Experts Can Diagnose Lewy Body Dementia 18 Months Faster

ATLANTA — Lewy body dementia (LBD) is the most misdiagnosed form of dementia, taking on average more than 18 months and three doctors to receive a correct diagnosis.

LBD Not Well Recognized

Even though it is second only to Alzheimer’s disease as the most common cause of progressive dementia, affecting 1.3 million Americans, the symptoms of LBD are not well recognized by many physicians, especially primary care physicians and other general practitioners. Unfortunately, then, most people are not diagnosed until they are at moderate or severe states, leaving their caregivers unprepared and the patient vulnerable to potentially deadly medication side effects.

“Recognizing LBD at its earliest stage is critical not only for an accurate diagnosis by the appropriate specialist but also because it is important for a patient with LBD to be managed by an expert familiar with dementia in general and LBD in particular,” says Howard I. Hurtig, M.D., Chair Emeritus, Department of Neurology, Pennsylvania Hospital, and Elliott Professor of Neurology, Perelman School of Medicine, University of Pennsylvania. “A primary care physician with the best intentions may not be well informed about LBD, so it becomes the duty of the patient and caregiver to know about resources, such as the Lewy Body Dementia Association (LBDA), for help when needed.”

What is LBD?

Lewy body dementia (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. Sometimes the disease presents symptoms similar to Parkinson’s or Alzheimer’s, hence the frequent misdiagnosis. The most prominent symptoms of Parkinson’s disease affect motor abilities. Alzheimer’s disease primarily affects areas of the brain involving learning and memory. What complicates diagnosis is that some people may have changes in the brain from more than one memory disorder. Most often a specialist like a neurologist or geriatric psychiatrist will distinguish symptoms to achieve an accurate diagnosis, sometimes with the help of a neuropsychologist, who plays an important role in understanding cognitive problems.

LBD Treatment Strategy

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. People with LBD have medication sensitivities, and an early and accurate diagnosis can protect them from receiving medications that can worsen their symptoms, cause severe side effects or trigger a potentially deadly reaction. Hurtig warns, “The avoidance of medications that can worsen the symptoms of LBD cannot be overemphasized. Every patient with LBD and their caregiver(s) should memorize the list of acceptable and forbidden drugs.”

Support for Healthcare Providers and Families

Because symptoms of LBD closely resemble both Alzheimer’s and Parkinson’s disease, creating a diagnostic dilemma for doctors, the Lewy Body Dementia Association offers resources to help people with this challenging disease. Both experts and concerned families can download an LBD Diagnostic Symptoms Checklist to facilitate their discussion.