Talk:Lewy body dementia/Archive 1

Also

Does this category also include the Lewy body variant of Alzheimer's disease and/or Hallervorden-Spatz syndrome? WhatamIdoing (talk) 17:51, 29 March 2018 (UTC)

@WhatamIdoing: I cannot find indications of these in any of the sources I have, but I see:

• PMID 2153271 (dated, primary)
• PMID 28410662 added it as article citation, but I do not have full text.

I could investigate further the next time I am the clinic, but for now, cannot locate any free full text helpful sources. SandyGeorgia (Talk) 18:05, 29 March 2018 (UTC)

@WhatamIdoing:, I just came across this statement from the Fourth Consensus Report:

• Because of considerable pathologic heterogeneity, some dementia presentations associated with Lewy-related pathology are atypical, e.g., if abundant neocortical neuritic plaques and tangles are present in addition to Lewy bodies (LB), the clinical profile may more closely resemble AD rather than DLB. Such mixed pathology cases are common, explaining why up to half of carefully research-diagnosed patients with AD may have unsuspected Lewy-related pathology at autopsy. Criteria for the detection of such patients, previously characterized as the LB variant of AD, remain to be formulated.

SandyGeorgia (Talk) 02:27, 22 April 2018 (UTC)

OK, with further reading, I am fairly certain the variant terminology has been ditched (after the Third Consensus Report on DLB). The shared pathology between AD and LBD are now recognized, and are thought of more as a continuum or spectrum. SandyGeorgia (Talk) 01:59, 23 April 2018 (UTC)

If the spectrum idea were explained, then maybe we could redirect the "variant" name here. WhatamIdoing (talk) 04:15, 30 April 2018 (UTC)

OK, let me see if I can remember to work on this ... soon-ish :) I saw mention in several reviews, and now I have to remember which! SandyGeorgia (Talk) 04:25, 30 April 2018 (UTC)

• PMID 29510692 says: "DLB and PDD are important dementia syndromes that overlap in many clinical features, genetics, neuropathology, and management. They are currently considered as subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), from incidental Lewy body disease and non-demented Parkinson's disease to PDD, DLB, and DLB with Alzheimer's disease at the most severe end."
• PMID 22546279
• PMID 29629495

Merge

Sociological and cultural aspects of Lewy body dementia has been created. However this would be much better if it was inserted into this page here, as the current article has too little content, and the Sociological and cultural aspects of Lewy body dementia looks a bit like an essay, pages with "aspects" in the title are likely inappropriate narrowing of topics. Graeme Bartlett (talk) 00:52, 21 April 2018 (UTC)

The Sociological and cultural aspects article applies to dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), and Lewy body dementia (LDB).

Essay? Please see WP:MEDMOS, where Sociological and cultural aspects sub-articles are encouraged (specifically, WP:MEDCASE). It fits well with the dementia with Lewy bodies article, which is the only developed article in this entire series and requires summary style to sub-articles (the other two articles did not even exist or were incorrect redirects until last month). A better long-term solution would be for this article and the PDD article to be developed, and it's rather amazing that they didn't even exist until i started working up DLB. :)

The other BIG problem is that almost no sources accurately distinguish between PD, PDD, DLB and LBD, so combining them to one article helps. Also, by "inserting" the content of a sub-article into this article, we would then have two places needed to maintain one set of text. SandyGeorgia (Talk) 01:06, 21 April 2018 (UTC)

@Graeme Bartlett: could you please take a fresh look at the suggested merge? I am trying to work up dementia with Lewy bodies for FAC, and having the suite tagged would not make an optimal presentation for FA. As WP:MEDMOS explains, there is a structure that is commonly used throughout medical articles, which includes "Sociological and cultural aspects of ..." articles, which typically contain content that needs lesser application of WP:MEDRS, and would significantly overburden the medical article.

In this case, there are even more reasons for having a separate "Sociological and cultural ..." article. First, there are four medical articles that will share the Sociological information (Lewy body dementia, Parkinson's disease dementia, Parkinson's disease and dementia with Lewy bodies). Second (and partly because of the confusing terminology), the media almost never is clear when discussing these conditions which one they are referencing (notice the mess that extended even to the autopsy write-up on Robin Williams), so a separate article works better. It could not be optimally placed at LBD, because there is confusion even between PD and PDD (Parkinson's and Parkinson's disease dementia-- again, see Robin Williams). I have not yet begun to tackle the LBD or the PDD articles, mostly because (oddly) they did not even exist when I started working up DLB. When they are fully developed, the "Sociological and cultural aspects ..." will result in too much length, and are better placed as a sub-article, using summary style.

There is a similar situation at Sociological and cultural aspects of autism, which can be is linked from every condition in the autism spectrum (autism, Asperger syndrome, etc), becoming an article that contains information common to all conditions on the spectrum.

There is also Sociological and cultural aspects of Tourette syndrome which focuses on the extreme media sensationalism wrt TS, and would overburden the main article. Note that TS and both autism articles are all FAs, and all have "Socioligical and cultural ... " sub-articles, which were well discussed in the years that WP:MED spent working up WP:MEDMOS.

Best regards, SandyGeorgia (Talk) 01:46, 23 April 2018 (UTC)

PS, here is how the sub-article works in the fully developed, almost ready for FAC, Dementia with Lewy bodies#Society and culture. That article is now 7,000 words, and the sub-article is optimally applied there. SandyGeorgia (Talk) 01:54, 23 April 2018 (UTC)

I don't think the proposal affects the FAC. But anyway I have been confused by the similar titles that have different meanings. Anyway I an not insisting on any merge, just proposing it, and I am hoping that those that know more about the topic can say if it should happen or not. If the Sociological and cultural aspects does cover three different topics then merging to one is not appropriate. If the content is merged then it would become a redirect, so no dual maintenance. Graeme Bartlett (talk) 02:01, 23 April 2018 (UTC)

I pinged WT:MED: I know the terminology is confusing because of the spectrum issue, but I would like to be able to work up the entire suite correctly before presenting to FAC, so would like to get this worked out. The text does not optimally belong at LBD because there is also confusion with Parkinson's. The media writes that Robin Williams was misdiagnosed, but Lewy bodies are part of PDD and DLB and PDD is part of PD, so neither the media nor the coroner got it right, and the Lewy Body Dementia Association had to clarify, but even they don't know ... And even without all that, MEDMOS suggests Sociological and cultural sub-articles, and one sub-article to discuss the non-medical aspects associated with Lewy body conditions is optimal. SandyGeorgia (Talk) 02:32, 23 April 2018 (UTC)

Given that most sources for this subtopic will be lower in quality than we would wish in the disease articles, I'd prefer to see the merge go to "Sociological and cultural aspects of dementias". Many of the sources will confuse or misreport the type of dementia, and they will often attract "Celebrity X had it" cruft as opposed to "Writer Y changed the popular perception of it" or "Actor Z lifted the taboo around it".LeadSongDog come howl! 13:48, 23 April 2018 (UTC)

This is a very interesting proposal, LeadSongDog and I was all prepared to go with it, until I saw Alzheimer's disease in the media. (We have to keep future Featured Lists like List of polio survivors and List of people with epilepsy in mind. Alzheimer's has enough data on its own to lend to such Featured lists. Colin reminds us-- with those Featured lists-- to avoid thinking of the content as "cruft", although these articles attract that kind of editing.) So, here is some data we might contemplate in making this decision.

Alzheimer's is by far the most common of the dementias (50 to 60% of cases, according to all sources I've seen). The Lewy body dementias are next, at about 20 to 25%-- likely to grow as diagnoses improve with the new criterion. After that, the common dementias drop off to conditions that are fairly rare, and Sociological aspects are easily handled within their own main articles.

So, the real decision here is whether it is helpful to have Alzheimer's and the Lewy bodies in one article. And seeing Alzheimer's disease in the media alone (without mention of other issues or notable cases) gives me concern that, should we combine them, we would simply find ourselves needing to separate them down the road, as Alzheimer's will dominate. I don't think sources will confuse Alzheimer's and the Lewy bodies and the very rare dementias; it is within the Lewy bodies that we find diagnostic confusion and confusion in the media, so I feel like the issues specific to the Lewy bodies are better dealt with in their own article. Also, Alzheimer's is so common that its legal, healthcare, advocacy etc issues are quite different than those of the Lewy bodies, where educating healthcare professionals is still a big problem. There is still so much I can write about the Sociological and cultural aspects of the Lewy bodies, and those aspects are different than in Alzheimer's, but I don't want to keep adding content until I know where this is headed and how to work it back in to dementia with Lewy bodies. Best,SandyGeorgia (Talk) 14:51, 23 April 2018 (UTC)

I'm a mergeist. However, merging 7,000 words into an 11-sentence article just doesn't seem like a good idea.

On a somewhat related point, I would like to recommend that the other page be moved to use the word societal rather than sociological in its title. WhatamIdoing (talk) 15:55, 23 April 2018 (UTC)

"Societal" works for me, WhatamIdoing. SandyGeorgia, given the gossip/society-page sources common to these things, at least by having one composite article spanning dementias we would incent editors to consider the question of which section their additions should go into. They could see distinct subsections for AD, Parkinson's, LBD, DLB, and overarching topics. Another possibility might be to merge into Dementia#Society and culture, if that would work any better.LeadSongDog come howl! 16:53, 23 April 2018 (UTC)

But again, the societal and culture issues of the Lewys are very different from the Alzheimer's, and Lewy would be lost. Not only that, but people edit the topics they know and are passionate about. I have created a clean, well-sourced article, and know how I want to develop it. If I have to dump this content into a poor-quality article, I will unwatch that article-- no interest in constantly cleaning up student editing or a generally poor article. So the content created here will probably degrade, rather than by expanded as planned.

WAID, I like societal, but since we now have multiple of these articles, I feel like we should bring that up at the talk page of MEDMOS, and considering moving all of them at once if there is consensus? [1] SandyGeorgia (Talk) 17:39, 23 April 2018 (UTC)

 Done SandyGeorgia (Talk) 19:59, 23 April 2018 (UTC)

"In film" section a mistake?

I don't often edit Wikipedia articles, but the "In film" mention of Mike Birbiglia's REM disorder seems totally misplaced here. He's spoken of struggling with a sleep disorder since early adulthood, and doesn't seem to experience any kind of Lewy body dementia. The whole section could be deleted easily. — Preceding unsigned comment added by 73.61.18.119 (talk • contribs) 15:08, April 25, 2018 (UTC)

Sorry, there was missing context. I have added this information. The person with REM sleep behavior disorder (RBD) has a 94 to 98% chance of conversion to Parkinson's or Lewy body dementia within 15 years. Regards, SandyGeorgia (Talk) 15:20, 25 April 2018 (UTC)

External link

@Little pob:, the codes you added in the External links here are the same as for dementia with Lewy bodies. Lewy body dementia, I believe, is not a diagnosis-- it is an umbrella term that encompasses both dementia with Lewy bodies and parkinson's disease dementia. You may want to check? I suspect we need to drop the codes from here. SandyGeorgia (Talk) 18:33, 28 April 2018 (UTC)

@SandyGeorgia:, apologies for the late response. From a coding point-of-view; Lewy body dementia is an indexable term in ICD-10, so the codes themselves are "correct". <aside>It's well known that ICD-10 is out-of-date on many concepts - esp within Chapter V. Also, because it's a classification (rather than a nomenclature), there is often overlap of what conditions are covered by which codes.</aside> From a Wiki POV; I have a weak preference for codes to be listed on umbrella terms. If there is consensus that ICD codes should or shouldn't be listed on umbrella terms we should ideally document this in WP:MEDMOS. Little pob (talk) 09:21, 30 April 2018 (UTC)

OK, thanks @Little pob:. SandyGeorgia (Talk) 12:35, 30 April 2018 (UTC)

Umbrella term

There was a question posted to my talk page about whether the umbrella term Lewy body dementia (LBD) for Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) enjoys broad consensus, since it is not found in the DSM-5. Yes, it does appear so; since others are likely to have the same question, I will list multiple sources here (in no particular order, just as I sort through things I have around). Perhaps confusion arises because the DSM does not specifically use the umbrella term. In writing dementia with Lewy bodies, I did not encounter recent articles using the term Lewy body dementia when they meant dementia with Lewy bodies; the use of LBD as an umbrella was always clear.

First, some sources discussing DSM-5 treatment of dementias:

1. Differentiating Alzheimer Disease, Lewy Body, and Parkinson Dementia Using DSM-5 explains the DSM criterion for:

   NCDLB (Neurocognitive disorder with Lewy bodies), and

   NCD due to PD (Neurocognitive disorder due to Parkinson's disease)

2. This source further explains how the DSM-5 treats dementias.
3. Another source that explains DLB and PDD from a DSM-5 perspective, saying,

   "...They are currently considered as subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases) ..."

Next, turning to the most recent secondary reviews used in the article at dementia with Lewy bodies:

1. Boot 2013 is about DLB, never uses the term LBD, and distinguishes DLB from PDD.
2. Boot 2015, same.
3. Galasko 2017 uses LBD as Lewy body disorders.
4. Gomperts 2016
5. Kosaka K, ed. (2017). Dementia with Lewy bodies: clinical and biological aspects (1st ed.). Japan: Springer. doi:10.1007/978-4-431-55948-1. ISBN 978-4-431-55948-1.

   The first chapter explains how all the nomenclature came about.

6. Levin 2016, explains the term often used in Europe, atypical parkinsonian syndromes ...
7. McKeith, Fourth Consensus Report, 2017 says:

   "Since publication of the 2005 consensus report, DLB has been confirmed as a major dementia subtype, categorized in DSM-5 as neurocognitive disorder with LB, and distinguished from neurocognitive disorder due to PD. The consensus group remains supportive of the 1-year rule distinguishing DLB from PD dementia ... "

8. Mueller 2017 is only about DLB, never mentions LBD, and distinguishes DLB from PDD.
9. NIA, Diagnosing Lewy Body Dementia:

   It’s important to know which type of Lewy body dementia (LBD) a person has, both to tailor treatment to particular symptoms and to understand how the disease will likely progress. Clinicians and researchers use the “1-year rule” to diagnose which form of LBD a person has. If cognitive symptoms appear within a year of movement problems, the diagnosis is dementia with Lewy bodies. If cognitive problems develop more than a year after the onset of movement problems, the diagnosis is Parkinson’s disease dementia.

10. NINDS.NIH 2017,

    "There are two types of LBD—dementia with Lewy bodies and Parkinson’s disease dementia."

11. Palma 2018 is an article about autonomic dysfunction, discussing all synucleinopathies, and uses the terms DLB and PDD but never LBD.
12. Pezzoli 2017 uses LBD to mean Lewy body disease:

    Patients with Lewy body disease (LBD) ... namely Parkinson’s disease (PD), and dementia with Lewy bodies (DLB).

13. St Louis Nov 2017 is an article about RBD, and never refers to LBD, but does use the terms DLB and PDD to correctly distinguish the two.
14. Taylor 2014,

    The term ‘LBD’ covers two related clinical diagnoses which have similar underlying pathology and symptoms but which have different patterns of onset. ‘Dementia with Lewy bodies’ (DLB) is diagnosed when a person develops dementia and any other DLB symptoms before, or within a year of, developing extrapyramidal symptoms (bradykinesia, rigidity, or postural instability), with tremor being a less pronounced feature. Many individuals with Parkinson’s disease will go on to develop dementia a year or more after the onset of motor symptoms. This is diagnosed as ‘Parkinson’s disease dementia’ (PDD). ... In this article, LBD is used to refer to both clinical diagnoses. DLB or PDD will be used only when referring to a specific clinical diagnosis.

15. Tousi 2017 is only about DLB, and makes clear the distinction between LBD, DLB and PDD.
16. Velayudhan 2017, New Therapeutic Strategies for Lewy Body Dementias,

    "Lewy body dementias (LBD), i.e., dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) ...

17. Walter 2015,

    "An umbrella term that includes clinically diagnosed dementia with Lewy bodies and Parkinson’s disease dementia."

18. Weil 2017 distinguishes DLB and PDD as having " widespread cortical Lewy body deposition", but does not use the umbrella term LBD.
19. Zwieg 2014, Lewy body dementia: the impact on patients and caregivers:

    "LBD is an umbrella terminology that encompasses both Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB), with the difference being one of timing of onset between the cognitive and motor features. In this article, we will use LBD to characterize both groups unless it is specifically necessary to differentiate."

Third, scholar.google.com search on "Lewy body dementia", since 2014 (not used as sources) and other articles not used as sources:

1. Lewy body dementia, M Delenclos, S Moussaud, PJ McLean - Disease-Modifying Targets in …, 2017 - Elsevier. Lewy body dementia (LBD) is a term used to encompass both Parkinson's disease dementia and dementia with Lewy body disorders.
2. Clinical prevalence of Lewy body dementia, JPM Kane, A Surendranathan… - … research & therapy, 2018 - alzres.biomedcentral.com. The prevalence of dementia with Lewy bodies (DLB) and dementia in Parkinson's disease (PDD) in routine clinical practice is unclear.
3. Lewy Body Dementia Association; [2]

   "Lewy body dementias include two clinical diagnoses, dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which share essentially the same array of symptoms."

4. Ahlskog, J. Eric (2014). Dementia with Lewy Bodies & Parkinson's Disease Dementia. Oxford University Press. p. ix.

   "This book focuses on two Lewy body disorders, dementia with Lewy bodies and Parkinson's disease with dementia."

   Note, this book never really uses the term "Lewy body dementia", rather refers to the DLB and PDD as Lewy body disorders or conditions.

And finally, searching in PubMed reveals that authors often use the term as a plural (Lewy body dementias) to refer to both DLB and PDD. I just have not come across any recent research that failed to use the terms LBD, DLB and PDD as defined here, although there was quite a mess in the Robin Williams autopsy situation. SandyGeorgia (Talk) 02:51, 15 May 2018 (UTC)

Foundations 2 2019, Group 5c goals

Our editing goals for Lewy body dementia (LBD) include:

1. Elaborating on the pathophysiology of Lewy body dementia, which includes defining Lewy bodies and neutrites and their roles in Dementia with Lewy bodies and Parkinson's disease dementia
2. Elaborating on the epidemiology of Lewy body dementia, both in Dementia with Lewy bodies and Parkinson's disease dementia
3. Adding a "History" section that details the discovery and research of Lewy bodies and Lewy body dementia
4. Adding a "Management" section that details some pharmacological and non-pharmacological treatments of Lewy body dementia

Vicknguy (talk) 22:18, 29 July 2019 (UTC)

Group 5B Review

• The group's edits, especially the section on management and standard treatment are really helpful for the audience seeking more information on Lewy Body Dementia. The edits are straight forward and easy to understand as recommended by the guiding framework. It may be helpful to link some of the complex terminology (like drug names) to internal wikipedia links to help guide those seeking information.
• The group achieved most of their determined goals (pathophysiology, history and management.) They could elaborate on the epidemiology section more.

• A. Draft submission reflects a neutral point of view. Well done! Tranhtruong (talk) 21:31, 5 August 2019 (UTC)

• B. All citations added were cited from secondary sources and are easily accessible. Good job! Kmiller22 (talk) 21:17, 5 August 2019 (UTC)

• C. Consistent use of acronyms previously used in the article (such as DLB) is good. Language of additions are uniform and at the level of understanding for someone familiar with molecular biology and clinical terms. For improvement, I think addition of hyperlinks to wiki pages for "Cholinesterase Inhibitors" and "Levodopa" in the Management section would be good. Kevindichosen1 (talk) 21:44, 5 August 2019 (UTC)

• D. The edits look well thought out and free of plagiarism. The sentence linked to citation 12 is a very similar sentence so maybe consider writing it differently. Aside from that, great job! -JVIDUYA (talk) 21:43, 5 August 2019 (UTC)

Group 5C Response to Group 5B Review

Thank you so much for your input. Our group went ahead and added some additional internal links to the article, specifically to the medications (ie. Levodopa, cholinesterase inhibitors). We also went ahead and revised the sentence linked to citation 12 and added more information under the "Epidemiology" section as recommended. Vicknguy (talk) 17:07, 6 August 2019 (UTC)

December 2019 edits

Nickmsalcido, please read the entries on your talk page, at User talk:Nickmsalcido. The content you want to add is not properly sourced (see WP:MEDRS) and if sourced, might belong at Lewy bodies, but not at an article that is about an umbrella term rather than an individual condition. SandyGeorgia (Talk) 16:58, 17 December 2019 (UTC)

In use to repair accumulated damage

Zefr (and anyone else following), once the situation in the section above settles down, I am going to put the article in use to repair the damage from the last course editing, which added unnecessary text here and altered the original citation style (WP:CITEVAR). To repair so much damage, I will have to revert to the version before citation style was altered, and then go through and re-add good changes made since then. Please let me know if that will create a problem ... I will do this work after the current semester ends, as I suspect that is the issue here. SandyGeorgia (Talk) 17:04, 17 December 2019 (UTC)

Thanks for the notice. There certainly is a disconnect between the instructor guidance for this course at UCSF, WikiEd staff, and what topics student editors should be tackling based on their knowledge background and course expectations; WP:CIR is ignored. Not unique to this topic, but occurs widely across WP medical content. Thanks for your patience and willingness to repair. --Zefr (talk) 17:32, 17 December 2019 (UTC)

Zefr, I am going to work on this today. SandyGeorgia (Talk) 20:10, 22 December 2019 (UTC)

Done. I reinstated the good additions (that had to do with both conditions and are not better covered in the individual articles), while leaving off additions that were not about the distinction between the two conditions covered by the term. After the CITEVAR (citation style change) breach, there was endless fiddling to the citations, and many of those edits added good changes. But to go back and catch all of them, after a CITEVAR breach, is work that I will leave for someone else. There was off-topic content added at the same time as the citation style was changed, resulting in too much to fix. SandyGeorgia (Talk) 21:03, 22 December 2019 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Vicknguy, Snselim, Msleee, Storm1625.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 00:04, 18 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 2 September 2020 and 11 December 2020. Further details are available on the course page. Student editor(s): Sydneysheridan, Tdean1234, Hvonruden13, Jkoll24. Peer reviewers: Sam Halada, Cailen1.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 02:31, 17 January 2022 (UTC)