Thank you for the opportunity to review this paper. It is a brief narrative review of issues surrounding the diagnosis and management of delirium in LBD. The topic is undoubtedly of great importance to clinicians and researchers alike. The authors are well recognised as being among the leaders of their field in the topic.

The “Diagnosing delirium in LBD” section highlights the difficulties in diagnosing delirium, particularly in the research setting. They briefly describe the tests used to recognise delirium in all cause dementia samples and how these could be further limited in LBD cohorts. Although I was interested to read the findings from the only paper used to detect delirium in LBD, I note that this is from the same author group, and there is no evidence of a systematic review that might identify further studies. I feel that is a significant weakness.

The management section has a distinctly clinical focus, which contrasts with the diagnosis section – which focuses on research studies. Discussion of the practical aspects of the tests described in the diagnosis section would be of benefit to the clinical reader and might diminish the difference in approach to the two sections.

The management section comprises mostly generic and widely available advice regarding the management of delirium in dementia. Only briefly does it relate this advice to LBD, referencing neuroleptic sensitivity. This is inevitable given the scarcity of evidence described by the authors. However, I feel that much more detail could have been provided on negative clinical trials mentioned. I also feel that readers would appreciate discussion of specific benzodiazepines and antipsychotics – haloperidol is the only antipsychotic mentioned by name. Discussion of the advantages and disadvantages of quetiapine, for example, might have been considered.

This is a helpful and well written review but lacks a systematic search and detail in some places.