Lewy Body Dementia (LBD) affects more than 1 million individuals in the United States, making it one of the most common types of dementia. In fact, the amount of people struggling with Lewy Body Dementia could be even higher than we think. The symptoms can be very similar to those of Alzheimer’s disease, which unfortunately leads to a large number of missed or mis-diagnoses in the medical world.
It’s important to speak to an expert when learning the key differences in the most common types of dementia. To help us understand, we reached out to David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute.
First and foremost, Dr. Shprecher explained that Lewy Body Dementia is an umbrella term, including both Parkinson’s dementia and dementia with Lewy Bodies. Parkinson’s begins with symptoms in movement, with disruptive thinking and memory problems developing at least one year later. Dementia with Lewy Bodies is the opposite, starting with dementia symptoms in the first year.
Cognitive symptoms of LBD
“Of course, not every patient will experience every symptom,” Dr. Shprecher explained. “But it’s possible to distinguish patients with LBD, based on a few unique traits.” The following traits are found in cases of LBD, including dementia with Lewy Bodies and Parkinson’s.
- Visual-spatial perception is one of the first things to be affected, which means patients may have trouble with traveling using directions or they could struggle to draw items even when they can see them.
- Difficulty in paying attention.
- Struggle to come up with the right words.
- Inability to process information quickly.
- Trouble focusing on more than one task at a time.
- Sleeping issues, such as dream enactment, can be present early on and often before other signs of dementia appear.
- Patients may begin to experience hallucinations or long spells of inattention.
Key cognitive differences from Alzheimer’s
In cases of Alzheimer’s, issues with memory are a common symptom. Memory is also affected by LBD, but these symptoms tend to show up later. Additionally, drastic fluctuations in mood and cognition are more common symptoms for patients with LBD and can be a helpful distinction from Alzheimer’s.
Hallucinations are another distinguishing feature found more prominently in LBD. Dr. Shprecher noted that while visual hallucinations are an early defining feature of dementia with Lewy Bodies, they are only seen late in the course of Alzheimer’s.
Movement symptoms of LBD
As LBD develops, movement symptoms can make daily life very difficult. Dr. Shprecher explained that “patients can develop parkinsonism, including tremors (especially when at rest), very slow movements, shuffling gait, muscle rigidity, restless leg syndrome, and sudden drops in blood pressure.” They may also begin to act out their dreams while asleep, flailing their arms and legs.
An important diagnosis
To add to the nuance, Dr. Shprecher noted that many patients with Lewy Body Dementia may also have Alzheimer’s disease. The crossover between the LBD and Alzheimer’s can make diagnosing difficult. To help make the right diagnosis, Dr. Shprecher often prescribes neuropsychological testing to evaluate memory and critical thinking. He also recommends an MRI or CT scans of the brain to look for brain shrinkage, strokes or other less common causes of movement or cognitive symptoms. In some cases, a special scan to look for dopamine deficiency, or a sleep study to look for abnormal muscle activity during sleep, could point out key indicators of LBD.
Dementias can be very disorienting for patients and their families. It’s perfectly normal to feel confused in the beginning. Work with a clinician that specializes in diagnosing these conditions to better understand what your body is experiencing and the appropriate treatment. This is especially important as treatments will vary between LBD and Alzheimer’s patients. Certain medications used for Alzheimer’s could actually make LBD symptoms much worse.
“Every patient is different,” said Dr. Shprecher. “It’s takes experience and attention-to-detail to understand the nuances of each case.” If you or a loved one is experiencing symptoms that resemble dementia or Parkinson's, schedule an appointment with a memory or movement disorders specialist to begin to understand your symptoms.