Dementia with Lewy bodies —an Investigation of Cause and Consequence

University dissertation from Clinical Memory Research Unit, Lund University

Abstract: Dementia with Lewy bodies (DLB) is today considered to be the second most common primary neurodegenerative dementia after Alzheimer’s disease. However, the disease has only been a clearly defined entity for 13 years. Due to its recent recognition, DLB is still not as extensively studied as are other major dementia disorders such as Alzheimer’s disease (AD), vascular dementia, and fronto-temporal dementia.

In summary, this thesis demonstrates important differences between AD and DLB. Paper I and II focus on the ultimate consequences of the disease, including resource consumption and impact on quality of life, and demonstrate much more severe consequences of DLB. Paper III and IV focus on diagnosis and prediction of disease progression through CSF analysis, and demonstrate a robust increase of CSF Ca and Mg in DLB but not in AD. Furthermore, CSF t-tau, a marker of AD and neurodegeneration, is demonstrated to increase mortality in DLB, but not in AD. These DLB specific CSF findings give us further understanding of the factors that may trigger the disease and determine disease course. Furthermore, CSF Mg and Ca may be a valuable tool in making a DLB diagnosis, especially when the considered differential diagnosis is AD.