Differences Between Alzheimer's & Lewy Body Dementia

As a Florida elder care attorney, it’s natural that many of my clients have some form of early, mid, or late stage dementia. To better serve my clients as both a lawyer and a community resource, I try to stay educated on these conditions. To that end, this article is going to focus on the difference between Alzheimer’s Dementia and Lewy-Body Dementia.  

There are approximately 1.2 Million unpaid caregivers in Florida who are helping those with Alzheimer’s Disease. Most of this care is delivered at home by an unpaid friend or family member. Our firm tries to alleviate some of this stress on the caregivers through Medicaid-planning, which can give caregivers access to resources in the form of personal services contracts, helping spouses, children and other caregivers get paid directly by Florida Medicaid or access to respite care for a well-deserved break. Its also important to think about estate planning, especially getting a well-drafted durable power of attorney, while someone is alert and oriented, even if only intermittently.

Keep in mind – we are an elder care law firm, not doctors. We try to link to source material when we can, but this article should not betaken as medical advice. Seek the advice of your doctor. 

Different Types of Dementia

The term “dementia” is really an umbrella term for several diseases, including:

1.  Alzheimer’s Disease – the most common form of dementia. Alzheimer’s is a brain disease that causes problems with thinking, memory and behavior. There are about 280,000 Floridians with Alzheimer’s. Alzheimer’s refers to the build of a-beta amyloid proteins in-between cells and or twisted fibers of Tau proteins inside the cell, (a/k/a “tangles”).
2. Lewy Body Dementia – the second most common form of Dementia involves the buildup of certain microscopic deposits that damage braincells over time leading to a decline in thinking, reasoning, and independent function. Lewy Body Dementia is also, itself, an umbrella term for multiple diseases.
3. Vascular Dementia – indicates reduced blood flow in the brain.
4. Frontotemporal Dementia – marked by cell loss in the front section of the brain; and
5. Prion Disease (also called: Creutzfeldt-Jakob Disease) 

Now let’s dive deeper in to these two forms of dementia: Alzheimer’s Disease and Lewy Body Dementia.

Alzheimer’s Disease

Alzheimer’s dementia is divided into three main stages: (i) Stage 1 Alzheimer’s Disease (Early/Mild) – the person will still function independently, but they’ll start to have difficulty performing some tasks and have trouble recalling newly-acquired information; (ii) Stage 2 Alzheimer’s (Middle/Moderate) – there will be word confusion, some personality and behavioral changes, forgetfulness of significant and personal events from their history and some changes in sleep patterns; and (iii) Stage 3 (Severe or Late Stage Alzheimer’s) – the person will require nearly 24/7 care due to severe degradation of physical abilities and will be unable to hold a conversation or meaningfully respond to their environment, they will be unaware of recent experiences.  

Alzheimer’s Risk Factors and Alzheimer’s Disease Treatments

The greatest risk factor for developing Alzheimer’s is age, but genetics and family history also play a role. After age 65, the risk of Alzheimer’s doubles every five years. 32% of people age 85 and older have Alzheimer’s Disease.  

Unfortunately, there is no medication or therapy available to prevent, treat or slow the progression of Alzheimer’s. But, there are FDA approved treatments that can address symptoms, that come in two primary forms:  

• Cholinesterase Inhibitors (e.g. Aricept™, Exelon™ and Razadyne™) to prevent the breakdown of acetylcholine which is important for memory.
• Glutamate Modulators: (e.g. Nemenda™) regulates glutamate activity which is important for information storage and retrieval.  

Alzheimer’s Demographics

Almost 2/3rds of Alzheimer’s sufferers are women (women living longer is only a partial explanation; researchers believe that genetic differences between men and women also play a role. Alzheimer's demographics also show that those of Hispanic descent are 1.5x as likely as their white counterparts to develop Alzheimer’s disease. Black men and women are nearly twice as likely to be diagnosed. 

Alzheimer’s is thought of as more of a memory problem. In Lewy-Body Dementia, the memory problems usually come later in the disease’s progression, whereas Lewy-Body disease will bring more issues with multitasking, analytical thinking and problem solving earlier on. Lewy-Body sufferers are also more prone to movement disorders and hallucinations and delusions (spouse is having an affair or someone is robbing them). Lewy Body sufferers have more fluctuations (minute by minute or hours by hour), whereas those with more generalized dementia will tend to have good days vs. bad days.  

Lewy-Body Dementia

Lewy-Body Dementia is also sometimes referred to as Alzheimer disease related dementia or “Atypical Parkinsonism.” It accounts for5-10% of dementia-related cases. The number one risk factor for Lewy-Body Dementia is age, but it is also more commonly found in men and those who have been involved with head trauma. Genetics almost certainly plays a small role as well. Interestingly, exercise, caffeine and smoking have all been identified as being correlated with having a protective effect (but still, no doctor is suggesting you smoke).  

Lewy-Body Dementia is, itself, an umbrella term covering Dementia with Lewy Bodies and Parkinson Disease Dementia. If the memory problems come first, then the diagnosis is usually Dementia with Lewy Bodies. If the physical symptoms appear first, then the diagnosis is usually Parkinson Disease Dementia.  

Dementia with Lewy Bodies

Dementia with Lewy Bodies is characterized by memory and thinking problems from the beginning. As the disease progresses there will be fluctuations that will see the onset and disappearance of visual hallucinations, Parkinson-like movement problems and prominent autonomic system issues such as sudden blood pressure drops, urinary symptoms and constipation.  

Parkinson Disease Dementia

Parkinson’s like movement disorder is found early on in the disease (before dementia symptoms) which is why Parkinson Disease Dementia is not usually diagnosed right away. But it will be marked by disability caused by the movement issues earlier. Memory and thinking issues become apparent in later stages of Parkinson Disease Dementia. Some hallucinations can come as well.

Elder Care Resources

Thank you to the Alzheimer's Association for their plethora of information and resources related to all types of dementia. They have a helpline, available 24/7: 800.272.3900 that you can call. You can also visit www.alz.org/CRF for additional programs and community resources.

Difference between Lewy Body Dementia, Alzheimer's Disease and Parkinson's Disease.

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