The temporal onset of the core features in dementia with Lewy bodies

Parichita Choudhury, Jonathan Graff-Radford, Jeremiah A. Aakre, Lincoln Wurtz, David S. Knopman, Neill R. Graff-Radford, Kejal Kantarci, Leah K. Forsberg, Julie A. Fields, Otto Pedraza, Qin Chen, Toji Miyagawa, Gregory S. Day, Philip Tipton, Rodolfo Savica, Hugo Botha, Christian Lachner, Brynn Dredla, R. Ross Reichard, Ronald C. PetersenDennis W. Dickson, Bradley F. Boeve, Tanis J. Ferman

Research output: Contribution to journalArticlepeer-review


Introduction: We examined the temporal sequence of the core features in probable dementia with Lewy bodies (DLB). Methods: In 488 patients with probable DLB, the onset of each core feature and time to diagnosis was determined for men and women, and a pathologic subgroup (n = 209). Results: REM sleep behavior disorder (RBD) developed before the other core features in men and women. Men were more likely to have RBD and were diagnosed with probable DLB earlier than women. Visual hallucinations developed after the other core features in men, but in women, they appeared earlier and concurrently with fluctuations and parkinsonism. Women were older and more cognitively impaired at first visit, were less likely to have RBD, more likely to be diagnosed with probable DLB later than men, and more likely to have neocortical tangles. Discussion: An earlier latency to probable DLB was associated with men, RBD, and Lewy body disease without neocortical tangles.

Original languageEnglish (US)
Pages (from-to)591-601
Number of pages11
JournalAlzheimer's and Dementia
Issue number4
StatePublished - Apr 2022


  • Alzheimer's disease
  • Lewy body disease
  • neuropsychiatric
  • sex

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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