The prodromal presentation of dementia with Lewy bodies: Application of the proposed research criteria

Abstract INTRODUCTION Research criteria for prodromal dementia with Lewy bodies (DLB) recently proposed mild cognitive impairment with Lewy bodies (MCI‐LB), delirium‐onset, and psychiatric‐onset presentations. We aimed to classify the DLB prodromal stage in a research cohort against the proposed criteria, and describe the frequency of DLB‐associated clinical features in the prodrome. METHODS Retrospective file review and expert clinician consensus classified DLB participants’ prodromal symptoms against the research criteria and identified clinical features within six domains (cognitive, gait/motor, autonomic, sleep, psychiatric, and sensory). RESULTS Of 45 participants, 80.0% were MCI onset, 11.1% delirium onset, 6.7% psychiatric onset, and 2.2% unclear. All experienced cognitive symptoms. Sleep (80.0%), psychiatric (73.3%), and gait/motor (66.7%) changes were common. The earliest prodromal symptoms were sleep related (35.6%). DISCUSSION MCI‐LB was the most common presentation. Small numbers of delirium‐onset or psychiatric‐onset participants potentially reflects the bias of cohorts recruited from memory assessment services. Improved identification of non‐cognitive DLB prodromes is needed in clinical and research settings.