Dementia with Lewy body often has symptoms of both PD and AD (uncommon)

• Alzheimer's-like symptoms:
  • Cognitive decline
  • Amnesia
  • Confusion
  • Difficulty with problem-solving
• Parkinson's-like symptoms:
  • Slow movement (bradykinesia)
  • Muscle rigidity
  • Tremors
  • Balance and coordination issues
• Mimick delirium
  • Can also present with visual hallucinations (vivid)
  • Fluctuating level of memory and LOC
  • Delusions
• REM sleep disorder

Treatment

• Treatment: focus on the cognitive and behavioural aspects, don’t help with motor aspect)
  • Antipsychotics
    • primary S/E of Quetiapine (Seroquel®) = sedation
      • advise pt to take quetiapine at night
      • reduce day-night reversal
    • if have an issue with sedation: Risperidone
      • For daytime visual hallucinations/delusions
    • Can combine if have indications for both: take risperidone daytime, take quetiapine at night
    • Avoid olanzapine due to severe cognitive S/Es (Parkinsonism syndromes)