When should I consider referring a patient with suspected Dementia with Lewy Bodies to a specialist for further evaluation?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

You should consider referring a patient with suspected Dementia with Lewy Bodies (DLB) to a specialist dementia diagnostic service, such as a memory clinic or community old age psychiatry service, once reversible causes of cognitive decline have been investigated and dementia is still suspected ,.

Reversible causes of cognitive decline include delirium, depression, sensory impairment (such as sight or hearing loss), or cognitive impairment from medicines associated with increased anticholinergic burden ,.

Once referred, specialist investigations for suspected dementia may include structural imaging (MRI or CT scan) . If the diagnosis remains uncertain and DLB is suspected, the specialist may consider further tests such as I-FP-CIT SPECT or I-MIBG cardiac scintigraphy, particularly if knowing the dementia subtype would change management ,.

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