Comorbid Pathologies and Their Impact on Dementia with Lewy Bodies-Current View

Area of Science:

• Neurology
• Neuroscience
• Pathology

Background:

• Dementia with Lewy bodies (DLB) is a primary neurocognitive disorder, second to Alzheimer disease (AD).
• DLB frequently exhibits co-pathologies, including Alzheimer disease-related neuropathological changes (ADNC), TDP-43 proteinopathies, and cardiovascular/aging disorders.
• Cerebrovascular lesions and cardiovascular conditions like hypertension and hyperlipidemia are common comorbidities in DLB.

Purpose of the Study:

• To review the types and frequency of co-pathologies in DLB.
• To assess the clinical impact of these co-pathologies on DLB patients.
• To evaluate the utility of biomarkers for assessing and preventing DLB and its co-pathologies.

Main Methods:

• Literature review of neuropathological and clinical studies on DLB co-pathologies.
• Analysis of the prevalence and impact of co-existing conditions in DLB.
• Evaluation of biomarker potential for DLB diagnosis and progression prediction.

Main Results:

• Alzheimer disease-related neuropathological changes (ADNC) and TDP-43 proteinopathies are common co-pathologies in DLB.
• Cerebrovascular lesions, particularly cerebral amyloid angiopathy, are the most frequent non-neurodegenerative co-pathologies.
• Cardiovascular disorders, hypertension, and hyperlipidemia are highly prevalent comorbidities in DLB patients.

Conclusions:

• Co-pathologies significantly influence DLB clinical presentation and progression.
• Clinical trial designs for DLB should incorporate the impact of co-pathologies.
• Biomarker evaluation for co-pathologies can enhance diagnostic accuracy and predict clinical outcomes in DLB.