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To the Editor:
In a recent comparative clinicopathologic study of 98 autopsy-proven cases of dementia with Lewy bodies (DLB), Merdes et al.1 observed that DLB patients with low Braak stages (0–2) had a higher frequency of visual hallucinations and extrapyramidal signs (EPS) but a nonsignificantly higher degree of EPS than those with high neuritic Braak stages (3–6). The clinical diagnostic accuracy for DLB was relatively low (48%), but higher for subjects with lower (75%) than those with higher (38%) Braak stages, suggesting that the degree of concomitant Alzheimer’s disease (AD) tangle pathology has an important influence on both clinical features and clinical diagnostic accuracy of DLB.
These data can, at least in part, be confirmed by the results of a personal consecutive series of 96 cases of autopsy-proven DLB. Average age at onset was 67 (SD 12.7) years, and median survival from symptom onset was 5.0 years, 95% CL of median 4.6–5.4, mean 6.7 years.2 The cohort included 60 cases with low Braak stages (mean 3.5 [range 1.5 to 4]), 24 men, 36 women, with a mean …
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