Accurate Diagnosis of Dementia Type Crucial for Treatment, Future Interventions

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Clinical evaluations for specific type of dementing neurodegenerative disease are critically important, suggest 2 new literature reviews from German researchers.
In the first analysis, investigators write that correct diagnosis is crucial because treatment differs significantly between dementia with Lewy bodies (DLB), Parkinson disease dementia (PDD), and Alzheimer's disease (AD) dementia.

For patients with DLB, cognitive and/or psychiatric impairments are their first symptoms. For them, dopaminergic treatments should be given "if motor manifestations arise within 1 year," write Brit Mollenhauer, PD, Dr. med, from the Paracelsus-Elena Hospital in Kassel and the Georg-August University in Göttingen, Germany, and colleagues.

In PDD, memory impairment and cognitive deficits occur only after motor symptoms have fully developed and been present for at least 1 year. For these patients, the study authors write that early screening is needed so that "further diagnostic and therapeutic steps can be taken in timely fashion."

In addition, both DLB and PDD patients have been found to respond well to cholinesterase inhibitors for treating cognitive problems and behavioral disturbances. However, "because of the serious side effects associated with administration of traditional neuroleptic drugs, it’s important to distinguish" these dementia types from AD, add the study authors.

In the second review, the researchers note that new biomarkers can increase the probability of identifying AD at the predisease stage of mild cognitive impairment (MCI) to higher than 80%.

"Early detection of [AD] before the onset of dementia provides an opportunity to study potential approaches for secondary prevention, which are now an object of intense clinical research," write Gerhard W. Eschweiler, PD, Dr. med, from the Department of Psychiatry and Psychotherapy at the University of Tübingen and from the Geriatric Center at the University Hospital of Tubingen, Germany, and colleagues.
The 2 reviews were published in the October dementia theme issue of Deutsches Ärzteblatt International, the official journal of the German Medical Association.

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