Abstract

Solène Frileux , Pr. Bruno Millet, Pr. Philippe Fossati

Obsessive-compulsive disorder (OCD) usually begins in adolescence or young adulthood. OCD cases appearing after the age of 50 are rare, most often associated with inflammatory, brain lesions or neurodegenerative comorbidities. Thus, some authors suggest that early- and late-onset OCD are different diseases. In view of fueling this discussion, we present 2 cases of late-onset OCD followed by the development of Lewy body dementia (LBD), which treatment resulted in OCD improvement. Those two disorders have never been described as associated before. We then raised this question: would late-onset OCD belong to DLB prodromes?

To discuss this hypothesis, we investigated both OCD cases following brain conditions and common pathophysiology to DLB and OCD. We conducted a PubMed search using the search terms “late-onset OCD”; “acquired OCD”; “obsessive-compulsive disorder” AND “dementia”; “obsessive-compulsive disorder” AND “Lewy body dementia”. Our search initially yielded 99 results. The ones related to our review topic were considered to further understand the pathophysiological mechanisms underlying late-onset OCD.