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Ajantha Abey - From Alzheimer’s to Lewy Body Disease - Expanding our Research Horizons

January 27, 2026·10 min·1 clip

Ajantha Abey reveals why Lewy body disease, with only 1,000 PubMed results, deserves more attention despite Alzheimer's having 20,000.

1. Dementia Researcher Blogs presents Ajantha Abey, a postdoctoral researcher at the University of Oxford, reading her blog on Lewy body disease and its significance to the broader dementia research field. 2. Ajantha Abey identifies herself as an Alzheimer's disease researcher who expanded her focus to Lewy body disease during her PhD, initially studying tau pathology before discovering co-occurring Lewy body pathology in Alzheimer's tissue. 3. The episode's core argument is that Lewy body disease is underfunded, underdiagnosed, and systematically neglected despite being one of the most common causes of dementia. 4. A search for 'dementia' on PubMed in early 2026 returns over 35,000 articles, while Alzheimer's disease returns over 20,000 and Parkinson's disease over 15,000; Lewy body disease returns only about 1,000 results. 5. Lewy bodies are clumps of aggregated proteins, primarily alpha-synuclein, that build up inside neurons and are named after pathologist Dr. Friedrich Lewy, who was among the first to describe them. 6. When alpha-synuclein misfolds and aggregates, it forms Lewy body structures and related deposits called Lewy neurites, linking a set of conditions called synucleinopathies. 7. Lewy body disease is not limited to Parkinson's disease; it presents clinically as a spectrum including dementia with Lewy bodies and Parkinson's disease dementia, with shared features such as visual hallucinations, cognitive fluctuations, Parkinsonism, and REM sleep behavior disorder. 8. Abey notes that naming and terminology in this area is 'mind-bendingly convoluted,' the result of competing discoveries accumulated over time that do not always form a coherent system, and that disagreement on nomenclature persists among researchers. 9. A critical patient safety issue is that people with Lewy body dementia can have severe and sometimes life-threatening reactions to antipsychotic and neuroleptic medications, making early and accurate diagnosis medically consequential. 10. During her PhD, Abey found that Lewy body pathology, which she initially treated as an awkward outlier in her Alzheimer's data, was present in more than half of all Alzheimer's disease cases according to recent neuropathology reviews. 11. She argues that if Alzheimer's researchers never account for concomitant Lewy body disease, they are 'probably missing a big piece of the biological reality' of what they are studying. 12. Large-scale neuropathology work consistently finds that co-occurring pathologies — including vascular injury, TDP-43, and Lewy bodies — are the norm in aged brains, not the exception. 13. Abey uses the example of a clinical trial recruiting an Alzheimer's cohort where half the participants may have substantial Lewy body disease: the cohort is not one biological population but a mixture, which dilutes treatment effects when a therapy targets only one disease mechanism. 14. Biomarkers, she argues, are not only tools for earlier diagnosis but for defining each patient's unique pathological profile — personalized medicine applied to neurodegeneration. 15. The 2024 revision of the Alzheimer's Association Working Group criteria explicitly expanded beyond the classic ATN (amyloid-tau-neurodegeneration) framework to include alpha-synucleinopathy as a biomarker category, citing that vascular and synuclein pathologies frequently co-occur with Alzheimer's in older adults. 16. There is currently no disease-modifying therapy for dementia with Lewy bodies or Lewy body dementia, making the research attention gap harder to justify than for diseases that already have approved treatments in development. 17. The episode is structured as a formal blog-reading rather than a conversation: Abey reads a prepared academic-style essay at a measured pace, with no interview back-and-forth or listener call-in segments. 18. The tone is calm, methodical, and advocacy-oriented — an insider making a structured case to a peer audience of researchers rather than a general-public explainer. 19. Researchers in Alzheimer's, Parkinson's, or adjacent neurodegeneration fields who want grounding in why Lewy body disease should be part of their reading. 20. General-public listeners or those seeking patient-facing dementia guidance rather than scientific research argumentation.

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