Seems like PD is difficult to even diagnose let alone treat
Yes and no. The majority of times, PDD follows the diagnosis of PD by several years. If a patient presents with a tremor, bradykinesia, regidity and gait disturbance that respond to Sinemet, we can be pretty sure about the diagnosis of PD. Then if dementia comes on, we can be fairly certain the patient has PDD. PDD and Lewy body dementia overlap and misdiagnosis can occur. LBD has more fluctuations, REM sleep disturbance (often first sign), earlier cognitive issues and less tremor than PD --- but in real life the distinction is not always clear.
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