Dementia with Lewy bodies treated with rivastigmine: Effects on cognition,neuropsychiatric symptoms, and sleep

Dementia with Lewy bodies (DLB) is a common cause of the dementia syndrome. Symptomatic treatment of the fluctuating cognition, visual hallucinations, and sleep disturbance that characterize this condition is challenging; neu roleptics are relatively contraindicated. We describe eight patients fulfil ling the consensus diagnostic criteria for probable DLB who were treated wi th rivastigmine. Clinical features rated were: cognition by the Modified Mi ni-Mental State Examination (3MS); and behavioral and psychiatric symptoms by the Neuropsychiatric Inventory (NPI). Additional information was obtaine d from family and nursing reports. Seven patients showed resolution or impr ovement in cognition and neuropsychiatric symptoms as demonstrated by impro vement in their 3MS and NPI scores. They also became more independent in mo bility and activities of daily living, and the majority returned to live in their own home. Of the seven patients with sleep disruption, six improved. One case had no improvement in his symptomatology and the rivastigmine was stopped. Outcomes in this case series suggest that rivastigmine is well to lerated in clinical practice.