Ashley Arroyo,1 Elysia Teruya,1 Matthew Fujikami,1 Andrew Mettias,1 Jan Aurelio,2 Matthew Kao,2 Janette Bow-Keola,2 Tyrone Sumibcay,2 Masako Matsunaga,3 Qi Zhi,1 Enrique Carrazana,2 Kore Liow1,2
1 Hawaii Memory Disorders Center, Hawaii Pacific Neuroscience, Honolulu, HI
2 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
3 JABSOM Biostatistics Core Facility, Department of Quantitative Health Sciences, University of Hawaiʻi John A. Burns School of Medicine, Honolulu, H
Background: The clinical presentation of Lewy Body Dementia (LBD) is not a uniform occurrence, yet data from diverse populations remain sparse. This study aims to characterize the demographic, clinical, and comorbidity profiles of LBD across Hawaii’s diverse population to identify distinct phenotypes and clinical profiles of LBD patients.
Methods: A retrospective chart review was performed on 223 patients who received care at Hawaii Pacific Neuroscience between June 2015 – June 2025. Data on demographics, core LBD features, clinical characteristics, and comorbidities were gathered. Statistical analyses were conducted using Kruskal-Wallis rank sum and Fisher’s exact tests.
Results: Asians were older and predominantly female (72%); recurrent visual hallucinations (RVH) were highest among Asians and lowest among NHPI. Clinically, Asian patients had the lowest mean BMI and a particularly high rate of being underweight (24% vs < 8% in all other groups). NHPI patients presented the highest rates of current smoking (15%) and co-morbid dementia (78%), suggesting a clinical profile influenced by multi-morbidity.
Conclusion: These findings suggest a distinct Asian LBD phenotype, characterized by advanced age, female predominance, high RVH frequency, and low BMI. This clustering of features raises questions about the interplay between age, sex, genetics, and metabolic status in modulating core LBD symptoms. Given the observed ethnoracial variation of RVH prevalence, a core diagnostic feature of LBD, current criteria may possess varying sensitivity across groups, potentially leading to systematic over/under diagnosis. Therefore, characterizing these population-specific phenotypes is essential for advancing equitable care in LBD.
