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Dementia with Lewy bodies — ABFM Board MCQ

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HardGeriatricsDementia with Lewy bodiesABFM Board

A 78-year-old woman has progressive memory loss, impaired instrumental activities of daily living, and visual hallucinations. Her daughter reports dream enactment and fluctuating alertness. Mini-Cog is abnormal. Which of the following is the most likely diagnosis?

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Correct answer: A — Major neurocognitive disorder with Lewy bodies

Fluctuating cognition, visual hallucinations, parkinsonism, and REM sleep behavior disorder suggest dementia with Lewy bodies. Antipsychotic sensitivity is a key management consideration.

Reference: American Academy of Neurology Dementia Guidance