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View Diary: Lessons from the Dementia Diner (88 comments)

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  •  We can't be sure without post-mortem (31+ / 0-)

    We can't be 100% sure without post-mortem. But the profile is more like LBD than like AD: she had delusions and hallucinations (well controlled now with low-dose quetiapine), visual-perceptual abnormalities, sleep disturbance, and very poor executive function. Her memory, including short-term, was relatively spared. On MRI, her hippocampal volume was pretty normal for her age (96). We did not bother with cerebrospinal fluid sampling or amyloid imaging, though as a research AD center, we have access to a lot of stuff that is not yet in standard clinical practice. She was already getting the standard of care for either dementia, anyway.

    Her neurologist is one of the top guys in the world, a long-time colleague of mine, and we also consulted with a couple of other colleagues/friends, one at Mayo Clinic and one at UC San Diego, who see a lot of LBD. The general consensus was that it looked like probable LBD, though at her age she is likely to have some AD pathology lurking around, too.

    So while we don't have a definitive diagnosis, it looked like LBD at first, and it has evolved along those lines more than like AD.

    •  Well, the neurologist that made both... (26+ / 0-)

      ...diagnonses on my mother-in-law, was not the final word, as my in-laws consulted a more-competent doctor. While initially my mother-in-law exhibited what might be LBD symptoms, she went downhill after having three small strokes in the worst possible places in her brain. Another complication was a benign cyst that was observed on the scans, which was crowding and probably injuring brain tissue. Today she only seems to minimally recognize most family members, particularly my father-in-law, since they've been married since 1948. She also cannot hold a conversation, feed herself, bath herself, or use sanitary facilities by herself. She spends much of the day sleeping, but responds positively to music.

      I worry about Calamity Jean, as her mother's younger sister also suffered from dementia before she died, several years ago. My wife's cousin had to deal with both of her parents developing dementia at the same time, and between the load of work that landed on her shoulders, and being adopted, she did not have autopsies done. My father-in-law is adamant that we don't have an autopsy done on my mother-in-law, but Calamity Jean says she will insist on one should he precede her mother in death. Theri ages are 92 (m-i-l) and 96 (f-i-l) so it might be possible. Time only knows...

      Float like a manhole cover, sting like a sash weight! Clean Coal Is A Clinker!

      by JeffW on Sun May 26, 2013 at 08:47:42 PM PDT

      [ Parent ]

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