ShareThisBy LEE BOWMAN
Scripps Howard News Service
Tuesday, May 29, 2007
Researchers say a simple personality test may help doctors detect a type of dementia caused by protein tangles inside nerve cells, but which is often confused with Alzheimer's disease.
Called dementia with Lewy bodies, it is the second most common neurodegenerative disease cause of dementia. Although it shares characteristics with both Alzheimer's and Parkinson's disease -- and like them has no cure -- doctors say it's important to diagnose early because some drugs given to treat the mental health symptoms of Alzheimer's can be dangerous for patients with Lewy body dementia.
In a new study published Tuesday in the journal Neurology, doctors at Washington University School of Medicine in St. Louis found that personality changes revealed which people in a group of nearly 300 were likely to have Lewy body dementia several years before conventional diagnosis.
"Currently we mainly look for memory problems and other cognitive problems to detect dementia, but personality changes can often occur several years before the cognitive problems," said Dr. James Galvin, lead author of the study.
Lewy body dementia is second only to Alzheimer's as the leading cause of degenerative dementia in the elderly, affecting some 800,000 people. In addition, about half of patients with Parkinson's disease develop a form of dementia also related to deposits in an area of the brainstem where they deplete the brain signaling chemical dopamine.
Different types of protein tangles are found in patients with Alzheimer's, but some patients have been found with both types of damage.
The research involved 290 people who were part of a larger study and were tested every year for an average of five years. The researchers followed each patient through death, including an autopsy. During annual reviews prior to their death, participants or their family members were asked about changes in personality, interests and drives.
By the end of the study, 128 of the participants had been confirmed to suffer dementia with Lewy bodies, 128 had Alzheimer' s and 34 had no form of dementia.
The researchers found that people with Lewy body dementia displayed passive personality changes, such as diminished emotional response, disinterest in hobbies, repetitive behaviors and increasing apathy, or lack of interest, more often than those with Alzheimer's.
They found that people with Lewy bodies were two times more likely to have passive personality traits at the time of the first exam than people with Alzheimer's. By the time of death, up to 75 percent of those with dementia with Lewy bodies had passive personality changes, compared with 45 percent of those with Alzheimer's.
"Identifying the earliest features of dementia may enable doctors to begin therapy as soon as possible," Galvin said. "This will become increasingly important as newer, potentially disease-modifying medications are developed. It also gives the patient and family members more time to plan for the progressive decline."
Galvin said more detailed personality tests are often not used in most office settings because of time and lack of training. "Our results show incorporating a brief, simple inventory of personality trains may help improve the detection of this form of dementia."
