The main difference is in the “one-year rule” associated with cognitive symptoms. Patients with Parkinson's disease typically do not present cognitive issues until at least a year after movement symptoms begin. DLB is the exact opposite, with cognitive symptoms showing up first for at least a year.
Because LBD symptoms can closely resemble other more commonly known disorders like Alzheimer's disease and Parkinson's, it is often underdiagnosed or misdiagnosed. In fact, many doctors or other medical professionals still are not familiar with LBD.
Variation in Cognition
People who have dementia with Lewy bodies tend to exhibit greater variation in cognitive ability than those with Parkinson's disease dementia.
SUMMARY The Lewy body is a distinctive neuronal inclusion that is always found in the substantia nigra and other specific brain regions in Parkinson's disease. It is mainly composed of structurally altered neurofilament, and occurs wherever there is excessive loss of neurons.
There are no tests that can definitively diagnose LBD. Currently, only a brain autopsy after death can confirm a suspected diagnosis.
However, Lewy bodies are also common with other conditions, such as Alzheimer's and Parkinson's disease. In fact, most people with PD also have Lewy bodies in their brain. However, even if they have Lewy bodies, not all Parkinson's patients will also develop LBD.
Unlike Alzheimer's disease, which tends to progress gradually, this disease often starts rapidly, with a fast decline in the first few months. Later, there may be some leveling off but Lewy body dementia typically progresses faster than Alzheimer's. A patient can survive from five to seven years with the disease.
The interlocking finger test (ILFT) is a bedside screening test in which the subject must imitate four bimanual finger gestures without symbolic meaning. We assessed the utility of the test in the cognitive evaluation of patients with Parkinson's disease (PD).
Visual hallucinations are usually caused by damage to the brain. They are more common in people with dementia with Lewy bodies and Parkinson's disease dementia.
Tests for dementia with Lewy bodies
an assessment of mental abilities – this will usually involve a number of tasks and questions. blood tests to rule out conditions with similar symptoms. brain scans, such as an MRI scan, CT scan or a SPECT scan – these can detect signs of dementia or other problems with the brain.
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia.
Issues and Parkinson's symptoms associated with mood, sleep, medications or other medical problems can all look like dementia. Because many other factors can impact cognitive skills in PD, an accurate diagnosis is essential.
Imaging techniques like computerized tomography (CT) scans and magnetic resonance imaging (MRI) scans have been around for many years and have been vital tools in diagnosing a very wide variety of diseases. While neither is diagnostic of Lewy body dementia (LBD), they can assist the physician in diagnosis.
People who have dementia caused by Lewy body disease, such as Parkinsons' disease (PD) or dementia with Lewy bodies (DLB) are often sleepy by day but have very restless and disturbed nights. They can suffer from confusion, nightmares and hallucinations.
Failure to thrive is the most common cause of death in DLB (65%), followed by pneumonia/swallowing difficulties (23%) [5].
Many, if not most, people with Lewy Body Dementia have Parkinsonism mobility issues. Pain, of an often inexplicable source is very common, and has often been believed to be related to lack of mobility from the condition.
Age: Advanced age is the greatest known risk factor for Lewy body dementia. Lewy body dementia typically presents between the ages of 50 and 85, though it has been diagnosed in younger individuals.
Persons living with dementia (PLwD) have increasing problems with memory and overt changes in personality. The person in the middle stage of dementia has increasing difficulties with instrumental activities of daily living (IADL).
Acetylcholinesterase (AChE) inhibitors, such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl), may help improve hallucinations, confusion and sleepiness in some people.
Patients who have dementia with Lewy bodies should not be given the older, typical D2-antagonist antipsychotic agents such as haloperidol (Haldol), fluphenazine (Prolixin), and chlorpromazine (Thorazine). Patient records should document this and caregivers should be informed.
People with dementia have up to eight times the odds of being in a car accident compared with other seniors. But in the early stages of the condition, people with a dementia diagnosis can often drive safely, the study team writes in the Journal of The American Geriatrics Society.