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.

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

Mental Floss has affiliate relationships with certain retailers and may receive a small percentage of any sale. But we choose all products independently and only get commission on items you buy and don't return, so we're only happy if you're happy. Thanks for helping us pay the bills!

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

Mental Floss has affiliate relationships with certain retailers and may receive a small percentage of any sale. But we choose all products independently and only get commission on items you buy and don't return, so we're only happy if you're happy. Thanks for helping us pay the bills!