalence of dementia with Lewy bodies (DLB) and dementia in Parkinson's disease (PDD) in routine clinical practice is unclear. Prevalence rates observed in clinical and population-based cohorts and neuropathological studies vary greatly. Small sample sizes and methodological factors in these studies limit generalisability to clinical practice.

Methods: We investigated prevalence in a case series across nine secondary care services over an 18-month period, to determine how commonly DLB and PDD cases are diagnosed and reviewed within two regions of the UK.

Results: Patients with DLB comprised 4.6% (95% CI 4.0-5.2%) of all dementia cases. DLB was represented in a significantly higher proportion of dementia cases in services in the North East (5.6%) than those in East Anglia (3.3%; χ2 = 13.6, p < 0.01). DLB prevalence in individual services ranged from 2.4 to 5.9%. PDD comprised 9.7% (95% CI 8.3-11.1%) of Parkinson's disease cases. No significant variation in PDD prevalence was observed between regions or between services.

Conclusions: We found that the frequency of clinical diagnosis of DLB varied between geographical regions in the UK, and that the prevalence of both DLB and PDD was much lower than would be expected in this case series, suggesting considerable under-diagnosis of both disorders. The significant variation in DLB diagnostic rates between these two regions may reflect true differences in disease prevalence, but more likely differences in diagnostic practice. The systematic introduction of more standardised diagnostic practice could improve the rates of diagnosis of both conditions.

Keywords: Dementia in Parkinson’s disease; Dementia with Lewy bodies; Epidemiology; Prevalence.

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Conflict of interest statement

Ethics approval and consent to participate

Permission was granted by the UK Confidentiality Advisory Group to collect limited data from the clinical notes of all patients attending participating services without the requirement of informed consent. Ethical approval for the study was also awarded by an NHS Regional Ethics Committee (NRES Committee North East—Newcastle & North Tyneside 1; Reference 13/NE/0268).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
DLB prevalence by region and service. DLB dementia with Lewy bodies, EA East Anglia, NE North-East England, A–I services
Fig. 2
Fig. 2
DLB prevalence and age at dementia diagnosis. DLB dementia with Lewy bodies
Fig. 3
Fig. 3
Percentage of cases of PDD diagnosed within our screening period compared to cases diagnosed before our screening period. Confidence interval (CI) calculated using standard (approximate method)
Fig. 4
Fig. 4
Comparison of cognitive scores at the time of PDD diagnosis between regions. MMSE Mini-Mental State Examination
Fig. 5
Fig. 5
Negative correlation between age at initial diagnosis of PD and time before dementia onset. PD Parkinson’s disease, PDD Parkinson’s disease dementia
See this image and copyright information in PMC

References

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