Recent advances in the management of Lewy body dementia: evaluating progress and future directions

Lewy body dementia (LBD), encompassing dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is progressive and heterogeneous in clinical presentation and underlying pathobiology. LBD substantially impacts patient function, independence, and quality of life. Current therapies are symptomatic, and disease-modifying therapies are not established. Advances in in vivo biomarkers provide an important window for early disease diagnosis and intervention.

This review examines the complex spectrum of LBD, including DLB, PDD, and prodromal states of MCI-LB and PD-MCI. Advances in biomarkers and biological frameworks are considered along with limitations in DLB. Recent pharmacological and non-pharmacological clinical trials are highlighted. The authors offer commentary on the challenges and opportunities for current and future research and care in LBD.

LBD remains a diagnostic and therapeutic challenge. The development and validation of in vivo biomarkers of LBD permit improved and earlier diagnosis, along with deeper characterization of LBD. Further research is needed to harmonize and implement biological frameworks and staging, develop and validate biomarkers and LBD-relevant clinical outcome measures, and design clinical trials using biologically based agents for disease-modification. Lastly, creating holistic care plans that span the entire disease is essential for improving patient outcomes.