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American Journal of Alzheimer's Disease and Other Dementias®
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Dementia with parkinsonism: Alzheimer's disease is more common than dementia with Lewy bodies

Carol F. Lippa, MD

Department of Neurology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania

Thomas W. Smith, MD

Departments ofPathology (Neuropathology) and Neurology, University of Massachusetts Medical Center, Worcester, Massachusetts

Joan Swearer, PhD

Department of Neurology, University of Massachusetts Medical Center, Worcester, Massachusetts

The spectrum ofpathologic diagnoses in patients presenting with dementia who subsequently develop parkinsonism is incompletely defined. To address this issue, we examined the brains from 19 patients with symptomatic parkinsonism within a year of their initial evaluation for dementia. Eighteen patients met CERAD pathologic criteria for Alzheimer k disease (AD), 14 of these hadpure AD and four had AD with concurrent cortical Lewy bodies (CLB). Only one case had dementia with Lewy bodies (DLB) without AD changes. Wefound no clinicalfeatures that could distinguish pure AD patientsfrom patients with CLB with certainty however the presence of disordered ideation increased the likelihood of DLB. We conclude that patients who present with dementia and subsequently develop parkinsonism frequently have AD if other signs of DLB are absent.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 13, No. 5, 229-235 (1998)
DOI: 10.1177/153331759801300503
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