The Dana Foundation has just published a new online article on Lewy Body Dementia. The website’s editor says:
After Alzheimer’s disease, Lewy body dementia (LBD) is the most prevalent progressive dementia of the many cognitive disorders wreaking unspeakable havoc on millions of lives. LBD is characterized by the presence of Lewy bodies, which are abnormal aggregates of a protein called alpha-synuclein, and are found in regions of the brain that regulate behavior, memory, movement, and personality. Many of the symptoms of Alzheimer’s, Parkinson’s, and LBD overlap, but LBD is more difficult to diagnose. Underdiagnosis is just part of the reason why LBD is unknown to the public and many health-care providers, and why funding for research lags far behind that for almost every other cognitive disorder.
While it’s a good article, I think it would be challenging reading for those who are new to LBD. Probably most of our group members won’t have a problem with it!
The article makes a few points:
- The underdiagnosis of LBD may delay appropriate symptomatic treatments and expose patients to dangerous medications. It also leads to a lack of LBD research.
- An early diagnosis of LBD helps families prepare.
- Though the majority of both LBD caregivers and Alzheimer’s caregivers mention “memory impairment” as the most common presenting symptom, the nature of the memory impairment is different. “Alzheimer’s affects the ability to encode new experiences into one’s long-term memory, whereas the disorder in LBD can be one that affects retrieval of memory.”
- “If medications are employed for LBD patients, a complex and delicate degree of balance is required. Drugs that are commonly used to treat the rigidity and immobility of Parkinson’s cannot be used as liberally in dementia with Lewy bodies, since they tend to worsen hallucinations.”
These facts were new to me, and I’ll have to ask around about them:
- “[The] amount of overall pathology associated with alpha-synuclein occurs at lower levels than amyloid and tau proteins in Alzheimer’s, which makes it harder to develop lab tests that measure it.”
- “[There] are fewer genetic causes of LBD that can be used to create experimental models than there are of Alzheimer’s.”
- “It wasn’t until the development of a staining technique in the late 1990s that researchers learned how much more common LBD is than previously thought.”
There are two things that I take issue with in the article. First and most importantly, with just about all publications about Lewy Body Dementia, there is a co-mingling of two disorders — Dementia with Lewy Bodies, and Parkinson’s Disease Dementia. These disorders actually have separate diagnostic criteria though you wouldn’t know that from this article or from the Lewy Body Dementia Association website.
Second, RBD (REM sleep behavior disorder) seems to have slipped into being identified as a “core feature” of LBD rather than a “suggestive feature.” (The diagnostic criteria for DLB lists RBD as a “suggestive feature.”)
Here’s a link to the article:
Lewy Body Dementia: The Under-Recognized but Common Foe
By Meera Balasubramaniam and James E. Galvin
October 02, 2013
If you pick up on items of interest to you, please share! News about this article was recently posted to an LBD-related online support group.