Skip to main content Accesibility Help

The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studies

  • S. A. Vann Jones (a1) and J. T. O'Brien (a1) (a2)

Dementia with Lewy bodies (DLB) is increasingly recognized as a common cause of dementia in older people. However, its true frequency remains unclear, with previous studies reporting a prevalence range from zero to 22.8% of all dementia cases. This review aimed to establish the population prevalence and incidence for DLB and to compare this to its prevalence in secondary care settings.


A literature review of all relevant population and clinical studies was conducted using PubMed. Additional references from papers found during that process were added to this.


DLB accounted for 4.2% of all diagnosed dementias in the community. In secondary care this increased to 7.5%. The incidence of DLB was 3.8% of new dementia cases. There was a significant increase in DLB diagnoses when using the revised (2005) International Consensus Criteria (ICC) for DLB compared to the original (1996) criteria.


DLB currently accounts for around one in 25 dementia cases diagnosed in the community and one in 13 cases in secondary care. The significantly higher rates of DLB in secondary care may reflect enhanced diagnostic accuracy in specialist settings and/or the increased morbidity and carer burden of the DLB syndrome compared to other dementias. However, the true prevalence is likely to be much higher because DLB diagnoses are often missed, although there is evidence that new criteria aid case identification.

Corresponding author
* Address for correspondence: Professor J. T. O'Brien, Department of Psychiatry, Level E4, Box 189, Addenbrooke's Hospital, Cambridge CB2 0QC, UK. (Email:
Hide All
Aarsland, D, Rongve, A, Nore, SP, Skogseth, R, Skulstad, S, Ehrt, U, Hoprekstad, D, Ballard, C (2008). Frequency and case identification of dementia with Lewy bodies using the revised consensus criteria. Dementia and Geriatric Cognitive Disorders 26, 445452.
Alladi, S, Mekala, S, Chadalawada, SK, Jala, S, Mridula, R, Kaul, S (2011). Subtypes of dementia: a study from a memory clinic in India. Dementia and Geriatric Cognitive Disorders 32, 3238.
Arslantas, D, Oezbabalik, D, Metintas, S, Oezkan, S, Kalyoncu, C, Oezdemir, G, Arslantas, A (2009). Prevalence of dementia and associated risk factors in Middle Anatolia, Turkey. Journal of Clinical Neuroscience 16, 14551459.
Ballard, C, Grace, J, McKeith, I, Holmes, C (1998). Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer's disease. Lancet 351, 10321033.
Ballard, C, McKeith, I, Burn, D, Harrison, R, O'Brien, J, Lowery, K, Campbell, M, Perry, R, Ince, P (1997). The UPDRS scale as a means of identifying extrapyramidal signs in patients suffering from dementia with Lewy bodies. Acta Neurologica Scandinavica 96, 366371.
Barber, R, Panikkar, A, McKeith, IG (2001). Dementia with Lewy bodies: diagnosis and management. International Journal of Geriatric Psychiatry 16, S12S18.
Barker, RA, Foltynie, T (2003). How common is dementia with Lewy bodies? Journal of Neurology, Neurosurgery and Psychiatry 74, 697698.
Bostrom, F, Jonsson, L, Minthon, L, Londos, E (2007). Patients with Lewy body dementia use more resources than those with Alzheimer's disease. International Journal of Geriatric Psychiatry 22, 713719.
Chan, SSM, Chiu, HFK, Lam, LCW, Leung, VPY (2002). Prevalence of dementia with Lewy bodies in an inpatient psychogeriatric population in Hong Kong Chinese. International Journal of Geriatric Psychiatry 17, 847850.
Cummings, JL, Mega, M, Gray, K, Rosenberg-Thompson, S, Carusi, DA, Gornbein, J (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44, 23082314.
de Silva, HA, Gunatilake, SB, Smith, AD (2003). Prevalence of dementia in a semi-urban population in Sri Lanka: report from a regional survey. International Journal of Geriatric Psychiatry 18, 711715.
Dimitrov, I, Tzourio, C, Milanov, I, Deleva, N, Traykov, L (2012). Prevalence of dementia and mild cognitive impairment in a Bulgarian urban population. American Journal of Alzheimer's Disease and Other Dementias 27, 131135.
Falagas, M, Pitsouni, E, Malietzis, G, Pappas, G (2007). Comparison of PubMed, Scopus, Web of Science, and Google Scholar: strengths and weaknesses. FASEB Journal 22, 338342.
Ferman, TJ, Smith, GE, Boeve, BF, Ivnik, RJ, Petersen, RC, Knopman, D, Graff-Radford, N, Parisi, J, Dickson, DW (2004). DLB fluctuations: specific features that reliably differentiate from AD and normal aging. Neurology 62, 181187.
Fernandez, Martinez M, Castro, Flores J, Perez de las, Heras S, Mandaluniz, Lekumberri A, Gordejuela, Menocal M, Zarranz, Imirizaldu JJ (2008). Prevalence of neuropsychiatric symptoms in elderly patients with dementia in Mungialde County (Basque Country, Spain). Dementia and Geriatric Cognitive Disorders 25, 103108.
Galasko, D, Salmon, D, Gamst, A, Olichney, J, Thal, LJ, Silbert, L, Kaye, J, Brooks, P, Adonay, R, Craig, UK, Schellenberg, G, Borenstein, AR (2007). Prevalence of dementia in Chamorros on Guam: relationship to age, gender, education, and APOE. Neurology 68, 17721781.
Galvin, JE, Duda, JE, Kaufer, DI, Lippa, CF, Taylor, A, Zarit, SH (2010). Lewy body dementia: caregiver burden and unmet needs. Alzheimer Disease and Associated Disorders 24, 177181.
Gascon-Bayarri, J, Rene, R, Del Barrio, JL, De Pedro-Cuesta, J, Ramon, M, Manubens, JM, Sanchez, C, Hernandez, M, Estela, J, Juncadella, M, Rubio, FR (2007). Prevalence of dementia subtypes in El Prat de Llobregat, Catalonia, Spain: the PRATICON study. Neuroepidemiology 28, 224234.
Geser, F, Wenning, GK, Poewe, W, McKeith, I (2005). How to diagnose dementia with Lewy bodies: state of the art. Movement Disorders 20, S11S20.
Gurvit, H, Emre, M, Tinaz, S, Bilgic, B, Hanagasi, H, Sahin, H, Gurol, E, Kvaloy, JT, Harmanci, H (2008). The prevalence of dementia in an urban Turkish population. American Journal of Alzheimer's Disease and Other Dementias 23, 6776.
Hanyu, H, Sato, T, Hirao, K, Kanetaka, H, Sakurai, H, Iwamoto, T (2009). Differences in clinical course between dementia with Lewy bodies and Alzheimer's disease. European Journal of Neurology 16, 212217.
Harvey, RJ, Skelton-Robinson, M, Rossor, MN (2003). The prevalence and causes of dementia in people under the age of 65 years. Journal of Neurology, Neurosurgery and Psychiatry 74, 12061209.
Herrera, E, Caramelli, P, Silveira, ASB, Nitrini, R (2002). Epidemiologic survey of dementia in a community-dwelling Brazilian population. Alzheimer Disease and Associated Disorders 16, 103108.
Ikeda, M, Hokoishi, K, Maki, N, Nebu, A, Tachibana, N, Komori, K, Shigenobu, K, Fukuhara, R, Tanabe, H (2001). Increased prevalence of vascular dementia in Japan: a community-based epidemiological study. Neurology 57, 839844.
Jhoo, JH, Kim, KW, Huh, Y, Lee, SB, Park, JH, Lee, JJ, Choi, EA, Han, C, Choo, IH, Youn, JC, Lee, DY, Woo, JI (2008). Prevalence of dementia and its subtypes in an elderly urban Korean population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA). Dementia and Geriatric Cognitive Disorders 26, 270276.
Kim, KW, Park, JH, Kim, M-H, Kim, MD, Kim, B-J, Kim, S-K, Kim, JL, Moon, SW, Bae, JN, Woo, JI, Ryu, S-H, Yoon, JC, Lee, N-J, Lee, DY, Lee, DW, Lee, SB, Lee, JJ, Lee, J-Y, Lee, C-U, Chang, SM, Jhoo, JH, Cho, MJ (2011). A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. Journal of Alzheimer's Disease 23, 279289.
Kish, L (1965). Survey Sampling. John Wiley & Sons: New York.
Klatka, LA, Louis, ED, Schiffer, RB (1996). Psychiatric features in diffuse Lewy body disease: a clinicopathologic study using Alzheimer's disease and Parkinson's disease comparison groups. Neurology 47, 11481152.
Knapp, M, Prince, M, Albanese, E, Banerjee, S, Dhanasiri, S, Fernandez, J, Ferri, C, McCrone, P, Snell, T, Stewart, R (2007). Dementia UK: the full report. Alzheimer's Society, Kings College London and the London School of Economics: London. Report number: 1.
Litvan, I, Bhatia, KP, Burn, DJ, Goetz, CG, Lang, AE, McKeith, I, Quinn, N, Sethi, KD, Shults, C, Wenning, GK; Movement Disorders Society Scientific Issues Committee (2003). Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Movement Disorders 18, 467486.
Londos, E, Passant, U, Brun, A, Gustafson, L (2000). Clinical Lewy body dementia and the impact of vascular components. International Journal of Geriatric Psychiatry 15, 4049.
Matsui, Y, Tanizaki, Y, Arima, H, Yonemoto, K, Doi, Y, Ninomiya, T, Sasaki, K, Iida, M, Iwaki, T, Kanba, S, Kiyohara, Y (2009). Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study. Journal of Neurology, Neurosurgery and Psychiatry 80, 366370.
Mayeux, R, Denaro, J, Hemenegildo, N, Marder, K, Tang, MX, Cote, LJ, Stem, Y (1992). A population-based investigation of Parkinson's disease with and without dementia. Relationship to age and gender. Archives of Neurology 49, 492497.
McKeith, IG, Dickson, DW, Lowe, J, Emre, M, O'Brien, JT, Feldman, H, Cummings, J, Duda, JE, Lippa, C, Perry, EK, Aarsland, D, Arai, H, Ballard, CG, Boeve, B, Burn, DJ, Costa, D, Del Ser, T, Dubois, B, Galasko, D, Gauthier, S, Goetz, CG, Gomez-Tortosa, E, Halliday, G, Hansen, LA, Hardy, J, Iwatsubo, T, Kalaria, RN, Kaufer, D, Kenny, RA, Korczyn, A, Kosaka, K, Lee, VMY, Lees, A, Litvan, I, Londos, E, Lopez, OL, Minoshima, S, Mizuno, Y, Molina, JA, Mukaetova-Ladinska, EB, Pasquier, F, Perry, RH, Schulz, JB, Trojanowski, JQ, Yamada, M; Consortium on DLB (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65, 18631872.
McKeith, IG, Galasko, D, Kosaka, K, Perry, EK, Dickson, DW, Hansen, LA, Salmon, DP, Lowe, J, Mirra, SS, Byrne, EJ, Lennox, G, Quinn, NP, Edwardson, JA, Ince, PG, Bergeron, C, Burns, A, Miller, BL, Lovestone, S, Collerton, D, Jansen, ENH, Ballard, C, deVos, RAI, Wilcock, GK, Jellinger, KA, Perry, RH (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 47, 11131124.
McKeith, IG, Rowan, E, Askew, K, Naidu, A, Allan, L, Barnett, N, Lett, D, Mosimann, UP, Burn, D, O'Brien, JT (2006). More severe functional impairment in dementia with Lewy bodies than Alzheimer disease is related to extrapyramidal motor dysfunction. American Journal of Geriatric Psychiatry 14, 582588.
Miech, RA, Breitner, JCS, Zandi, PP, Khachaturian, AS, Anthony, JC, Mayer, L (2002). Incidence of AD may decline in the early 90 s for men, later for women: the Cache County study. Neurology 58, 209218.
Mitchell, AJ (2009). A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. Journal of Psychiatric Research 43, 411–131.
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. British Medical Journal 339, b2535.
Molero, AE, Pino-Ramirez, G, Maestre, GE (2007). High prevalence of dementia in a Caribbean population. Neuroepidemiology 29, 107112.
O'Brien, JT, McKeith, IG, Walker, Z, Tatsch, K, Booij, J, Darcourt, J, Marquardt, M, Reininger, C, Group, DLBS (2009). Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. British Journal of Psychiatry 194, 3439.
Palmqvist, S, Hansson, O, Minthon, L, Londos, E (2009). Practical suggestions on how to differentiate dementia with Lewy bodies from Alzheimer's disease with common cognitive tests. International Journal of Geriatric Psychiatry 24, 14051412.
Perez, F, Helmer, C, Dartigues, JF, Auriacombe, S, Tison, F (2010). A 15-year population-based cohort study of the incidence of Parkinson's disease and dementia with Lewy bodies in an elderly French cohort. Journal of Neurology, Neurosurgery and Psychiatry 81, 742746.
Plassman, BL, Langa, KM, Fisher, GG, Heeringa, SG, Weir, DR, Ofstedal, MB, Burke, JR, Hurd, MD, Potter, GG, Rodgers, WL, Steffens, DC, Willis, RJ, Wallace, RB (2007). Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology 29, 125132.
Prince, M, Ferri, CP, Acosta, D, Albanese, E, Arizaga, R, Dewey, M, Gavrilova, SI, Guerra, M, Huang, Y, Jacob, KS, Krishnamoorthy, ES, McKeigue, P, Rodriguez, JL, Salas, A, Sosa, AL, Sousa, RM, Stewart, R, Uwakwe, R (2007). The protocols for the 10/66 dementia research group population-based research programme. BMC Public Health 20, 165.
Rahkonen, T, Eloniemi-Sulkava, U, Rissanen, S, Vatanen, A, Viramo, P, Sulkava, R (2003). Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older. Journal of Neurology, Neurosurgery and Psychiatry 74, 720724.
Ricci, M, Guidoni, SV, Sepe-Monti, M, Bomboi, G, Antonini, G, Blundo, C, Giubilei, F (2009). Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Archives of Gerontology and Geriatrics 49, 101104.
Sambrook, R, Herrmann, N, Hebert, R, McCracken, P, Robillard, A, Luong, D, Yu, A (2004). Canadian outcomes study in dementia: study methods and patient characteristics. Canadian Journal of Psychiatry 49, 417427.
Shaji, KS, Iype, T, Anandan, KR (2002). Clinical diagnosis of dementia with Lewy bodies. British Journal of Psychiatry 181, 168169.
Shinagawa, S, Ikeda, M, Toyota, Y, Matsumoto, T, Matsumoto, N, Mori, T, Ishikawa, T, Fukuhara, R, Komori, K, Hokoishi, K, Tanabe, H (2007). Frequency and clinical characteristics of early-onset dementia in consecutive patients in a memory clinic. Dementia and Geriatric Cognitive Disorders 24, 4247.
Sonnesyn, H, Nilsen, DW, Rongve, A, Nore, S, Ballard, C, Tysnes, OB, Aarsland, D (2009). High prevalence of orthostatic hypotension in mild dementia. Dementia and Geriatric Cognitive Disorders 28, 307313.
Stevens, T, Livingston, G, Kitchen, G, Manela, M, Walker, Z, Katona, C (2002). Islington study of dementia subtypes in the community. British Journal of Psychiatry 180, 270276.
Takada, LT, Caramelli, P, Radanovic, M, Anghinah, R, Hartmann, A, Guariglia, CC, Bahia, VS, Nitrini, R (2003). Prevalence of potentially reversible dementias in a dementia outpatient clinic of a tertiary university-affiliated hospital in Brazil. Arquivos de Neuro-Psiquiatria 61, 925929.
Tognoni, G, Ceravolo, R, Nucciarone, B, Bianchi, F, Dell'Agnello, G, Ghicopulos, I, Siciliano, G, Murri, L (2005). From mild cognitive impairment to dementia: a prevalence study in a district of Tuscany, Italy. Acta Neurologica Scandinavica 112, 6571.
Walker, MP, Ayre, GA, Cummings, JL, Wesnes, K, McKeigh, IG, O'Brien, JT, Ballard, CG (2000). The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. Two methods to assess fluctuating confusion in dementia. British Journal of Psychiatry 177, 252256.
Wilcock, GK (2003). Dementia with Lewy bodies. Lancet 362, 16891690.
Williams, MM, Xiong, CJ, Morris, JC, Galvin, JE (2006). Survival and mortality differences between dementia with Lewy bodies vs Alzheimer disease. Neurology 67, 19351941.
Yamada, T, Hattori, H, Miura, A, Tanabe, M, Yamori, Y (2001). Prevalence of Alzheimer's disease, vascular dementia and dementia with Lewy bodies in a Japanese population. Psychiatry and Clinical Neurosciences 55, 2125.
Yamada, T, Kadekaru, H, Matsumoto, S, Inada, H, Tanabe, M, Moriguchi, EH, Moriguchi, Y, Ishikawa, P, Ishikawa, AG, Taira, K, Yamori, Y (2002). Prevalence of dementia in the older Japanese-Brazilian population. Psychiatry and Clinical Neurosciences 56, 7175.
Yokota, O, Sasaki, K, Fujisawa, Y, Takahashi, J, Terada, S, Ishihara, T, Nakashima, H, Kugo, A, Ata, T, Ishizu, H, Kuroda, S (2005). Frequency of early and late-onset dementias in a Japanese memory disorders clinic. European Journal of Neurology 12, 782790.
Yoshida, H, Terada, S, Honda, H, Ata, T, Takeda, N, Kishimoto, Y, Oshima, E, Ishihara, T, Kuroda, S (2011). Validation of Addenbrooke's cognitive examination for detecting early dementia in a Japanese population. Psychiatry Research 185, 211214.
Yusuf, AJ, Baiyewu, O, Sheikh, TL, Shehu, AU (2011). Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria. International Psychogeriatrics 23, 379386.
Zaccai, J, McCracken, C, Brayne, C (2005). A systematic review of prevalence and incidence studies of dementia with Lewy bodies. Age and Ageing 34, 561566.
Zupancic, M, Mahajan, A, Handa, K (2011). Dementia with Lewy bodies: diagnosis and management for primary care providers. Primary Care Companion to CNS Disorders 13, pii: PCC.11r01190.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed