Alzheimer's disease is typically the predominant diagnosis in dementia. However a significant number of patients will present with dementia due to Lewy Body disease, Parkinson's dementia, frontotemporal dementia or vascular dementia.
A recent study helps clinicians to distinguish Lewy Body from Alzheimer's dementia and Parkinson's disease.
Douglas Scharre and collegues from Ohio State University conducted a matched pair analysis of 21 patients with Lewy Body dementia with 21 patients with Alzheimer's disease and 21 patients with Parkinson's disease.
Parkinson's disease subjects in this study had higher cognitive function scores than the Lewy Body disease subjects but were matched on level of motor impairment.
Subject groups were assessed on a variety of motor, cognitive and neuropsychological domains. Lewy Body dementia subjects differed from the Alzheimer's group in the following areas:
- Higher impairment scores on executive function and visuospatial function
- Lower impairment on memory and orientation
- Higher scores on measures of sleepiness
- Higher scores on fluctuation of cognitive and behavior deficits
- More hallucinations
- More sleep apnea
Lewy body dementia subjects differed from the Parkinson's disease group in the following areas:
- More impairment in axial motor function
- More impairment in gait and balance function
- Higher scores on measures of sleepiness
- Higher scores on fluctuation of cognitive and behavior deficits
- More hallucinations
- More sleep apnea
The authors noted that measures of axial motor, gait and balance impairment correlated higher with level of executive function impairment, visuomotor function impairment and global cognitive impairment.
This is an important study and highlights the need for specific neuropsychological testing along with assessment of motor, gait and balance domains dementia evaluations.
Readers with more interest in this study can access the author's uncorrected proofs by clicking on the DOI link in the citation below.
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Scharre, D., Chang, S., Nagaraja, H., Park, A., Adeli, A., Agrawal, P., Kloos, A., Kegelmeyer, D., Linder, S., Fritz, N., Kostyk, S., & Kataki, M. (2016). Paired Studies Comparing Clinical Profiles of Lewy Body Dementia with Alzheimer’s and Parkinson’s Diseases Journal of Alzheimer's Disease, 1-10 DOI: 10.3233/JAD-160384
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