Research criteria for the diagnosis of prodromal dementia with Lewy bodies.

The prodromal phase of dementia with Lewy bodies (DLB) includes (i) mild
cognitive impairment (MCI), (ii) delirium, and (iii) psychiatric-onset
presentations. The purpose of our review is to determine whether there is
sufficient information yet available to justify development of diagnostic
criteria for each of these. Our goal is to achieve evidence-based
recommendations for the recognition of DLB at a pre-dementia, symptomatic
stage. We propose operationalized diagnostic criteria for probable and
possible mild cognitive impairment with LB (MCI-LB), which are intended
for use in research settings pending validation for use in clinical
practice. They are compatible with current criteria for other prodromal
neurodegenerative disorders including Alzheimer’s and Parkinson’s disease.
While there is still insufficient evidence to propose formal criteria for
delirium-onset, and psychiatric-onset presentations of DLB, we feel it
important to characterise them, raising the index of diagnostic suspicion
and prioritising them for further investigation.