Dementia with Lewy bodies has been difficult to diagnose early, but comprehensive cognitive testing could change that

"Criteria for better identifying DLB exists in research settings, but we wanted to pull research studies together to establish something applicable for clinical settings," says Ece Bayram, MD, PhD, assistant professor of neurology at the University of Colorado Anschutz Medical Campus and study lead author. "By pooling information from available publications, we were able to establish a cognitive profile that can differentiate DLB from Alzheimer's before the dementia stage hits, which could better help inform the direction of care for people with these diseases."

Researchers were able to identify consistencies in cognitive symptoms among people with DLB compared to people with Alzheimer's in a meta-analysis of pre-dementia stage diagnoses. At the pre-dementia stage, people with DLB demonstrated more diminished attention, processing speed and executive function as well as better immediate recall and memory compared to people with Alzheimer's.

"Identifying cognitive profiles gave us the outcome necessary to suggest guidelines that practitioners could easily be trained in to better tailor plans of care," says Bayram. "Furthermore, providing framework for clinical assessment versus biomarker testing means more accessibility for practitioners. 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 ease disease by providing proper symptomatic treatment. People with DLB, for instance, are reactive to certain types of commonly prescribed medications for psychosis, such as haloperidol, that tend to worsen their condition. Dr. Bayram says, overall, this study provides a promising step in advancing dementia prevention and care.

"We are seeing more and more treatment trials that are focused on disease modification for both Alzheimer's and Lewy body diseases. Having validated clinical criteria to diagnose DLB before dementia hits means we can prevent it from happening instead of reacting to it after significant loss in the brain has occurred. These types of clinical assessments provide opportunities for everyone to receive care even without access to a specialty center."