Are the hallucinations/delusions the main difference between DLB and Alzheimers? And can people presenting with delusions otherwise score quite well on standard cognitive testing, like the MMSE?
The MMSE is a commonly-used test to detect a general decline in cognitive function and memory. Because people with LBD typically fluctuate in their cognitive abilities and often perform well on the MMSE early in the disease, the MMSE is not sensitive enough to diagnose DLB, nor is it adequate by itself to diagnose Alzheimer’s disease (AD). There are a number of distinguishing features that help differentiate DLB from AD. For example, the cognitive profile in DLB features deficits in executive functioning, such as problem solving, abstract thinking, and reasoning, while Alzheimer’s features a predominant decline in memory. Hallucinations occur earlier in Lewy body dementia, while they appear later in Alzheimer’s disease. Severe sensitivity to antipsychotic medications used to treat hallucinations is common in LBD, but not so in Alzheimer’s disease. REM sleep behavior disorder is common in DLB, but not in Alzheimer’s. For a more detailed discussion, please visit LBDA’s webpage on LBD sym
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