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TOPLINE:

The pooled worldwide incidence of dementia with Lewy bodies (DLB) is higher than previously reported population-based studies of other uncommon neurologic disorders and is highest among those aged 65 years or older, the first known systematic review and meta-analysis of population-based studies of DLB showed. Incidence was also higher in men than in women, although the difference was not significant.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis and included 12 population-based studies that reported the incidence and/or prevalence of DLB based on validated diagnostic criteria.
• Studies conducted across Europe, the US, Taiwan, Japan, and Australia were identified from PubMed, Embase, and Scopus databases. The researchers included reconstructed cohort registry-based designs, national insurance database analyses, and prevalence surveys, with the target period between 1985 and 2022 across 149.98 million person-years.
• Incidence and prevalence estimates were pooled, with subgroup analyses exploring heterogeneity by age (< 65 years vs ≥ 65 years), sex, geographic region, and study design.

TAKEAWAY:

• In individuals aged 65 years or older, the pooled incidence of DLB was 46.85 per 100,000 person-years and the pooled prevalence was 352.26 per 100,000 population. In those younger than 65 years, the pooled incidence of DLB was 0.34 per 100,000 person-years and the pooled prevalence was 2.52 per 100,000 population.
• The pooled incidence of DLB was higher in men than in women (5.45 per 100,000 person-years vs 4.32 per 100,000 person-years), but the difference was not statistically significant.
• Between-study heterogeneity was high, partly reflecting the challenges associated with the diagnosis of DLB. Heterogeneity observed in reconstructed cohort studies was lower than that seen in claims-based studies.
• The pooled incidence of DLB was higher than previously reported population-based estimates for other uncommon neurodegenerative disorders, including frontotemporal dementia (2.28 per 100,000 person-years), amyotrophic lateral sclerosis (1.59 per 100,000 person-years), progressive supranuclear palsy (0.81 per 100,000 person-years), and corticobasal syndrome (0.28 per 100,000 person-years).

IN PRACTICE:

“Given the clinical impact of DLB, characterized by faster progression, greater functional decline, and higher caregiver burden than AD [Alzheimer’s disease], reliable estimates are essential for healthcare planning, policy development, and resource allocation,” the investigators wrote.

“These findings provide a robust reference for future epidemiologic research and public health planning, underscoring the need for standardized diagnostic approaches and inclusion of underrepresented populations to refine global burden estimates,” they added.

SOURCE:

The study was led by Daniele Urso, MD, MPH, and Stefano Giannoni-Luza, MD, MPH, both from the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari ‘Aldo Moro,’ Tricase, Italy. It was published online on May 11 in JAMA Neurology.

LIMITATIONS:

Heterogeneity across studies was high, owing to diversity in study design, diagnostic criteria, methods of case ascertainment, and healthcare delivery systems. Prevalence data were sparse and age- and sex-stratified data were inconsistent. Most studies were conducted in high-income countries, which limits the generalizability of the findings. Diagnostic criteria changed over time, and there was a potential risk for misclassification due to clinical and pathologic overlap with Alzheimer’s disease and Parkinson’s disease dementia. Additionally, a formal assessment of publication bias was not performed given the small number of studies per outcome.

DISCLOSURES:

The study was funded by Regione Puglia and CNR for Tecnopolo per la Medicina di Precisione and Regione Puglia through the National Fund for Alzheimer’s and Dementia, 2021-2023. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.