By Jimena Romero
Your sex may impact the symptoms and signs of a developing brain diseases like dementia with Lewy bodies (DLB), a disease that causes memory and thinking problems along with other symptoms such as Parkinson-like movement changes, hallucinations, ups and downs in alertness, and acting out of dreams.
To understand how sex impacts the presentation of DLB, Shannon Chiu, M.D., M.Sc., assistant professor in the Department of Neurology and movement disorders specialist at the Norman Fixel Institute for Neurological Diseases at UF Health, and Melissa Armstrong, M.D., M.Sc., FAAN, associate professor in the Department of Neurology and movement disorders specialist at the Norman Fixel Institute for Neurological Diseases at UF Health, reviewed current and past research in DLB.
“Many studies show that DLB is more common in men, but this finding is inconsistent and varies by study approach. Women with DLB are typically under-represented in clinical trial research,” said Dr. Chiu. “If we can understand the impact sex plays in the presentation of DLB, we can help clinicians diagnose the disease earlier, treat symptoms better, and support caregivers.”
For their research, Drs. Chiu and Armstrong compiled data on DLB research prior to July 2022 with exclusions related to research based solely on Parkinson’s disease, Alzheimer’s disease, and other dementias. Based on research with specific data on sex or gender, Drs. Chiu and Armstrong found the following conclusions:
- Visual hallucinations are more common and occur earlier in women with DLB, whereas Rapid Eye Movement (REM) sleep behavior disorder (acting out dreams) may be more common and occur earlier in men with DLB.
- Parkinson-like movement changes appear more frequent in men with DLB, while frequency of fluctuations (ups and downs in alertness) appears similar between the sexes.
- Women tend to be older, have more memory and thinking changes at their first visit, and are delayed in meeting DLB diagnostic criteria compared to men.
- On autopsy, women are more likely to have mixed Lewy body disease and co-existing Alzheimer related pathology than so-called “pure” Lewy body disease, while men may present with either.
“Increasing awareness of sex differences in how and when DLB presents in a patient is critical. We can ensure more accurate and timely diagnosis, including at the earliest disease stages. In turn, this will help guide appropriate counseling and patient and caregiver support,” said Dr. Chiu.