Abstract
Lewy body dementia (LBD) is the second most common neurodegenerative dementia in older adults, yet there remains a delay in diagnosis that limits healthcare providers’ ability to maximize therapeutic outcomes and enhance patient and caregiver quality of life. The impact of LBD on patients includes limiting the potential exposure to medications that may cause adverse outcomes, and addressing how the disease manifestations, such as autonomic features and behavior, affect quality of life. LBD impact on caregivers has been discussed to a greater degree in the literature, and there is clear evidence of caregiver burden and grief associated with disease manifestations. Other common caregiving concerns, such as access to care, prevention of hospitalization, managing behavior, and reviewing prognosis and nursing home placement, are important to comprehensively address the needs of patients with LBD and their caregivers.
Highlights
The Lewy body dementias (LBDs) are the second most common form of dementia in older adults after Alzheimer’s disease (AD) [1,2]
Parkinson’s disease dementia (PDD) caregivers were the most distressed but there was no significant difference between this group and the dementia with Lewy bodies (DLB) group
This presentation can be challenging in LBD as it can be difficult to distinguish from the fluctuating disease course; reports of any acute cognitive decline should trigger a medical investigation
Summary
The Lewy body dementias (LBDs) are the second most common form of dementia in older adults after Alzheimer’s disease (AD) [1,2]. Once the diagnosis was established, around 50% of LBD patients had to see two or more clinicians for symptom management and 58% of caregivers reported difficulty with managing the care among different providers [10]. While each LBD patient and caregiver may report their own individual concern about which disease feature most affects QOL, autonomic symptoms and behavioral features are common complaints. Prevention of hospitalization Management goals for all patients with dementia should include avoidance of hospitalization This is important for LBD patients if they present with behavioral manifestations due to the risk they may be given a neuroleptic and suffer adverse outcomes. As in all dementias, underlying medical illness can initially present as worsening confusion This presentation can be challenging in LBD as it can be difficult to distinguish from the fluctuating disease course; reports of any acute cognitive decline should trigger a medical investigation. Especially to direct care providers in longterm care such as nurses and nursing assistants is valuable
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