Lewy Body Dementia Treatment Options
There is currently no cure for Lewy body dementia or therapies to stop or slow its progression. Treatments such as medications, counseling, and physical, occupational, and speech therapies aim to manage symptoms.
Doctors may prescribe medications to treat the cognitive, psychiatric, and motor symptoms of LBD while others may prescribe medication commonly used to treat Parkinsons disease to help with motor issues. Side effects of these medications can include psychiatric and behavioral problems, so the risks must be weighed against the benefits.
A safe living environment, equipment that makes daily tasks easier, and a skilled care team will help improve the quality of life of an individual with this disease. The prognosis for Lewy body dementia is similar to that of Alzheimers and Parkinsons. The average survival time after diagnosis is about eight years but can range from two to 20 years.
Treating Movement Symptoms In Lewy Body Dementia
LBD-related movement symptoms may be treated with medications used for Parkinson’s disease, called carbidopa-levodopa. These drugs can help make it easier to walk, get out of bed, and move around. However, they cannot stop or reverse the disease itself. Side effects of this medication can include hallucinations and other psychiatric or behavioral problems. Because of this risk, physicians may recommend not treating mild movement symptoms with medication. Other Parkinson’s medications are less commonly used in people with LBD due to a higher frequency of side effects.
People with LBD may benefit from physical therapy and exercise. Talk with your doctor about what physical activities are best.
Diagnosis: Parkinsons Dementia Or Dementia With Lewy Bodies
During assessment, a specialist may look at when the dementia symptoms first appeared before reaching a diagnosis of Parkinsons dementia or dementia with Lewy bodies.
If there have been motor symptoms for at least one year before dementia symptoms occur, specialists will often give a diagnosis of Parkinsons dementia.
If dementia symptoms occur before or at the same time as motor symptoms, specialists will usually give a diagnosis of dementia with Lewy bodies.
However, it should be noted that in some cases of dementia with Lewy bodies, no motor symptoms develop at all.
Theres no single test diagnosis is made through several different assessments, usually starting with an appointment with your GP or Parkinsons nurse.
Some people find it helps to go to the appointment with someone who knows them well, who can give the GP or Parkinsons nurse information about changes theyve noticed.
Your GP can discuss your symptoms with you and carry out a physical examination, including blood and urine tests, to rule out other potential causes of the symptoms .
Your GP may also review your medication, in case your symptoms are side effects.
If your GP thinks you have dementia, they can refer you to a specialist, such as a neurologist, psychiatrist or geriatrician.
You might be referred to a memory clinic or memory service. In some areas of the country, you can refer yourself to these services.
But if you feel you need to see the specialist again, you can ask to be referred back.
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Rem Sleep Behavior Disorder And Insomnia
Melatonin is a safe, over-the-counter natural substance that may also offer benefit either as monotherapy without risk or in conjunction with clonazepam. Prescription medications may be prescribed.
For insomnia, treatment can be attempted with antidepressants, low doses of benzodiazepines or specific sedative-hypnotic agents. These medications have not been extensively studied in LBD, and worsening confusion and daytime sedation is a potential side effect of sedative-hypnotics.
Memory And Thinking Problems
You may experience forgetfulness, slowed thinking and difficulty concentrating. You might find it harder to follow conversations, and remember some words and names. This can make communication difficult.
You may also find it increasingly difficult to make decisions, plan activities and solve problems. This can make everyday activities harder.
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Create A Support System
Your family and close friends are likely aware of changes in your thinking, movement, or behavior. You may want to tell others about your diagnosis so they can better understand the reason for these changes. For example, you could say that you have been diagnosed with a brain disorder called Lewy body dementia, which can affect thinking, movement, and behavior, and that you will need more help over time. By sharing your diagnosis, you can build a support team to help you manage LBD.
As LBD progresses, you will likely have more trouble managing everyday tasks such as taking medication, paying bills, and driving. You will gradually need more assistance from family members, friends, and perhaps professional caregivers. Although you may be reluctant to get help, try to let others partner with you so you can manage responsibilities together. Remember, LBD affects your loved ones, too. You can help reduce their stress when you accept their assistance.
Finding someone you can talk with about your diagnosis a trusted friend or family member, a mental health professional, or a spiritual advisor may be helpful.
Dementia & Alzheimer’s Disease
After a person has been diagnosed with Lewy body dementia, the first thing they want to know is the options available in regards to Lewy body dementia treatment.
This is a type of dementia that develops when abnormal protein deposits, also known as Lewy bodies, are found in various areas of the brain.
These round, smooth lumps end up disrupting the normal functioning of the brain.
Sadly, to date, there is still no cure for the condition.
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A Word From Get Meds Info
If you or a loved one has been diagnosed with Lewy body dementia, be sure to address all your concerns and questions with your healthcare provider. Its also a good idea to consider having a family meeting if you are ready and comfortable. This way you can discuss issues, like goals of care and treatment expectations.
Types Of Lewy Body Dementia And Diagnosis
LBD refers to either of two related diagnoses dementia with Lewy bodies and Parkinson’s disease dementia. Both diagnoses have the same underlying changes in the brain and, over time, people with either diagnosis develop similar symptoms. The difference lies largely in the timing of cognitive and movement symptoms.
In DLB, cognitive symptoms develop within a year of movement symptoms. People with DLB have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time, they also develop movement and other distinctive symptoms of LBD.
In Parkinson’s disease dementia, cognitive symptoms develop more than a year after the onset of movement symptoms . Parkinson’s disease dementia starts as a movement disorder, with symptoms such as slowed movement, muscle stiffness, tremor, and a shuffling walk. These symptoms are consistent with a diagnosis of Parkinson’s disease. Later on, cognitive symptoms of dementia and changes in mood and behavior may arise.
Not all people with Parkinson’s disease develop dementia, and it is difficult to predict who will. Many older people with Parkinson’s develop some degree of dementia.
Caregivers may be reluctant to talk about a person’s symptoms when that person is present. Ask to speak with the doctor privately if necessary. The more information a doctor has, the more accurate a diagnosis can be.
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Episodes Of Fainting Or Loss Of Consciousness
Episodes of fainting or loss of consciousness is due to dysautonomia . Someone affected by this can have very low blood pressure, which leads to dizziness, fainting spells and loss of consciousness when they stand up quickly. They can also develop supine hypertension, meaning that when they are lying down, the blood pressure will increase significantly.
Causes Of Lewy Body Dementia
LBDs are poorly understood but are thought to be characterized by the buildup of Lewy bodies in the brain. Lewy bodies are groupings or clumps of badly formed proteins called alpha-synuclein proteins. Healthy alpha-synuclein proteins are normally found widely throughout the brain and are thought to play many roles, including participating in plasticity. This means that they affect how brain cells communicate with one another and change in response to a persons experience. However, when these proteins misfold and accumulate, the result is Lewy bodies, which lead to cell death in the brain.
The type of LBD a person has is determined by where in the brain the Lewy bodies first begin forming. When Lewy bodies first begin to form in the cortex, dementia with Lewy bodies is the most likely result. These initial protein deposits in the cortex lead to early cognitive changes, such as inattention. When the Lewy bodies first deposit in areas of the brain more related to motor control and movement, such as the substantia nigra, PDD is the most likely result.
But what causes these Lewy bodies to form in the first place?
Genetics or hereditary elements likely play a role. The following genes are thought to be involved in the spectrum of disorders related to PD, including dementia with Lewy bodies and PDD.
Here are two common scenarios that may sound familiar:
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Is Lewy Body Dementia An Inherited Condition
One of the more recent discoveries toward identifying a cause of Lewy body dementia is the finding of an increasing number of gene mutations. Two genetic risk factors recently discovered are variants in the APOE and GBA genes. APOE is already known to increase the risk of developing Alzheimers disease. There is growing evidence that it also increases the risk for dementia with lewy bodies. Similarly, the GBA gene increases the risk for both Parkinsons disease and dementia with lewy bodies. Despite these findings, genetic changes as a cause of LBD are still considered rare by scientists. Most cases of Lewy body dementia are not thought to be inherited.
Genetic testing for routine screening for LBD is not currently recommended. Discuss the pros and cons of testing with your healthcare providers if you have a family history of multiple members with Parkinsons disease and/or dementia with lewy bodies.
Can Imaging Tests Diagnose Lewy Body Dementia
Imaging tests, such as computed tomography or magnetic resonance imaging , are done to rule out other causes of dementia such as brain tumors, brain bleeds, stroke, hydrocephalus or other structural causes. Imaging studies for Lewy body dementia are usually normal. The only way to make an absolute diagnosis of LBD is by examining the brain at autopsy.
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Icipate In Activities You Enjoy
Despite the many challenges and adjustments that come with an LBD diagnosis, you can have moments of love, humor, tenderness, and gratitude with the people closest to you. Your attitude can help you find enjoyment in daily life.
Make a list of events and activities you can still enjoy then find a way to do them! For example, listen to music, exercise, or go out for a meal with family and friends. If you can’t find pleasure in daily life, talk with your doctor or another health care professional about effective ways to cope. Let your family know if you are struggling emotionally so they can offer support.
Symptoms Of Lewy Body Dementia
Symptoms of Lewy body dementia include:
- Hallucinations visual hallucinations are often a first sign of Lewy body dementia patients may see objects, people or animals that are not there.
- Impaired thinking cognitive function may be impaired, so patients with Lewy body dementia may have challenges thinking clearly, memory loss, poor attention span and feel confused.
- Difficulty walking patients with Lewy body dementia may shuffle, become rigid or walk more slowly.
- Difficulty sleeping patients with Lewy body dementia report acting out dreams while they are sleeping.
- Changes in behavior changes in behavior, such as loss of attention span, loss of motivation or speech problems, can occur in patients with Lewy body dementia.
- Tremors Parkinsons disease-like tremors can occur in patients with Lewy body dementia.
Symptoms start slowly and intensify as the disease progresses. In late stages of the disease, patients with Lewy body dementia may need assistance to perform day-to-day activities.
Diagnosis of Lewy body dementia
It is difficult to diagnose Lewy body dementia because symptoms are similar to other progressive brain disorders such as Alzheimers disease. If you think you or a loved one has Lewy body dementia, schedule an appointment with a Mercy Health neurologist for testing.
Other testing to diagnose Lewy body dementia includes:
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How To Help Someone Manage Lewy Body Dementia
When it comes to helping someone manage the symptoms of LBD, small things can often make a big difference.
Create a routine. It can help someone with LBD to have predictable routines, especially around meal times and sleep times.
Establish a nighttime ritual. Try to establish bedtime rituals that are calming and away from the noise of television, meal cleanup, and active family members. Limiting caffeine consumption and daytime napping, and encouraging exercise can help curb restlessness at night.
Modify tasks. Break tasks into easier steps and focus on success, not failure.
Walk together. Taking a walk with the patient with LBD is a win-win activity. Being outdoors and exercising is vital for the health and state of mind for both the patient and you.
Strengthen senses. Have a doctor evaluate each the patients five senses in order to identify and treat any abnormalities. Then ask about exercises to improve them.
Make lifestyle changes. To help minimize the risk of fall-related injuries, you can help stabilize blood pressure. Help your loved one stay well hydrated, exercise, take in adequate sodium , avoid prolonged bed rest, and stand up slowly.
Tips for managing behavioral changes
One of the major challenges of caring for a loved one with dementia can be coping with the troubling behavioral changes that often occur. As a caregiver, you cant change the person with dementia, but you can employ strategies to modify or better accommodate any problem behaviors.
Treatment And Care For Lewy Body Dementia
While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. An LBD treatment plan may involve medications, physical and other types of therapy, and counseling. A plan to make any home safety updates and identify any equipment can make everyday tasks easier.
A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers.
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Treatment & Important Information
IMPORTANT The onset of aggression in Lewy Body Dementia may have a variety of causes, including infections , medications, misinterpretation of the environment or personal interactions, and the natural progression of the disease.
If confusion or aggressive behavior suddenly begins, there are several reasons this may be occurring, other than that it may be a progression of the disease. If there were any recent medication changes, be sure to call your doctor as it may be an indication that the newly introduced drug is not agreeing with the person with LBD. They are extremely sensitive to certain medications. Infections, such as a urinary tract infection , will often have a person display this behavior, as will dehydration. Other possibilities could be environmental, such as a new item in the room that may bring on hallucinations or a change in timing.
Parkinsons Disease Dementia And Dementia With Lewy Bodies
The key pathological hallmark found in brains of Parkinsons disease and Parkinsons disease dementia patients are abnormal microscopic deposits composed of alpha-synuclein. This protein is found widely in the brain but its normal function is not yet well understood. The deposits are called Lewy bodies. Lewy bodies are also found in several other neurodegenerative brain disorders, including dementia with Lewy bodies . Evidence suggests that Parkinsons disease and Parkinsons disease dementia, and dementia with Lewy bodies, may be linked to the same underlying abnormalities in brain processing of alpha-synuclein.
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Diagnosing Lewy Body Dementia: For Professionals
Lewy body dementia can be difficult to diagnose. Talking to both patients and caregivers helps doctors make a diagnosis. It is important to ask the patient and their care partners about any symptoms involving thinking, movement, sleep, behavior, or mood. Certain medications can worsen LBD symptoms be aware of all current medications and supplements the patient is taking.
Dementia with Lewy bodies is often hard to diagnose because its early symptoms may resemble those of Alzheimer’s disease or a psychiatric illness. As a result, it is often misdiagnosed or missed altogether. As additional symptoms appear, making an accurate diagnosis may become easier.
The good news is that doctors are increasingly able to diagnose LBD earlier and more accurately, as researchers identify which symptoms and biomarkers help distinguish it from similar disorders.
Visiting a family doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. If a persons primary doctor is not familiar with LBD, they may have patients seek second opinions from specialists, like a geriatric psychiatrist, neuropsychologist, or a geriatrician to help diagnose LBD. If a specialist cannot be found in your community, ask the neurology department at a nearby medical school for a referral. Neurologists generally have the expertise needed to diagnose LBD.
Difficult as it is, getting an accurate diagnosis of LBD early on is important so that a person:
Slowing The Progression Of Symptoms
The same healthy lifestyle changes that are used to prevent dementia can also be useful in slowing the advancement of LBD symptoms.
To learn more about putting these strategies into action, see Preventing Alzheimers Disease.
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