OBJECTIVES

To investigate and establish the prevalence of dementia with Lewy body (DLB) symptoms in all nursing home (NH) residents in Malmö, the third largest city in Sweden. DLB is a neurocognitive disorder with core features, such as parkinsonism, visual hallucinations, and fluctuating cognition/excessive daytime sleepiness, and supportive features, such as rapid eye movement sleep behavior disorder. DLB is often misdiagnosed and unrecognized in elderly individuals.

DESIGN

A questionnaire, designed to cover the main DLB symptoms, according to consensus criteria from the third report of the DLB Consortium from 2005, was distributed in 40 NHs. The questionnaires were completed by the nursing staff after receiving specifically designed teaching. Medication lists were collected from the Swedish national medication dispensing system.

SETTING

Nursing homes.

PARTICIPANTS

Of 650 eligible residents, 620 (96%) were included. The mean age was 86.0 ± 7.5 years; 467 (75%) were women.

RESULTS

We found a prevalence of 16% of 2 or more main symptoms of DLB in the NH residents. However, when a wider more inclusive parkinsonism variable was used, the prevalence of DLB symptoms increased to 20%.

CONCLUSION

We conclude that elderly with 2 or more DLB symptoms may constitute between 16% and 20% of all residents in NHs. This emphasizes the importance of identification of DLB and guides clinicians to deliver appropriate treatment for this fragile patient group.