SMH Memory Disorder Clinic breaks down diagnostic differences between Alzheimer's and Lewy body dementia

SMH Memory Disorder Clinic specialists identified distinct biological markers that separate Alzheimer's disease from Lewy body dementia on October 30, following public discussion sparked by the death of actor Patrick Stewart.

The first key distinction lies in the specific proteins that accumulate in the brain. Dr. Erica Ailes stated that Alzheimer's involves the build-up of amyloid tau tangles. This accumulation leads to a gradual worsening of short-term memory over time. In contrast, Ailes noted that Lewy body dementia is associated with abnormal development of alpha-synuclein. This protein disrupts brain function and is linked to visual hallucinations, daily variability in attention, and sleep disruptions such as REM sleep behavior disorder symptoms.

The second key point is the necessity of precise diagnosis for treatment. The clinic staff explained that dementia is an umbrella term for a collective of symptoms including memory and functional decline. Identifying the specific disease causing these symptoms determines the appropriate medical approach. FDA-approved treatments for Alzheimer's differ from those available for Lewy body dementia. Patients may react negatively to one type of medication while tolerating the other, making correct identification essential for safe care.

The third key factor involves the diagnostic process at the SMH Memory Disorder Clinic. Daniel Valerie described the workup as including brain scans, blood work, and cognitive testing. He called cognitive tests the vital signs of the brain. These assessments measure memory, new learning, attention, language, executive functioning, and visual-spatial skills. Valerie explained that executive functioning refers to planning and organization. Neuropsychologists examine the pattern of these changes to identify the underlying disease process.

The clinic is state-funded through the Department of Elder Affairs. Valerie said newer blood tests are now available to detect amyloid protein, which aligns with Alzheimer's. Studies are currently evaluating blood proteins to identify other disease processes that cause dementia. The specialists noted that some patients have mixed dementia, featuring both amyloid and Lewy body proteins. They confirmed that while this is not always the case, it definitely happens. Treatment plans are individualized based on these mixed presentations.

Valerie said she is not aware of any new FDA-approved treatment specifically designed to remove Lewy body protein. A newer treatment exists that removes amyloid from the brain. She stated, We are hopeful that we see something on the horizon. But right now, there is nothing specifically for this type of disease. The clinic treats the condition with a team approach involving neurology and other specialists. Centers throughout the state specialize in Lewy body dementia. The specialists cited actor Robin Williams as a public figure who had Lewy body dementia.

The death of Patrick Stewart and the earlier diagnosis of Bruce Willis with primary progressive aphasia have increased public awareness of baseline evaluations. Willis was diagnosed with a form of frontotemporal dementia that affected his speech first. The specialists recommend that a baseline evaluation and full workup occur at age 65, if not 70. They observed that people are becoming more proactive about getting these evaluations due to public figures sharing their diagnoses. Evaluating someone sooner and tracking changes over time improves the patient's overall outcome.