Psychopathology at initial diagnosis in dementia with Lewy bodies versus Alzheimer disease: Comparison of matched groups with autopsy-confirmed diagnoses

Dementia with Lewy bodies (DLB) is believed to be the second most common fo rm of dementia, after Alzheimer disease (AD). DLB has been reported to be a ssociated with an increase in psychopathology; however, antemortem diagnosi s of DLB cannot always be made with certainty. We searched the database of University of California, San Diego SOCARE (Seniors Only Care) outpatient p rogram. There were 26 autopsy-confirmed cases of DLB; We matched them indiv idually with 26 autopsy-confirmed cases of 'pure' AD on gender, ethnicity, and Mini-Mental State Examination score at the baseline evaluation. We comp ared the two groups on psychopathologic measures and possible risk factors for psychopathology based on the data obtained at the time of the initial d iagnosis of dementia. Five psychiatric symptoms: hallucinations, delusions, anxiety, anhedonia, and loss of energy were significantly more common in D LB patients than in AD patients. DLB patients were younger at initial evalu ation and death as compared to AD patients, but there was no difference in age of onset of dementia, level of education, or family or past history of any major neuropsychiatric disorder, prescription of psychotropic medicatio ns, or sensory impairment. Psychiatric symptoms were more common at time of initial diagnosis of dementia in DLB than in AD patients. This difference could not be attributed to any known risk factors for psychopathology exami ned. Psychopathology should be considered an integral part of DLB, and shou ld be taken into account in the initial diagnosis of the type of dementia. Copyright (C) 2000 John Wiley & Sons, Ltd.