Low Frequency of Dementia with Lewy Bodies Diagnosis in a Colombian Memory Clinic

Background: The global burden of dementia is increasing, particularly in low- and middle-income countries. Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia but remains underreported and frequently misdiagnosed. Its prevalence in Latin America is largely unknown. Objective: The aim was to determine the frequency of DLB in a large memory clinic in Colombia and compare its clinical presentation with other neurodegenerative conditions, including Alzheimer's disease, frontotemporal dementia (FTD), vascular dementia, and Parkinson's disease dementia (PDD). Methods: We conducted a retrospective study at a referral memory clinic in Bogotá, Colombia, from January 2018 to December 2022. DLB was identified based on the Fourth Consensus Report criteria. Random samples of patients with other neurodegenerative conditions were selected for comparison, maintaining a maximum ratio of 4:1. Clinical assessments were conducted by an interdisciplinary team using validated neurocognitive, neuropsychiatric, neuropsychological, and functional tools. Imaging and biofluid biomarkers were not available. Results: Of 5518 patients, 38 (0.6%) were diagnosed with DLB. These individuals were predominantly male, with an average age of 72.3 years. Significant differences were observed between groups in age of onset, motor and cognitive function, and neuropsychiatric symptoms. Hallucinations were more common in DLB and PDD, whereas behavioral disturbances were frequent in FTD and DLB. Core symptoms of DLB were also present in patients diagnosed with other conditions, although cognitive fluctuations were not registered. Conclusions: DLB is likely underdiagnosed in this setting. Improved recognition and management are essential.