What Is Alzheimer’s Disease?

Alzheimer’s disease is the most common type of dementia, responsible for 60-80% of dementia cases. It primarily affects memory, language, and thinking skills. Alzheimer’s is caused by the buildup of Beta-Amyloid plaques and Tau tangles in the brain, which disrupt communication between brain cells and lead to brain cell death.

Key Symptoms of Alzheimer’s:

• Memory Loss: The most common early symptom, particularly short-term memory issues.
• Confusion with Time and Place: Difficulty remembering dates, seasons, and locations.
• Difficulty Completing Familiar Tasks: Struggling with daily activities like cooking or paying bills.
• Language Problems: Trouble finding the right words or following conversations.
• Personality and Mood Changes: Depression, anxiety, and withdrawal are common.

What Is Lewy Body Dementia?

Lewy Body Dementia (LBD) is the second most common type of progressive dementia after Alzheimer’s. It occurs when Lewy bodies—abnormal clumps of protein—build up in brain cells, disrupting brain function. LBD shares characteristics with both Alzheimer’s and Parkinson’s disease, which can make it difficult to diagnose.

There are two types of Lewy Body Dementia:

1. Dementia with Lewy Bodies (DLB): Cognitive decline appears first, followed by motor symptoms.
2. Parkinson’s Disease Dementia (PDD): Motor symptoms appear first, followed by cognitive decline.

For this article, we’ll focus on Dementia with Lewy Bodies (DLB).

Key Symptoms of Lewy Body Dementia (DLB):

• Visual Hallucinations: One of the early and distinctive signs of LBD, people often see things that aren’t there.
• Motor Symptoms: Similar to Parkinson’s disease, including tremors, stiffness, and slow movement.
• Cognitive Fluctuations: Attention and alertness can fluctuate widely from day to day or even hour to hour.
• REM Sleep Behavior Disorder: Acting out dreams or experiencing vivid nightmares.
• Memory Loss: Typically less severe in early stages than in Alzheimer’s, but becomes more pronounced as the disease progresses.

Alzheimer’s vs Lewy Body Dementia: Symptom Comparison

Progression: Alzheimer’s vs Lewy Body Dementia

Both Alzheimer’s and Lewy Body Dementia are progressive, but they progress in different ways.

• Alzheimer’s Disease:
  Alzheimer’s begins with memory loss, progressing to more severe cognitive issues like confusion, disorientation, and difficulty completing everyday tasks. In the later stages, patients may lose the ability to communicate or recognize loved ones. Motor skills and physical abilities typically remain intact until the very late stages.

• Lewy Body Dementia (LBD):
  Lewy Body Dementia, on the other hand, often starts with motor symptoms and visual hallucinations. Memory loss is less pronounced early on but becomes more significant as the disease progresses. One of the hallmarks of LBD is the fluctuation in cognitive ability, where patients may have clear, lucid moments followed by periods of confusion or disorientation. REM sleep behavior disorder is also common early in LBD, where patients may act out their dreams.

Diagnosis: Alzheimer’s vs Lewy Body Dementia

Diagnosing Alzheimer’s and Lewy Body Dementia can be tricky because both conditions share cognitive decline as a primary symptom. However, there are some key differences in how they are diagnosed.

1. Medical History and Physical Exam
   Both conditions are diagnosed through a detailed medical history and physical exam. Doctors will look for cognitive decline, memory issues, and any physical symptoms like tremors or visual hallucinations.

2. Cognitive Tests

   • Alzheimer’s: Cognitive tests like the Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) are commonly used to diagnose Alzheimer’s by assessing memory, problem-solving skills, and language.
   • LBD: The same tests may be used for LBD, but doctors will also look for fluctuating cognitive function and visual hallucinations. The Silver House Operational Exam (SHOE) is also a valuable tool here, as it covers both cognitive and motor functions, helping differentiate between Alzheimer’s and LBD.

3. Brain Imaging

   • Alzheimer’s: MRI and PET scans are used to detect Beta-Amyloid plaques and Tau tangles in the brain, which are characteristic of Alzheimer’s.
   • Lewy Body Dementia: Brain scans like SPECT or DaTscan may be used to detect reduced dopamine activity in the brain, which is indicative of Lewy Body Dementia. However, there’s no specific imaging test for LBD.

4. BAT Testing™

   • Alzheimer’s: A key tool for diagnosing Alzheimer’s is BAT Testing™, which measures Beta-Amyloid and Tau levels in the blood. This test is part of the BATWatch™ Protocol and allows for early detection of Alzheimer’s risk.
   • Lewy Body Dementia: There’s no equivalent blood test for LBD, making diagnosis more reliant on clinical evaluations and imaging.

5. Spinal Tap and Genetic Testing

   • Alzheimer’s: A spinal tap may be used to detect Beta-Amyloid and Tau proteins in cerebrospinal fluid, while genetic testing for the APOE-e4 gene can help assess risk.
   • Lewy Body Dementia: Genetic testing is not commonly used for LBD, and there’s no specific biomarker test available yet.

Treatment Options: Alzheimer’s vs Lewy Body Dementia

There is currently no cure for either Alzheimer’s or Lewy Body Dementia, but treatments are available to manage symptoms and improve quality of life.

• Alzheimer’s Treatment:
  Medications like Donepezil and Memantine are commonly prescribed to slow cognitive decline in Alzheimer’s patients. Additionally, non-medical treatments like CogStim therapy can help improve cognitive function and delay disease progression.

• LBD Treatment:
  Treatment for LBD is more complex because it involves managing both cognitive and motor symptoms. Medications like Rivastigmine can help with cognitive issues, while Levodopa may be prescribed to manage Parkinson’s-like motor symptoms. However, it’s important to note that some Alzheimer’s medications can worsen LBD symptoms, so careful management is crucial. CogStim therapy can also be helpful in managing both the cognitive and motor symptoms of LBD.

Wrapping Up…

While both Alzheimer’s and Lewy Body Dementia involve cognitive decline, the two conditions have distinct symptoms and progression. Alzheimer’s is primarily characterized by memory loss and confusion, while LBD often involves early visual hallucinations, motor symptoms, and fluctuations in cognitive ability. Early diagnosis is crucial for both conditions to ensure the right treatments are provided and to improve quality of life.

If you or a loved one is experiencing memory loss, hallucinations, or motor symptoms, schedule a consultation with a healthcare provider for a comprehensive evaluation, including options like BAT Testing™ for Alzheimer’s or DaTscan for Lewy Body Dementia.

Not sure if it’s Alzheimer’s or Lewy Body Dementia? Get clarity with a comprehensive evaluation. Schedule a consultation today to explore diagnostic options like BAT Testing™ for Alzheimer’s and DaTscan for Lewy Body Dementia, and take control of your cognitive health.