vere sensitivity to neuroleptic drugs, and these medications should be used with extreme
caution in managing the psychotic manifestations.
The diagnosis of mild NCDLB is appropriate for individuals who present with the core
or suggestive features at a stage when cognitive or functional impairments are not of suf-
ficient severity to fulfill criteria for major NC D. However, as for all mild NCDs, there will
often be insufficient ev idence to justify any si ngle etiology, and use of the unspecified di-
agnosis is most appropriate.
Associated Features Supporting Diagnosis
Individuals with NCDLB frequently experience  repeated falls and syncope and transient
episodes of unexplained loss of consciousness. Autonomic dysfunction, such as ortho-
static hypotension and urinary incontinen ce, may be observed. Auditory and other
nonvisual hallucinations are common, as are sy stematized delusions, delusional misiden-
tification, and depression.
Prevalence
The few population-based prev alence estimates for NCDLB available range from 0.1% to
5% of the general elderly popu lation, and from 1.7% to 30.5 % of all dementia cases. In
brain bank (autopsy) series, the pathological lesions known as Lewy bodies are present in
20%–35% of cases of dementia. The male-to- female ratio is approximately 1.5:1. 
Development and Course 
NCDLB is a gradually progressive disorder with  insidious onset. However, there is often
a prodromal history of confusional episodes (delirium) of acute onset, often precipitated
by illness or surgery. The distinction between NCDLB, in which Lewy bodies are primar-