A Three-Minute Test Diagnoses Lewy Body Dementia

Lewy Body Dementia (LBD) is a neurological condition that affects an estimated 1.4 million people in the U.S. alone, but very few people have ever heard of it. Even clinicians struggle to diagnose it because it overlaps with many other similar disorders such as Parkinson's and Alzheimer's—in fact, 80 percent of LBD cases are misdiagnosed as Alzheimer’s—and psychiatric conditions like schizophrenia. Before his death, actor Robin Williams had been diagnosed with Parkinson's, but an autopsy found "diffuse Lewy body dementia" in his brain. Now clinicians have a way to diagnose the disease. 

Technically, Lewy bodies are abnormal proteins called alpha-synuclein, but they're better known by their eponymous name; Dr. Friederich Lewy, a German neurologist, discovered them in 1912. When they accumulate in neurons, they disrupt brain function, causing cognitive decline, Parkinson’s-like tremors and motor problems, and memory problems. 

Since there are no identified biomarkers to easily diagnose LBD, Dr. James E. Galvin, a professor and associate dean for clinical research at the Charles E. Schmidt College of Medicine at Florida Atlantic University, has created a 3-minute test called the Lewy Body Composite Risk Scale (LBCRS), comprised of 10 questions [PDF], to which a patient must only get three “yes” answers to qualify as having LBD. The test is meant to be administered in a doctor's office. 

In a test-run of its accuracy in a real-world clinic setting, with 256 patients representing a "mixture of gender, education, comorbidities, behavioral, affective, motor symptoms, and diagnoses," the LBCRS was able to discriminate between Alzheimer's disease and LBD with 96.8 percent accuracy. These results were recently published in the journal Alzheimer's & Dementia

“In the absence of a biomarker, you need a tool that can capture these symptoms and frame them in a way that every clinician can ask every patient the same questions and either rule it out, or make the diagnosis likely,” Galvin says.

Diagnosis of LBD is difficult because some symptoms are hard to quantify. “For instance, one of the core features of LBD is cognitive fluctuations, but there is no well-agreed upon definition of these," Galvin explains. "The general consensus is that cognitive fluctuation is a spontaneous change in level of attention, alertness, or focus that can vary from minute to minute, hour to hour. So how do you capture that symptom?”

To make matters more complicated, Lewy bodies are found in many parts of the body, which can cause symptoms that masquerade as other conditions: “You’ll find [Lewy bodies] in the peripheral nervous system, the walls of the gut, the heart, in salivary glands, in sebaceous glands and more,” Galvin says. “Because of this, some of the early symptoms include chronic constipation, heart arrhythmias, changes in salivary glands—drooling—and even dermatitis.”

Though it’s often misdiagnosed as Alzheimer’s due to the shared decline in memory, there are some significant memory differences between the two illnesses. “Alzheimer’s patients have difficulty learning new information, whereas non Alzheimer’s-dementias, including LBD, are better able to learn information but have difficulty retrieving information,” Galvin says. 

LBD patients also have more visual-perceptual problems. “Many of these patients first go to an eye doctor because they think something is wrong with their glasses.”

Though there is not yet a cure for LBD, early diagnosis is helpful for patients, not the least because it can ease the strain that uncertainty puts on families. “[Not having a diagnosis] creates a sense of isolation when no one can explain what’s going on,” Galvin says. 

Early diagnosis is also crucial when it comes to treating symptoms with medications. To treat the various symptoms that occur with LBD, Galvin says, “we borrow medications from other fields. We use Alzheimer’s meds and Parkinson’s meds, and meds from the psychiatric field and the cardiology field.” 

Without a diagnosis of LBD, undiagnosed individuals are at risk for a dangerous condition resulting from neuroleptic medicines—antipsychotics—which are prescribed for hallucinations or schizophrenia-like symptoms. That's because they affect the brains of people with LBD differently, Galvin says: “LBD patients have a tenfold increased risk of getting neuroleptic malignant syndrome, which is characterized by high fever, muscle breakdown, kidney failure, and even death.” The earlier the diagnosis, the less chance of this happening.

Because the Lewy Body Composite Risk Scale is so new, it's not in use much yet. But Galvin is hopeful that eventually his test will help millions of people with the disease get a diagnosis and some form of symptom treatment. He stresses the need for greater awareness of the disease—and more research dollars to study it.

Keep Your Cat Busy With a Board Game That Doubles as a Scratch Pad

Cheerble
Cheerble

No matter how much you love playing with your cat, waving a feather toy in front of its face can get monotonous after a while (for the both of you). To shake up playtime, the Cheerble three-in-one board game looks to provide your feline housemate with hours of hands-free entertainment.

Cheerble's board game, which is currently raising money on Kickstarter, is designed to keep even the most restless cats stimulated. The first component of the game is the electronic Cheerble ball, which rolls on its own when your cat touches it with their paw or nose—no remote control required. And on days when your cat is especially energetic, you can adjust the ball's settings to roll and bounce in a way that matches their stamina.

Cheerable cat toy on Kickstarter.
Cheerble

The Cheerble balls are meant to pair with the Cheerble game board, which consists of a box that has plenty of room for balls to roll around. The board is also covered on one side with a platform that has holes big enough for your cat to fit their paws through, so they can hunt the balls like a game of Whack-a-Mole. And if your cat ever loses interest in chasing the ball, the board also includes a built-in scratch pad and fluffy wand toy to slap around. A simplified version of the board game includes the scratch pad without the wand or hole maze, so you can tailor your purchase for your cat's interests.

Cheerble cat board game.
Cheerble

Since launching its campaign on Kickstarter on April 23, Cheerble has raised over $128,000, already blowing past its initial goal of $6416. You can back the Kickstarter today to claim a Cheerble product, with $32 getting you a ball and $58 getting you the board game. You can make your pledge here, with shipping estimated for July 2020.

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Victorian Women Worked Out, Too—They Just Did It Wearing Corsets

Opening a door was nearly as taxing as an actual 19th-century workout.
Opening a door was nearly as taxing as an actual 19th-century workout.
ivan-96/iStock via Getty Images

The next time you’re gasping for breath in the middle of a cardio routine, try to imagine doing the same thing while decked out in a flowy dress and corset. That’s what female exercise enthusiasts faced in the 1800s.

According to Atlas Obscura, tailors weren’t churning out loose leggings or stretchy tracksuits for women to don for their daily fitness sessions, and workout guides for Victorian women were mainly written by men. To their credit, they weren’t recommending that ladies undergo high-intensity interval training or heavy lifting; instead, exercises were devised to account for the fact that women’s movements would be greatly constricted by tight bodices and elaborate hairstyles. As such, workouts focused on getting the blood flowing rather than burning calories or toning muscle.

In his 1827 book A Treatise on Calisthenic Exercises, Signor G.P. Voarino detailed dozens of options for women, including skipping, walking in zigzags, marching in place, and bending your arms and legs at specific angles. Some exercises even called for the use of a cane, though they were more geared towards balancing and stretching than weight-lifting.

To Voarino, the light calisthenic exercises were meant for “counteracting every tendency to deformity, and for obviating such defects of figure as are occasioned by confinement within doors, too close an application to sedentary employment, or by those constrained positions which young ladies habitually assume during their hours of study.”

Nearly 30 years later, Catharine Beecher (Harriet Beecher Stowe's sister) published her own workout guide, Physiology and Calisthenics for Schools and Families, which encouraged educators especially to incorporate exercise programs for all children into their curricula. Beecher was against corsets, but the illustrations in her book did still depict young ladies in long dresses—it would be some time before students were expected to change into gym clothes at school. Many of Beecher’s calisthenic exercises were similar to Voarino’s, though she included some beginner ballet positions, arm circles, and other faster-paced movements.

Compared to the fitness regimen of 14th-century knight Jean Le Maingre, however, Victorian calisthenics seem perfectly reasonable. From scaling walls to throwing stones, here’s how he liked to break a sweat.

[h/t Atlas Obscura]