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P1‐051: Assisting rural area providers in Illinois distinguish between Alzheimer's disease and Lewy body dementia
Author(s) -
Young Charlene,
Kyrouac Greg,
Schaver Maggie
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.327
Subject(s) - dementia , lewy body , psychosocial , dementia with lewy bodies , disease , lewy body disease , psychology , psychiatry , parkinsonism , rem sleep behavior disorder , medicine , parkinson's disease , pathology
Background: Alzheimer’s disease (AD) and Lewy Body Dementia (LBD) may present very similarly, thus presenting a diagnostic challenge for clinicians. LBD is still under diagnosed or not recognized by many clinicians. Effective treatment of LBD can be different than treatment of AD. It is well established that patients with LBD respond differently to medications than many patients with AD. They also have different physical and psychosocial needs than the AD patient. Outcomes for patients and caregivers are better if the LBD patient is properly treated; thus it is important that they be identified early. There are subtle differences clinicians can be trained to look for to assist in distinguishing between LBD and AD. Methods: Using the consensus criteria for diagnosis of LBD as developed by the Consortium on Dementia with Lewy Bodies, we elected to train clinicians, nurses, nurse practitioners, researchers, and other assessment staff in the identification of potential LBD patients to more quickly identify and properly treat them. Training components included additions to history taking and clinical exam as well as treatment. Staff were instructed to inquire about patient sleep habits, including REM Sleep Behavior Disorder, fluctuations in mentation, and problems with visual spatial tasks and executive function. Patients with mild cognitive impairment and difficulty drawing intersecting pentagons were to be examined for signs of Parkinsonism. Clinicians were educated in proper treatment of REM Sleep Behavior Disorder, psychosis and changes in gait. This training took place at our annual retreat for rural care providers, who service the 93 counties of Illinois outside of the Chicago area. Results: There was an increase in patients identified with LBD. There were fewer reported side effects from medications. Patients and families were educated as to what to expect from a diagnosis of LBD. Clinicians and staff increased their competency in diagnosing and treating patients with LBD.Conclusions: Patients with LBDmay not be diagnosed properly if clinicians are not trained specifically. Early treatment of physical, psychological and sleep disorders leads to better outcomes for patients and families.