Cognitive profiles for early diagnosis of dementia with Lewy bodies (DLB) have been outlined in a new study published today in Alzheimer’s and dementia. Although DLB is the most common neurodegenerative dementia after Alzheimer’s disease, it is commonly misdiagnosed, depriving affected people of access to care better suited to their prognosis.
“Criteria for better identifying DLB exist in research settings, but we wanted to bring together research studies to establish something applicable to clinical settings,” said Ece Bayram, MD, PhD, assistant professor of neurology at the Anschutz Medical Campus of the University of Colorado and research lead author. “By pooling information from available publications, we were able to establish a cognitive profile that can distinguish DLB from Alzheimer’s disease before the dementia stage sets in, which could better help determine the direction of care for people with these diseases.”
Researchers were able to identify consistencies in cognitive symptoms in people with DLB compared to people with Alzheimer’s disease in a meta-analysis of pre-dementia stage diagnoses. In the pre-dementia stage, people with DLB showed more impairments in attention, processing speed and executive functions, as well as better immediate memory and recall compared to people with Alzheimer’s disease.
“Identifying cognitive profiles gave us the outcome needed to propose guidelines in which practitioners could easily be trained to better tailor care plans,” says Bayram. “Additionally, providing a framework for clinical assessment versus biomarker testing means greater accessibility for clinicians. It is easier and cheaper to train in providing cognitive assessments than administering imaging or invasive biomarker tests,” says Bayram.
Researchers say identifying the form of dementia early can guide future planning for both the person with dementia and their care partners, and alleviate the disease by providing appropriate symptomatic treatment. For example, people with DLB respond to certain types of commonly prescribed anti-psychosis medications, such as haloperidol, which tend to worsen their condition. Dr. Bayram says that overall, this study is a promising step in advancing dementia prevention and care.
“We are seeing more and more treatment trials focused on disease modification for both Alzheimer’s disease and Lewy body disease. Having validated clinical criteria to diagnose DLB before dementia strikes means we can prevent it from happening rather than reacting to it after significant loss in the brain has occurred. These types of clinical assessments offer everyone the opportunity to receive care, even without access to a specialized center.”