LBD is frequently misdiagnosed as Alzheimer's disease, especially in the early stage. Over time, changes in movement, hallucinations, or RBD can help distinguish LBD from Alzheimer's disease. Lewy body dementia (LBD) is an umbrella term for a form of dementia that has three common presentations.
LBD refers to either of two related diagnoses — dementia with Lewy bodies (DLB) and Parkinson's disease dementia. Both diagnoses have the same underlying changes in the brain and, over time, people with either diagnosis develop similar symptoms.
80% of LBD patients are misdiagnosed
Lack of a diagnostic test and the fact that LBD presents so many symptoms that are associated with other conditions means the disease is very difficult to spot.
Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia might have visual hallucinations and changes in alertness and attention. Other effects include Parkinson's disease signs and symptoms such as rigid muscles, slow movement, walking difficulty and tremors.
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.
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.
HealthDay News — Magnetic resonance imaging (MRI) of the brain may aid diagnosis of dementia with Lewy bodies versus Alzheimer's disease, according to a study published online Nov. 2 in Neurology.
Symptoms of dementia with Lewy bodies
Fluctuating cognition that is delirium-like. Recurrent well-formed visual hallucinations. REM sleep behavior disorder that involves acting out dreams. Spontaneous parkinsonism with slowness of movement, rest tremor, or rigidity.
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.
Acetylcholinesterase (AChE) inhibitors, such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl), may help improve hallucinations, confusion and sleepiness in some people.
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.
Brain scans
Your doctor might order an MRI or CT scan to identify a stroke or bleeding and to rule out a tumor. While dementias are diagnosed based on the medical history and physical examination, certain features on imaging studies can suggest different types of dementia, such as Alzheimer's or Lewy body dementia.
This condition typically affects older adults, most often developing between ages 50 and 85. The life expectancy of individuals with dementia with Lewy bodies varies; people typically survive about 5 to 7 years after they are diagnosed. REM sleep behavior disorder may be the first sign of dementia with Lewy bodies.
One of the characteristic histological features of Parkinson's disease (PD), with or without dementia, is the presence of Lewy bodies (LBs) in the brainstem and neocortical and limbic structures. They are often accompanied by Alzheimer type pathology (ATP).
Can Lewy body dementia be prevented? While no therapy has yet been proven to prevent Lewy body dementia, some strategies may promote brain health, reduce dementia risk and improve general well-being. Recommendations include: Eat a healthy, well-balanced diet.
Dementia with Lewy bodies (DLB) causes problems with mental abilities and a number of other difficulties. The symptoms tend to come on gradually and get slowly worse over several years, although treatment can help.
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.
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).
LBD is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood.
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).
Failure to thrive is the most common cause of death in DLB (65%), followed by pneumonia/swallowing difficulties (23%) [5].
There are no tests that can definitively diagnose LBD. Currently, only a brain autopsy after death can confirm a suspected diagnosis.
Lewy bodies can also be detected in the brains of patients with Parkinson's disease (PD), where they are found in nigrostriatal neurones. However, in dementia with Lewy bodies, they are more widely distributed.
Most cases of LBD are not inherited and rarely does more than one family member have the disease. Certain genetic variants may increase the chance of developing dementia with Lewy bodies, but having a genetic variant does not mean that a person will definitely develop the disease.