The Many Faces of Dementia: Lewy Body
Special to The Union
Lewy Body Dementia is not a rare dementia. It currently affects more than a million people in the U.S. Because LBD symptoms can closely resemble other, more commonly known diseases like Alzheimer’s and Parkinson’s, it is currently widely underdiagnosed. Many doctors or other medical professionals still are not familiar with LBD.
LBD is an umbrella term for two related diagnoses. LBD refers to both Parkinson’s disease dementia and dementia with Lewy bodies. The earliest symptoms of these two diseases differ but reflect the same underlying biological changes in the brain. Over time, people with both diagnoses will develop very similar cognitive, physical, sleep and behavioral symptoms. For more detailed information, contact the Lewy Body Dementia Association Inc. at http://www.lbda.org.
Lewy Body Dementia or Dementia with Lewy bodies is one of the three most common types of progressive dementia. Lewy Body dementia is a progressive cognitive decline, combined with several defining features: There are pronounced “fluctuations” in alertness and attention, such as frequent drowsiness, lethargy, lengthy periods of time spent staring into space, or disorganized speech. There are recurrent visual hallucinations that may become evident early in the disease’s progression. And there are Parkinsonian motor symptoms, such as rigidity and the loss of spontaneous movement. Balance when walking or standing may also be a symptom.
The symptoms of Lewy Body dementia are caused by the build-up of Lewy bodies – accumulated bits of alpha-synuclein protein – not too dissimilar to the proteins present with Alzheimer’s disease. This same accumulation is linked to Parkinson’s disease.
Accurate diagnosis of LBD can be challenging. The similarity of symptoms between Lewy Body dementia, Parkinson’s disease, and Alzheimer’s disease, can often make it difficult for a doctor to make a definitive diagnosis. In addition, Lewy bodies are often also found in the brains of people with Parkinson’s and Alzheimer’s diseases. Lewy body dementia can occur concurrently with other dementias and usually occurs sporadically and may have no know family history of LBD.
While it may take more than a year or two for enough symptoms to develop for a doctor to diagnose LBD, it is critical to pursue a formal diagnosis. Early diagnosis allows for important early treatment that may extend quality of life and independence.
Treatment and care is generally aimed at controlling motor symptoms and cognitive decline. Healthcare professionals normally avoid prescribing antipsychotics for the hallucinatory symptoms. In many cases, hallucinations are not unpleasant, thus it may be better to provide positive reaffirmation in the care aspect, rather than prescribing strong medications. A person with LBD may “think” they have seen a large fluffy dog in their bedroom the previous night or look at a large picture book and see horses crossing a stream rather than the actual large boulders in the photograph. The obvious action by a caregiver would be to agree with the “sighting” and have a warm and friendly discussion.
At this point there is no cure for LBD, although research on the brain has been ramping up in recent years, and significant progress is being made in discovering the cause and cures of the dementias. At least half of individuals with Lewy body disease also have significant amounts of Alzheimer’s pathology. With more than 5 million people in the United States diagnosed with Alzheimer’s disease, it stands to reason that Alzheimer’s research will also ultimately lead to cures of Lewy body dementia.
Tor Eckert has owned and operated an Alzheimer’s care home, become an advocate on Dementia Care with various organizations and was designated as a Healthcare Professional by the Alzheimer’s Foundation. He can be contacted at TorEckert@sbcglobal.net or cell phone 530-277-0879.
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