The dementia that is not Alzheimer's disease

According to the Lewy Body Dementia Association (LBDA), accurate and early diagnosis is critical because people with LBD typically have sensitivities to medication, and many drugs prescribed for Alzheimer's can be very harmful to those with LBD.

Although, LBD is the second most common cause of progressive dementia it is not well recognized by physicians, especially primary care and general health care providers.

"While the symptoms of LBD may be similar to Alzheimer's and Parkinson's disease, the treatment strategy is more challenging because fewer medications can be used safely," warns Howard I. Hurtig, M.D., Chair, Department of Neurology, Pennsylvania Hospital, and member of the LBDA Scientific Advisory Council. "I cannot overemphasize the need to avoid medications that can worsen the symptoms of LBD. Every patient with this disease and their caregivers should be familiar with the list of acceptable and forbidden drugs."

Is it Alzheimer's or LBD?

These two diseases share some clinical and biological similarities that can make them difficult for many physicians to distinguish. Dementia experts are more experienced at differentiating between dementia types. Alzheimer's disease affects cognitive function, including making new experiences into memories. The disorder in LBD affects different aspects of cognition, such as problem solving and complex reasoning and movement.

LBDA has just issued a new brochure -- Lewy Who? Recognizing when it's not Parkinson's or Alzheimer's Disease -- that offers a symptom comparison chart that can help clarify the confusion. It can be downloaded from the LBDA.org website.

A Different Diagnosis

Lewy body dementia, which affects 1.4 million Americans, refers to two related diagnoses: dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Both DLB and PDD are considered Lewy body dementias. With DLB, cognitive (thinking) symptoms appear before Parkinson-like movement problems. With PDD, disabling cognitive symptoms do not develop until more than a year after movement problems begin.

LBD is characterized by an abnormal build up of Lewy bodies (alpha-synuclein protein deposits) in the areas of the brain that regulate behavior, memory, movement and personality. The most prominent symptoms of Parkinson's disease affect motor abilities. Alzheimer's disease primarily affects areas of the brain involving learning and memory. A specialist like a neurologist, geriatric psychiatrist or a neuropsychologist may be needed to distinguish the symptoms and provide an accurate diagnosis.