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Delirium prior to dementia as a clinical phenotype of Lewy body disease: an autopsied case report

Published online by Cambridge University Press:  16 August 2016

Hiroshige Fujishiro*
Affiliation:
Department of Sleep Medicine, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan Department of Psychiatry, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan
Ito Kawakami
Affiliation:
Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo, 156-0057, Japan
Kenichi Oshima
Affiliation:
Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo, 156-0057, Japan
Kazuhiro Niizato
Affiliation:
Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo, 156-0057, Japan
Shuji Iritani
Affiliation:
Department of Psychiatry, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan
*
Correspondence should be addressed to: Hiroshige Fujishiro MD, PhD, Department of Sleep Medicine, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan. Phone: +81-52-744-2282; Fax: +81-52-744-2293. Email: fujishiro17@hotmail.co.jp.

Abstract

Although delirium shares clinical characteristics with dementia with Lewy bodies (DLB), there is limited information regarding the relationship between delirium and Lewy body pathology. Here, we report an 89-year-old Japanese woman with an episode of delirium who was pathologically confirmed to have limbic-type Lewy body disease (LBD). Although she exhibited transient visual hallucinations during the delirium, she had no overt dementia. She developed no core clinical features of DLB and died of pneumonia at the age of 90 years. This autopsied case suggests that delirium may be one of the clinical phenotypes of LBD prior to the onset of dementia.

Type
Case Reports
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Auning, E. et al. (2011). Early and presenting symptoms of dementia with Lewy bodies. Dementia and Geriatric Cognitive Disorders, 32, 202208.CrossRefGoogle ScholarPubMed
Davis, D. H. J. et al. (2012). Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain, 135, 28092816.CrossRefGoogle ScholarPubMed
Ferman, T. J. et al. (2011). Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies. Neurology, 77, 875882.CrossRefGoogle ScholarPubMed
Fujishiro, H., Nakamura, S., Sato, K. and Iseki, E. (2015). Prodromal dementia with Lewy bodies. Geriatrics & Gerontology International, 15, 817826. doi: 10.1111/ggi.12466.CrossRefGoogle ScholarPubMed
Gore, R. L., Vardy, E. R. and O'Brien, J. T. (2015). Delirium and dementia with Lewy bodies: distinct diagnoses or part of the same spectrum? Journal of Neurology, Neurosurgery and Psychiatry, 86, 5059.CrossRefGoogle Scholar
Jicha, G. A. et al. (2010). Prodromal clinical manifestations of neuropathologically confirmed Lewy body disease. Neurobiology of Aging, 31, 18051813.CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (2005). Consortium on DLB. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 18631872.CrossRefGoogle ScholarPubMed
Sunwoo, M. K., Hong, J. Y., Choi, J., Park, H. J., Kim, S. H. and Lee, P. H. (2013). α-Synuclein pathology is related to postoperative delirium in patients undergoing gastrectomy. Neurology, 80, 810813.CrossRefGoogle ScholarPubMed
Vardy, E., Holt, R., Gerhard, A., Richardson, A., Snowden, J. and Neary, D. (2014). History of a suspected delirium is more common in dementia with Lewy bodies than Alzheimer's disease: a retrospective study. International Journal of Geriatric Psychiatry, 29, 178181.CrossRefGoogle ScholarPubMed