Lewy Bodies Dementia
Dementia with Lewy bodies (DLB) shares similarities with both Alzheimer's and Parkinson's diseases, often leading to misdiagnosis. Seeking specialized diagnosis is crucial because individuals with DLB may have adverse reactions to medications used for other forms of dementia.
DLB Symptoms:
- Mental symptoms resembling Alzheimer's disease include:
- Problems with attention and alertness
- Spatial disorientation
- Difficulties with planning and reasoning
- Memory loss, albeit to a lesser extent than in Alzheimer's disease
- Physical symptoms resembling Parkinson's disease include:
- Slowness and stiffness
- Tremors in the limbs
- Shuffling gait
- Loss of facial expression
- Weakening of vocal strength
Other symptoms specific to dementia with Lewy bodies include:
- Vivid and detailed visual hallucinations, often involving people or animals
- Fluctuating abilities that can change daily or even hourly
- Daytime sleepiness contrasting with disturbed nights characterized by nightmares, hallucinations, and confusion
- Episodes of fainting, falls, and transient periods of confusion
DLB accounts for approximately 10% of all dementia cases but tends to be underdiagnosed. It primarily affects elderly men and women. While DLB, like other forms of dementia, is treatable, it is not curable or reversible.
Alternate names for dementia with Lewy bodies include:
- Lewy body dementia
- Cortical Lewy body disease
- Diffuse Lewy body disease
Understanding "Lewy Bodies":
Lewy bodies are microscopic spherical protein deposits found in nerve cells, named after Dr. Lewy, who identified them in 1912. When they appear in the brain, they interfere with normal functioning by disrupting chemical messengers like acetylcholine and dopamine. Lewy bodies are also associated with Parkinson's disease, a neurological disorder affecting the brain's control over the body's muscles. Many individuals with Parkinson's disease may eventually develop dementia.
The Significance of Specialist Diagnosis for DLB:
Due to the potential for misdiagnosis, specialist evaluation is crucial for dementia with Lewy bodies. Misdiagnosis can lead to adverse reactions to drugs commonly used to treat other forms of dementia. A correct diagnosis opens the door to support services tailored to dementia patients and their caregivers, allowing for future planning and appropriate care.
Treating Dementia with Lewy Bodies:
Currently, there is no cure for dementia with Lewy bodies. However, specific medications are used to manage symptoms and slow the progression of the disease. Given the rapid fluctuations in symptoms, care approaches need to be flexible and may involve physiotherapy and one-on-one support.
Cholinesterase inhibitor drugs commonly used for Alzheimer's disease have shown some utility in DLB cases. Another Alzheimer's treatment, memantine/Ebixa, may also be beneficial.
Physical symptoms can be addressed with medications typically used for Parkinson's disease, although these drugs can exacerbate hallucinations and confusion. Physiotherapy and mobility aids are additional options.
Neuroleptics, potent tranquilizers, may be prescribed to reduce confusion and distress in individuals with dementia. However, in the case of dementia with Lewy bodies, these medications can cause severe side effects, including rigidity, immobility, impaired communication, and even sudden death. Therefore, neuroleptic use requires careful monitoring.
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