By Katie Tardiff, Vice President, Clinical Services on Sep 21, 2020 1:50:49 PM
Dementia is not a specific disease but refers to a group of symptoms that can impact a patient’s movement, thought, and reasoning. The third most common cause of dementia, after Alzheimer’s disease and vascular dementia, is Lewy body dementia (LBD). This form of dementia is caused by the buildup of protein deposits in the brain and can account for 5-10% of all dementia cases. Lewy body dementia refers to dementia that is caused by Lewy bodies.
As with all forms of dementia, early detection and diagnosis are critical to ensuring an effective long-term treatment plan. The symptoms of degenerative brain diseases such as Lewy body dementia can overlap with other conditions, such as Parkinson’s disease, and be difficult to diagnose in the early stages. In this post we’ll take a look at some of the important aspects of Lewy body dementia that differentiate it from other similar conditions.
What are Lewy Bodies?
The term “Lewy body” is named after German neurologist Dr. Friedrich Lewy, who discovered the presence of abnormal protein deposits in the brains of people with Parkinson’s disease. While it is not known exactly why these proteins form into these microscopic clusters, Dr. Lewy was able to determine that they could have an impact on brain function.
The type of protein found in Lewy bodies, alpha-synuclein, plays an important role in the normal function of brain synapses that are used for communication between brain cells. In Lewy body dementia, as these proteins form deposits, they inhibit the ability of neurons to work properly and these cells begin to die. Over time, this decay can lead to widespread damage to various regions of the brain, resulting in a loss of functional abilities associated with those brain regions.
What Are the Symptoms of Lewy Body Dementia?
The first symptoms to appear in patients with Lewy body dementia are typically related to cognitive and motor functions. Cognitive symptoms can include issues with memory, judgement, or thinking and are generally progressive in nature. In addition, they can also vary in severity from moment to moment and be very unpredictable.
Motor function can be impaired by Lewy body dementia, leading to muscle stiffness, tremors, or changes in walking patterns. A large majority of patients experience these motor problems during later stages of the disease, but they can also appear at any time. Some additional symptoms that can arise include depression and issues with bowel movements.
Lewy body dementia, Alzheimer’s disease, and Parkinson’s disease share many common symptoms, but there are some important differences that can help differentiate Lewy body dementia from the other conditions, such as:
- The intensity of memory and cognitive problems often fluctuates frequently.
- Hallucinations often appear during the early stages of the disease and can be vivid and frequent.
- Tremor is usually less pronounced with Lewy body dementia versus Parkinson’s disease, and patients do not respond as well to typical medications such as levodopa.
- Life expectancy is shorter in Lewy body dementia than with Alzheimer’s disease or Parkinson’s disease.
How is Lewy Body Dementia Diagnosed?
In many cases, the identification of dementia symptoms is the first starting point for a Lewy body dementia diagnosis. At that point, healthcare providers typically order additional testing to differentiate this condition from others. Additional testing can include brain scans, cardiac imaging, and sleep studies. Sleep studies can help confirm the presence and effects of any visual hallucinations, which are often a unique symptom during early stages of Lewy body dementia. A combination of these studies can help identify some of the unique biomarkers for Lewy body dementia and lead to a more definitive diagnosis.
What are the Treatment Options for Lewy Body Dementia?
There are no current treatments available that can slow or stop Lewy body dementia from progressing. When designing a treatment plan, medical professionals try to make the symptoms of the disease manageable to help patients maintain their quality of life for as long as possible.
Medications can have a positive effect on cognitive symptoms, blood pressure, tremors, and sleep disturbance. Patients with Lewy body dementia are often sensitive to medications, so healthcare providers often prescribe them with great caution. In some unique cases, antipsychotics can be used to treat symptoms such as hallucinations and paranoia.
Therapies are often used with some success to help improve a patient’s strength and ability to function. Physical therapy can improve overall health or help overcome a specific weakness in the body that may have developed. Occupational therapy can have a positive effect on everyday tasks such as bathing and eating. Speech therapy and mental health counseling are also used as needed to help patients manage their emotions, behaviors, or problems with speech or swallowing.
Lewy body dementia presents a number of challenges for patients, families, and health practitioners. By learning more about this condition, caregivers can help improve dementia patient care and increase awareness. Receiving a reliable diagnosis remains an important first step in working with the care team to develop a treatment plan that can have a positive impact on your loved one’s life.