Which cognitive domain is typically preserved in the early stages of dementia with Lewy bodies?
a) Memory
b) Language
c) Visuospatial abilities
d) Attention and executive function
The correct answer and explanation is:
Correct Answer: a) Memory
In the early stages of dementia with Lewy bodies (DLB), memory is typically better preserved compared to other cognitive domains. Unlike Alzheimer’s disease, where memory loss is often the first and most prominent symptom, individuals with DLB usually show more difficulties with attention, executive function, and visuospatial abilities early in the disease process.
DLB is a progressive neurodegenerative disorder that involves abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, known as Lewy bodies, disrupt normal brain function and lead to a range of cognitive, psychiatric, and motor symptoms. Early in the course of DLB, patients may show significant fluctuations in attention and alertness. They might also experience visual hallucinations and signs of parkinsonism, such as tremors or stiffness.
Visuospatial abilities, which involve understanding and interpreting visual information and spatial relationships, are often impaired in early DLB. This may cause trouble with tasks like driving, navigating familiar environments, or judging distances. Similarly, executive functions—such as planning, organizing, and decision-making—can be affected early, making it hard for individuals to manage daily tasks that require reasoning or flexible thinking.
Despite these challenges, memory remains relatively intact in the beginning stages. While some individuals may still report mild forgetfulness, the severity is usually not as pronounced as in Alzheimer’s disease. As DLB progresses, memory impairments may become more evident, but early preservation of memory is one of the clinical features that help distinguish DLB from other forms of dementia.
Understanding which cognitive abilities are initially preserved or impaired helps clinicians in the early identification and differential diagnosis of dementia types. This can guide treatment strategies and support planning for patients and caregivers.