Parkinson's and Lewy Body Dementia: Some Similarities and Differences

As I’ve stated, I attend a monthly support group in my area for Lewy Body Dementia.  Not only is it a great way to get out and meet people with similarities, but it also provides a great deal of information and support for all who attend.  Our leader lost her husband and is currently researching a book on the topic - which helps keep the group moving along with more knowledge being infused.   One of the questions the other day was, “How Does Parkinson’s Differ from Lewy Body Dementia, and How Are They Diagnosed Differently?”  A very good question and the response from the visiting neurologist gave some very good answers that made perfect sense.

Of course, PD and LBD are caused by the same misfolding of proteins and the onslaught of the Alpha-Synuclein Acids that affect the dopamine production and supply in the brain.  Remember, this cause is quite different from AD or most other dementias.   For the purpose of this post, I’m going to focus mainly on PD and LBD and their similarities and differences, in case anyone was really curious.

First of all, LBD (Lewy Body Dementia) and Parkinson’s Disease (PD) fall on the spectrum of dementias.  PD is at one end, and Alzheimer’s (AD)  is at the other.  LBD falls somewhere in the middle as it may contain symptoms of other dementias as well as Parkinsonisms.  

With Parkinson’s, the symptoms may begin small and over time (we’re talking quite a while in most cases) the tremors will begin affecting one side of the body.  The signs will gradually become noticeable to others - tremors, posture, walking, and facial expressions.  This is Stage One.

Stage Two will incorporate both sides of the body demonstrating tremors and stiffness. Walking and posture will be more affected and there may be more difficulty in dealing with Acts of Daily Living (ADL’s).  

Stage Three’s hallmarks (as this is considered “mid-disease”) are Loss of Balance and Slowness of Movement.  Falls are more commonplace during this phase.  While the patient is able to still conduct ADL’s, it is now more difficult.

Stage Four has the patient using aids for walking and movement and requires assistance in order to facilitate ADL’s.  This means the disease has become quite severe and this is readily apparent.

Stage Five happens when the patient is now no longer able to walk or care for themselves at all.  They may also develop hallucinations and delusions.  This is the most severe of all the stages.  (the above information is available at Parkinson.org).

Now, where does PD originate?  The same place as LBD.  The Spina Nigra where dopamine is produced.  The Alpha-Synuclein Acids begin to block the production and supply of the dopamine to the rest of the brain.  But, unlike LBD, it also begins in the Medula and the Olfactory Bulb and slowly works its way to the Cerebral Cortex.   Huh.  This is interesting.

With LBD, the bodies are present in the Spina Nigra and the Olfactory Bulb but are more present on the Cerebral Cortex and then work their way down and in.  So, in a sense, we have two diseases that, perhaps, work in opposite ways, while presenting themselves with similar symptoms.  

As I’ve already discussed ad bordomum (as though that’s a word) the symptoms of LBD, I’ll not go over that.  Just know the patients tend to show the same symptoms, but the dementia begins at an earlier stage, along with the hallucinations, delusions, and inability to carry out ADL’s.  

There is an interesting article, but for the purposes of this post, it addresses the differences/similarities between AD and PD.  You can find it at:  How Parkinson's Disease Affects Mental Ability.  

Now, how are they diagnosed to be different?  Well, that’s a question that really caught my ear.  Apparently, if you begin showing signs of PD and then within a specific range of time (one to two years - at most) dementia and the signs of LBD begin to demonstrate themselves, the diagnosis may change.  Interesting, non?!  

Anyhow, I hope I’ve done a little enlightening and piqued your interest a bit further.  It’s satisfying when I learn something new and can share it with others.  I hope you feel the same.