American Board of Psychiatry and Neurology (ABPN) Practice Exam

Dementia with Lewy bodies is characterized by several distinctive features. Among these are visual hallucinations, fluctuating cognition, and parkinsonism.

Visual hallucinations are a prominent symptom in Lewy body dementia and can occur early in the disease process. Patients may see things that are not there or have distorted perceptions of their environment. Fluctuating cognition refers to varying levels of attention and alertness, which can significantly affect the patient's daily functioning and cognitive abilities. This symptom is also a hallmark of Lewy body dementia, as patients may experience periods of confusion and then return to a more lucid state.

Parkinsonism, which includes symptoms such as tremors, rigidity, and bradykinesia, is often associated with dementia with Lewy bodies due to the overlap of pathophysiological features with Parkinson's disease.

In contrast, significant memory impairment is not necessarily an early feature of dementia with Lewy bodies. Unlike Alzheimer’s disease, where memory issues are typically prominent in the early stages, the cognitive decline in Lewy body dementia often begins with the aforementioned symptoms, and memory impairment may not be as noticeable until later in the course of the disease. This differentiates it from other types of dementia and underscores the importance of recognizing the