- Karen McPhail , RN, MSN, CDP
Identifying Lewy Body Dementia (LBD)
What is LBD?
LBD is a progressive brain disorder with an average duration of 5-7 years. It is one of the most common types of progressive dementia, but is often mis or under diagnosed by clinicians, due to a lack of understanding and time constrains placed on clinicians for patient visits and evaluation. Symptoms and progression are thought to be caused by the build up of Lewy bodies in areas of the brain. The areas of the brain effected control an individuals overall functionality, behavior, cognition, and movement. The specific cause of LBD is unknown, however several potential causative factors have been identified such as genetics, environment, age and heredity. Many medical professionals are still not familiar with LBD, so education and awareness is key! The traditional mini mental state examination will often times not identify issues related to LBD, so a detailed, specialized cognitive evaluation along with an accurate health history is vital.
How does LBD differ from other dementias?
LBD differs in several ways from other dementia's. For example, Alzheimer’s disease, another common form dementia involves primarily memory loss as a more prominent early symptom while early LBD does not. Advanced LBD may cause memory problems in addition to its more typical effects on judgment, planning and visual perception. Movement symptoms are more likely to be an important cause of disability and issues early in LBD than in Alzheimer's. Alzheimer's can cause problems with walking, balance and general mobility as it progresses to moderate and severe stages.
Hallucinations, delusions, and misidentification of familiar people are significantly more frequent in early stages of LBD than in Alzheimer’s. Autonomic dysfunction and REM sleep disorder is more common in early LBD than in Alzheimer’s. Disruption of the autonomic nervous system, causing a blood pressure drop on standing, dizziness, falls and urinary incontinence, is much more common in early LBD than in Alzheimer’s.
LBD - 2 related conditions: Dementia with Lewy bodies (DLB) & Parkinson's disease dementia (PDD)
The Key difference between is the timing of cognitive (thinking), behavioral and movement symptoms!
Many researchers and clinicians think of PDD and DLB as being on a continuum of a similar disease process rather than as two distinct entities. Early signs many differ, but same biologic brain changes noted and
overtime similar symptoms develop. Both involve disturbances of cognition, behavior, sleep, movement and autonomic functioning.
Dementia with Lewy bodies (DLB) - cognitive symptoms are noted within a year of parkinsonism, any condition that involves the types of movement changes, such as tremor or muscle stiffness, few symptoms in the early stages.
Parkinson’s Disease Dementia (PDD)- Parkinson’s disease dementia, movement symptoms are pronounced in the early stages, with cognitive symptoms developing years later. 78% of PD patients will eventually develop dementia!
Importance of early and proper diagnosis:
Obtaining proper care to avoid potential harm and harmful medication side effects
Time to plan medical, legal, and financial affairs
Time to express wishes, make choices, access counseling /supportive programs to maximize quality of life
DLB may progress faster than Parkinson’s
Social Security Administration has included these diseases on its Compassionate Allowances Listings.
People will be flagged by the SSA and processed in as little as 10 days rather than having to wait months or years for benefits.
Proper diagnosis and physician documentation is key!
If you or your loved one is experiencing the signs of Lewy body Dementia and need assistance please reach out via our contacts tab! We are here to help!