Fact 5. Autonomic Dysfunction in DLB: An Unseen Challenge
While cognitive symptoms and motor features often dominate the DLB narrative, the impact of autonomic dysfunction cannot be ignored. Autonomic symptoms in DLB include orthostatic hypotension (a sudden drop in blood pressure upon standing), constipation, urinary problems, and sexual dysfunction. These symptoms, often overlooked, can significantly affect a patient’s quality of life.
Orthostatic hypotension, for instance, can lead to dizziness, falls, and loss of consciousness. The consequent risk of injury and the fear of falling can limit the patient’s mobility and independence, leading to physical deconditioning and social isolation. Similarly, constipation and urinary problems can lead to discomfort, embarrassment, and potential complications like urinary tract infections or bowel obstruction.
Autonomic dysfunction also poses diagnostic challenges. The symptoms are often non-specific and can be mistaken for age-related changes or the side-effects of medication. Therefore, a high index of suspicion is required to recognize and attribute these symptoms to DLB.
Managing autonomic dysfunction requires a tailored approach, considering the patient’s overall health status, comorbidities, and medication regimen. Non-pharmacological measures like hydration, dietary modifications, and physical therapy form the first line of management. (5)
