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Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) represent the second most common type of degenerative dementia in patients aged 65 years and older, leading to progressive cognitive dysfunction and impaired quality of life. This study aims to provide a consensus based on a systematic Brazilian literature review and a comprehensive international review concerning PDD and DLB. Moreover, we sought to report on and give recommendations about the best diagnostic approaches focusing on primary and secondary care. Based on the available data, we recommend clinicians to apply at least one brief global cognitive instrument to assess PDD, such as the Mini-Mental State Examination and preferably the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised. Validated instruments to accurately assess functional abilities in Brazilian PD patients are still incipient. Further studies should focus on biomarkers with Brazilian cohorts.A demência da doença de Parkinson (DDP) e a demência com corpos de Lewy (DCL) representam a segunda causa mais comum de demência neurodegenerativa em pessoas com mais de 65 anos, ocasionando progressivo declínio cognitivo e comprometimento da qualidade de vida. O presente estudo tem como objetivo prover um consenso de especialistas sobre a DDP e DCL, baseado em revisão sistemática da literatura brasileira e revisão não-sistemática de literatura internacional. Ademais, tal estudo visa promover informação e conceder recomendações sobre abordagem diagnóstica, com foco nos níveis de atenção primária e secundária em saúde. Com base nos dados disponíveis, recomendamos que os profissionais realizem pelo menos um breve instrumento cognitivo global, como o Mini-Exame do Estado Mental, contudo de preferência optem pela Avaliação Cognitiva de Montreal e o Exame Cognitivo de Addenbrooke-Revisado. Observa-se uma carência de instrumentos validados para a avaliação precisa das habilidades funcionais em pacientes brasileiros com DDP e DCL. Além disso, mais estudos focando em biomarcadores com coortes brasileiras também são necessários.

Background: The anticholinergic burden is associated with a greater risk of functional/ cognitive decline and morbidity/mortality. Objectives: Our aim was to quantify the anticholinergic burden in the first visit in our dementia tertiary outpatient clinic. Methods: We performed a retrospective analysis of all first visit medical records of patients referred from primary health care to the outpatient dementia clinic of a tertiary hospital in Porto Alegre with a final diagnosis of dementia or Mild Cognitive Impairment (MCI) between 2014-2019. We evaluated all medications in use and we calculated a final score using Brazilian Anticholinergic Activity Drug (BAAD) score. This scale classified drugs according to its central anticholinergic activity from 1 to 3, with higher values indicating greater activity. The final score is the sum of the score for each drug. We divided the sample in two groups (score=0 and ⩾ 1) and performed a logist regression using age, sex, dementia diagnosis and MMSE as covariates. Results: We identified 199 final diagnoses of dementia (mostly Alzheimer’s Disease (AD) [45.2%]) and 39 of MCI. Most patients with dementia (76.4%) and MCI (74.3%) had at least a BAAD score = 1. Median (IQI) BAAD score was higher in VD, 4 (1.0-6.5). In the regression analysis, BAAD score was associated with MMSE, controlling for covariates. Conclusions: In our sample, the anticholinergic burden was high and correlated with dementia severity.