Table 2

Consensus criteria for clinical diagnosis of probable and possible dementia with Lewy bodies8

*Not described in original criteria but subsequently proposed to assist with diagnosis.
DLB, dementia with Lewy bodies.

  1. The central feature required for a diagnosis of DLB is progressive cognitive decline of sufficient magnitude to interfere with normal social and occupational function. Prominent or persistent memory impairment may not necessarily occur in the early stages but is usually evident with progression. Deficits on tests of attention and of frontal-subcortical skills and visuospatial ability may be especially prominent.

  2. Two of the following core features are essential for a diagnosis of probable DLB and one is essential for possible DLB:

    • fluctuation of cognition with pronounced variations in attention and alertness

    • recurrent visual hallucinations that are typically well formed and detailed

    • spontaneous motor features of parkinsonism

  3. Features supportive of the diagnosis are:

    • repeated falls

    • syncope

    • transient loss of consciousness

    • neuroleptic sensitivity

    • systematised delusions

    • hallucinations in other modalities

    • REM sleep behaviour disorder*

    • depression*

  4. A diagnosis of DLB is less likely in the presence of:

    • stroke disease, evident as focal neurological signs or on brain imaging

    • evidence on physical examination and investigation of any physical illness or other brain disorder sufficient to account for the clinical picture