Lewy Body Dementia (LBD) - Classic ParkinZheimer

LBD is classic ParkinZheimer, with shared symptoms of both Parkinson’s and Alzheimer’s. The overlapping symptoms make LBD extremely challenging to detect. Until now… thanks to biomarker testing.

At Amprion, we view Parkinson’s, Alzheimer’s, and other neurodegenerative conditions as diseases on the same ParkinZheimer spectrum. Through this ParkinZheimer prism, we focus on the similarities between various neurodegenerative disorders rather than their differences.

We strive to innovate breakthrough diagnostic and treatments for these age-old diseases.

Why ParkinZheimer Makes Sense?

Many neurodegenerative disorders share common symptoms, and this makes a precise clinical diagnosis challenging. For example, even Alzheimer’s and Parkinson’s patients rarely show cognitive signs or motor symptoms exclusively.

Both Alzheimer’s and Parkinson’s diseases can show a mixed bag of cognitive and motor-related symptoms, especially over the disease journey.

The overlapping signs and symptoms lead to high cases of misdiagnosis, leading to mistreatment.

Amprion - Alzheimers - Parkinsons - Confused Patient

Both Alzheimer’s and Parkinson’s diseases can show a mixed bag of cognitive and motor-related symptoms, especially over the disease journey.

The overlapping signs and symptoms lead to high cases of misdiagnosis, leading to mistreatment.

Examples of ParkinZheimer

We consider the following conditions as classic cases of ParkinZheimer:

  • Lewy Body Dementia (LBD),
  • Progressive Supranuclear Palsy (PSP)

Let’s start with LBD. Here’s an in-depth look at the overlapping symptoms of LBD:

Lewy Body Dementia shows Alzheimer’s-like symptoms

Clinically, LBD patients undergo progressive cognitive decline that can be indistinguishable from Alzheimer’s. These symptoms include:

  • Loss of reasoning or logic,
  • Loss of executive function,
  • Loss of memory, and
  • Hallucinations

Lewy Body Dementia also displays Parkinson’s-like clinical symptoms

Simultaneously, LBD patients frequently exhibit motor and other disorders associated with Parkinson’s, including:

  • Rigid muscles,
  • Difficulty initiating voluntary movements,
  • A shuffling walk,
  • Leaning towards one side,
  • Sleep disorders,
  • Autonomic changes affecting heart rate, blood pressure, and urinary incontinence.

How Is LBD Currently Diagnosed?

According to the Alzheimer’s Association, Alzheimer’s, Parkinson’s, and LBD diagnosis are often performed based on when the symptom appears in a patient. This traditional diagnosis method dramatically increases the risk of misdiagnosis, estimated at between 40 – 50%!  

LBD diagnosis is at the crux of the ParkinZheimer theory. 

Unfortunately, people who suffer from LBD, such as the brilliant Robin Williams, often are misdiagnosed or undetected until after death.   

According to a Guardian article, Robin Williams’ LBD case wasn’t even diagnosed until after death. Doctors could see that Williams’s worst fears had come true: the autopsy suggested that he had suffered from severe Lewy Body Dementia (LBD).

This meant Williams’ amazing mind had suffered perhaps decades of damage caused by misfolded Synuclein, which was undetectable without biomarker testing.   

Robin Williams

LBD diagnosis is at the crux of the ParkinZheimer theory. 

Unfortunately, people who suffer from Lewy Body Dementia, such as the brilliant Robin Williams, often are misdiagnosed or undetected until after death.   

According to a Guardian article, Robin Williams’ LBD case wasn’t even diagnosed until after death. Doctors could see that Williams’s worst fears had come true: the autopsy suggested that he had suffered from severe Lewy Body Dementia.

This meant Williams’ amazing mind had suffered perhaps decades of damage caused by misfolded Synuclein, which was undetectable without biomarker testing.   

LBD Misdiagnosis

The confusing, overlapping symptoms contribute to frequent misdiagnosis of Lewy Body Dementia. 

Too often, LBD patients are misdiagnosed as either Alzheimer’s or Parkinson’s. How can this occur? Consider the following scenarios:

LBD Initially Misdiagnosed As Alzheimer's

For example, if a patient shows mainly a loss of memory and modest disruption of planning and reasoning, the physician would likely diagnose the patient with Alzheimer’s.

On the other hand, if a patient with similar cognitive symptoms begins to show motor or autonomic symptoms at the time of diagnosis or within a year or two, doctors would most likely diagnose as Lewy Body Dementia.

Blog Featured Image - Abeta plague Alzheimer's
Assay About Parkinson’s disease

LBD Initially Misdiagnosed As Parkinson's

For a patient showing initial Parkinsonian motor symptoms without early evidence of cognitive symptoms, the doctor will likely diagnose the patient with Parkinson’s.

If this same patient develops early signs of dementia after more than one year, doctors will likely change the initial diagnosis of Parkinson’s Disease Dementia (PDD).

However, if the same patient develops signs of dementia within one year of Parkinson’s symptoms, doctors will change the initial diagnosis of Lewy Body Dementia.

As you see from the examples above, the clinical diagnosis of neurodegenerative diseases is, unfortunately, subject to change as symptoms evolve. In reality, cases are often much more complicated than the above examples. LBD patients are also more likely to experience visual hallucinations and delusions at the early stages of Lewy Body Dementia than Alzheimer’s patients.

PSP Initially Misdiagnosed As Parkinson's

Like Michael J Fox, Ozzy Osbourne, and other celebrities, Linda Ronstadt has publicly chronicled her long and winding journey through the labyrinth of misdiagnosis.

PSP Misdiagnosed As PD Initially

In 2000, Linda Ronstadt could no longer control her virtuoso voice and retired from singing in 2009. She then experienced shaking in her hands several years later as she tried to write her memoir.

In 2012, her doctors diagnosed her condition as Parkinson’s. By 2018, she noted publicly that her Parkinson’s symptoms were not responding to increased DOPA therapy.

In 2019, she received a new diagnosis of Progressive Supranuclear Palsy. This latest diagnosis came in 19 years after her initial symptoms and seven years post her initial Parkinson’s diagnosis.

linda ronstradt
Linda Ronstadt

Linda Ronstadt's Journey

“I couldn’t sing, and I couldn’t figure out why. I knew it was mechanical. I knew it had to do with the muscles, but I thought it might have also had something to do with the tick disease. And it didn’t occur to me to go to a neurologist. I think I’ve had it for seven or eight years already, because of the symptoms that I’ve had. Then I had a shoulder operation, so I thought that’s why my hands were trembling.

Parkinson’s is very hard to diagnose, so when I finally went to a neurologist, he said, ‘Oh, you have Parkinson’s disease,’ I was completely shocked. I wouldn’t have suspected that in a million, billion years. No one can sing with Parkinson’s disease. No matter how hard you try.” – Linda Ronstadt

Due to the elusive nature of neurodegenerative diseases and symptom manifestation, it’s clear that an accurate diagnosis based on clinical symptoms exclusively is a huge challenge, even with the most experienced care team.

The frequent misdiagnosis exasperates patients and loved ones while misleading science and research to find the cures. 

Conclusion:

Diagnosis of Alzheimer’s and Parkinson’s based on clinical symptoms was the only tool available until the 1950s.

Since then, we have made significant advancements in molecular science. Through medical and technological innovations, we will be soon able to diagnose and treat neurodegenerative diseases based on each patient’s unique biomarker profile.

Research shows that there are three prominent biomarkers abundantly present in the brain cells of most patients with ParkinZheimer diseases, namely Parkinson’s, Alzheimer’s, LBD, etc.:

  • Abeta amyloid (Abeta),
  • Alpha-synuclein (synuclein), and
  • Tau.

Soon, doctors will be able to order biomarker tests to diagnose the entire ParkinZheimer spectrum of diseases, such as Parkinson’s, Alzheimer’s, Lewy Body Dementia, etc. 

Furthermore, aided by these advanced diagnostics, physicians will gain a powerful, in-depth look at the actual biomarker profile driving the disease in the early stages for each patient.

This advanced biomarker profiling enriches science studies to race drug development toward a cure from a research perspective.

At Amprion, we believe biomarker testing is the pathway to breakthrough treatments and personalized brain health.  

Lewy Body Dementia Frequently Asked Questions

LBD stands for Lewy Body Dementia. This is a progressive cognitive disorder with symptoms resembling both Alzheimer's-liie loss of memory and confusion plus Parkinson's-like loss of motor control. Lewy Body Disease results from toxic accumulation of misfolded synuclein in the neocortex of the brain. The majority of LBD patients also show toxic accumulation of misfolded abeta and tau at later stages of disease.
LBD initially presents as either an atypical Alzheimer's disease with some loss of motor control, or as an atypical Parkinson's with more pronounced loss of memory and confusion than expected. LBD patients often exhibit visual hallucinations uncharacteristic of either typical Alzheimer's or Parkinson's patients.
Similar to other progressive neurodegenerative diseases, four predominant stages are described: prodromal, early, intermediate and late. Patients at the prodromal stages may show signs such as sleep disorders, occasional visual hallucinations, depression, or dizziness. Patients at the early stage begin to show symptoms consistent with either Alzheimer's or Parkinson's including: loss of memory, occasional disorientation, stiffness or tremor and loss of balance. Patients at the intermediate and late stages show progressive symptoms that resemble those of Alzheimer's and Parkinson's patients. LBD patients may exhibit signs of both Alzheimer's and Parkinson's at the same time. At the late stage, patients are unable to function independently and may require 24 hour care. Poor nutrition, infections, falling and pneumonia may lead to terminal illness.

In a manner similar to Alzheimer's patients, LBD patients often are unable to care for themselves at late stages of disease and die of the disease itself. Poor nutrition, infections due to lack of adequate self care, falling and pneumonia represent common causes of death.

How long can a person live with dementia like Lewy bodies? Patients with LBD usually live 6-10 years after diagnosis. This is comparable to patients with Alzheimer's. In contrast, patients with Parkinson's can live with the disease for more than 20 years and usually die of something other than Parkinson’s.

The confusion associated with LBD results from massive death of brain cells in the neocortex, the region controlling memory, associations and learning. The motor deficits associated with LBD results from death of cells in the midbrain, similar to Parkinson's. In both cases, the cell death is due to toxic proliferation of misfolded synuclein. In more than 50% of patients with LBD, proliferation of toxic misfolded abeta and tau also occurs in later stages of the disease. The original triggers for synuclein misfolding are unknown at present.
Lewy Body Dementia patients experience the symptoms from both Alzheimer's and Parkinson's patients...at the same time. Not only are memory, learning, and executive function severely impaired, but loss of motor control and visual hallucinations also appear commonly.
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robin williams
Robin Williams