Dementia with Lewy bodies: Challenges in the diagnosis and management

Chin, Kai Sin; Teodorczuk, Andrew; Watson, Rosie

doi:10.1177/0004867419835029

Cited by 38 publications

(62 citation statements)

References 102 publications

(165 reference statements)

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“…Fliuk tuo jan èios kog ni ty vi nës funk ci jos yra vie nas ne tik pa grin di niø kli ni ki niø DLK simp to mø, bet ir sun kiausiai at pa þás ta mø [3]. Ápras tai, ser gant DLK, fliuk tuo jan èios kog ni ty vi nës funk ci jos pa si reið kia kaip mie guis tu mas dienà, tuð èias þvilgs nis, ne nuo sek li kal ba, svy ruo jan tis dë mesys, pa ki tu si sà mo në ir at si ri bo ji mas po kal biø me tu [9,10]. Da lis ðiø simp to mø bu vo ma to mi pa cien tës el ge sy je ir ap -352 M. Ð. Markevièiûtë, M. Karnickas, A. Bagdonaitë…”

Section: Aptarimas Diagnostikaunclassified

“…Jos pa si reið kia iki 80 % pa cien tø, ser gan èiø DLK, ir daþ nai yra kel ro dis gydy to jams di fe ren ci juo jant li gas. Re gos ha liu ci na ci jos DLK pa cien tams pa pras tai yra su dë tin gos ir ge rai su formuo tos ar ba pa no ra mi nës, jo se ma to mi þmo nës, vai kai ir gy vû nai [9]. Pa cien tø re ak ci ja á ha liu ci na ci jas ski ria si tiek áþval gos laips niu, tiek emo ci ne re ak ci ja á jas.…”

Section: Pagrindiniai Klinikiniai Poþymiai (Pirmieji 3 Paprastai Atsiranda Anksti Dlk Eigoje Ir Gali Iðlikti)unclassified

“…Taip pat yra vaiz di niø ha liu ci na ci jø api bû di ni mo ir kie ky bi nio áver ti nimo ska lës [3]. Ta èiau ðie simp to mai taip pat daþ nai at si randa esant ki toms li goms, to kioms kaip de ly ras, psi chi niai su tri ki mai ir akiø li gos [9].…”

Section: Pagrindiniai Klinikiniai Poþymiai (Pirmieji 3 Paprastai Atsiranda Anksti Dlk Eigoje Ir Gali Iðlikti)unclassified

“…Ser gant DLK, pir mie ji kog ni ty vi nës funk cijos sil pnë ji mo simp to mai yra re tai pa ste bi mi ir pro gre suo ja di na mi ko je, o de ly ras yra ûmi sme ge nø dis funk ci jos bû sena, ku ri yra gráþ ta ma [15]. Di fe ren ci juo jant DLK nuo de lyro, bû ti na áver tin ti pa cien to anam ne zae ir ási ti kin ti, ar në ra bu vu sio in sul to ar ki tø fak to riø, ku rie ga lë jo su kel ti de ly rà [9,14]. Li te ra tû ro je pa brë þia ma, kad svar bu pa klaus ti apie anks ty và au to no mi nae dis funk ci jà ar REM mie go el ge sio su tri ki mus pra ei ty je, nes ðie po þy miai la biau ti kë ti ni DLK nei de ly rui [9].…”

Section: Pagrindiniai Klinikiniai Poþymiai (Pirmieji 3 Paprastai Atsiranda Anksti Dlk Eigoje Ir Gali Iðlikti)unclassified

“…Di fe ren ci juo jant DLK nuo de lyro, bû ti na áver tin ti pa cien to anam ne zae ir ási ti kin ti, ar në ra bu vu sio in sul to ar ki tø fak to riø, ku rie ga lë jo su kel ti de ly rà [9,14]. Li te ra tû ro je pa brë þia ma, kad svar bu pa klaus ti apie anks ty và au to no mi nae dis funk ci jà ar REM mie go el ge sio su tri ki mus pra ei ty je, nes ðie po þy miai la biau ti kë ti ni DLK nei de ly rui [9]. Neu rop si chiat ri niai simp to mai pa si reið kia maþ daug 80 % pa cien tø, ser gan èiø DLK, ir apie 50 % pa -cien tø, ser gan èiø de ly ru [15].…”

Section: Pagrindiniai Klinikiniai Poþymiai (Pirmieji 3 Paprastai Atsiranda Anksti Dlk Eigoje Ir Gali Iðlikti)unclassified

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An overview of methods for the treatment and diagnosis of dementia with Lewy bodies. Clinical case analysis

Markevičiūtė¹,

Karnickas²,

Bagdonaitė³

2020

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Demencija su Lewy kūneliais (DLK) yra progresuojanti, neurodegeneracinė, retai diagnozuojama nežinomos kilmės demencija, kuri pasireiškia fliuktuojančiomis kognityvinėmis funkcijomis, sudėtingomis regos haliucinacijomis, parkinsonizmu ir REM miego elgesio sutrikimu. Išskirtinis DLK patologinis bruožas yra autopsijos metu smegenyse aptinkami daugybiniai Lewy kūneliai – eozinofiliniai hialino intarpai neuronų citoplazmoje. Nors DLK yra trečia dažniausia demencijos priežastis tarp vyresnio amžiaus žmonių po Alzheimerio ligos ir kraujagyslinės demencijos, ji vis dar diagnozuojama per retai. Taip pat diagnozuoti DLK atvejai dažnai būna pastebėti vėlai, kadangi diagnostika ankstyvose stadijose yra sudėtinga, nes DLK gali pasireikšti panašiai kaip Alzheimerio ar Parkinsono liga, kraujagyslinė demencija, delyras ir kiti sutrikimai. Šiame straipsnyje pateikiame pacientės, sergančios DLK, klinikinį atvejį ir aptariame literatūrą, siekdami priminti, kad DLK pacientams pasireiškia plataus spektro simptomais, įskaitant kliedesius, nerimą, agresiją ir depresiją. Taip pat aptariame naujausius 2017 m. skelbtus DLK diagnostinius kriterijus, kuriuose daugiau dėmesio skiriama REM miego elgesio sutrikimui. Pagrindinis šio straipsnio tikslas yra priminti, kad DLK – tarpdisciplininė liga, kuriai kontroliuoti yra svarbus psichiatrų ir neurologų bendradarbiavimas. DLK gydymas yra kompleksinis ir sudėtingas dėl didelės nepageidaujamų reakcijų į vaistus rizikos. Paskirtas vaistas vieno ligos simptomo kontrolei gali sustiprinti kitus simptomus. Svarbu ir tai, kad pacientai gali būti išskirtinai jautrūs vaistams nuo psichozės, kurie skiriami kliedesių ir haliucinacijų kontrolei, todėl farmakologinis gydymas turi būti derinamas individualiai.

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Section: Aptarimas Diagnostikaunclassified

Section: Pagrindiniai Klinikiniai Poþymiai (Pirmieji 3 Paprastai Atsiranda Anksti Dlk Eigoje Ir Gali Iðlikti)unclassified

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An overview of methods for the treatment and diagnosis of dementia with Lewy bodies. Clinical case analysis

Markevičiūtė¹,

Karnickas²,

Bagdonaitė³

2020

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Sex Differences for Clinical Correlates of Alzheimer's Pathology in People with Lewy Body Pathology

2022

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Background Lewy body (LB) dementias have limited clinical diagnostic accuracy because of frequent copathologies contributing to clinical heterogeneity. Although sex differences in clinical prevalence and frequency of pure LB pathology were shown, differences for clinicopathological correlations are less known. Objective The aim of this study was to determine sex differences for clinical associations of Alzheimer's disease (AD) copathology in those with LB pathology. Methods Data were from National Alzheimer's Coordinating Center for 223 women and 468 men with limbic or neocortical LB, separated into two groups as those with high likelihood and low/intermediate likelihood for LB clinical phenotype based on pathology. Clinical associations of sex and interaction of sex and pathology for the clinical phenotype were analyzed. Results More severe AD copathology was associated with worse cognitive decline and lower likelihood of LB disease clinical phenotype. Women with more severe AD copathology and tau had worse cognitive decline and higher likelihood of AD clinical phenotype than men. Men with more severe AD copathology had lower likelihood of LB clinical phenotype than women. Interaction of sex and pathology was more pronounced in those aged between 70 and 80 years. Conclusions AD copathology reduces the likelihood of LB clinical phenotype for both women and men; however, men may be at higher risk for LB disease underdiagnosis and women at higher risk for dementia. The use of both LB and AD biomarkers, even when LB or AD pathology is not clinically expected, is necessary for the accurate clinical diagnosis of both LB diseases and AD. © 2022 International Parkinson and Movement Disorder Society.

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Mental health care for older adults: recent advances and new directions in clinical practice and research

et al. 2022

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The world's population is aging, bringing about an ever‐greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor‐intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry – one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient‐focused and family‐centered, we call for further research into enhancing the well‐being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late‐life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.

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Dementia with Lewy bodies: Challenges in the diagnosis and management

Cited by 38 publications

References 102 publications

An overview of methods for the treatment and diagnosis of dementia with Lewy bodies. Clinical case analysis

An overview of methods for the treatment and diagnosis of dementia with Lewy bodies. Clinical case analysis

Sex Differences for Clinical Correlates of Alzheimer's Pathology in People with Lewy Body Pathology

Mental health care for older adults: recent advances and new directions in clinical practice and research

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