What Are The Symptoms
The symptoms of dementia with Lewy body disease include:
- Difficulty with concentration and attention
- Extreme confusion
- Difficulties judging distances, often resulting in falls.
There are also three cardinal symptoms, two of which must be present in order to make the diagnosis:
- Visual hallucinations
- Fluctuation in mental state so that the person may be lucid and clear at one time and confused, disoriented and bewildered at other times. Typically this fluctuation occurs over a period of hours or even minutes and is not due to any underlying acute physical illness.
Some people who have Lewy body disease may also experience delusions and/or depression.
Find Time To Care For Yourself
As a caregiver, it is critical for you to take care of to maintain your own health and well-being. You may be at increased risk for poor sleep, depression, or illness as a result of your responsibilities. Watch for signs of physical or emotional fatigue such as irritability, withdrawal from friends and family, and changes in appetite or weight.
All caregivers need time away from caregiving responsibilities to maintain their well-being. Learn to accept help when it’s offered, and learn to ask family and friends for support. One option is professional respite care, which can be obtained through home care agencies and adult day programs. Similarly, friends or family can come to the home or take the person with LBD on an outing to give you a break.
Discuss Lewy Body Dementia Diagnosis With Family
Not all family members may understand or accept LBD at the same time. This can create conflict. Some adult children may deny that their parent has a problem, while others may be supportive. It can take a while to learn new roles and responsibilities.
Family members who visit occasionally may not see the symptoms that primary caregivers see daily and may underestimate or minimize your responsibilities or stress. Professional counselors can help provide guidance on how families can work together to manage LBD.
Although LBD and Alzheimer’s disease are different disorders, they share similar family concerns. For more information, read Helping Family and Friends Understand Alzheimer’s Disease and Helping Children Understand Alzheimer’s Disease.
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Assessing Your Mental Abilities
The Mini Mental State Examination is widely used to help test mental ability.
The MMSE can be used to assess a number of different mental abilities, including:
- short- and long-term memory
- ability to plan
- ability to understand instructions
The MMSE involves a series of tasks, which together carry a maximum score of 30 points. Example tasks include:
- memorising a short list of objects and then repeating the list back
- correctly identifying the day of the week, the date, or the year
The MMSE is not a test to diagnose dementia, but it’s useful for assessing the level of mental impairment a person with dementia may have.
What Are The Causes Of Lewy Body Dementia
The precise cause of LBD is unknown, but scientists are learning more about its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the brain that produce two important chemicals that act as messengers between brain cells . One of these messengers, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood.
Scientists are also learning about risk factors for LBD. A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. Age is considered the greatest risk factor. No specific lifestyle factor has been proven to increase one’s risk for LBD.
Other known risk factors for LBD include certain diseases and health conditions, particularly Parkinson’s disease and REM sleep behavior disorder, which have been linked to a higher risk of LBD.
Having a family member with LBD also may increase a person’s risk, though LBD is not considered a genetic disease. Variants in three genes APOE, SNCA, and GBA have been associated with an increased risk, but in most cases, the cause is unknown.
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The Key Difference Between Dementia With Lewy Bodies And Other Forms Of Dementia
Even when dementia with Lewy bodies is not always obvious, the presence of Lewy bodies can be an early sign of dementia. Protein deposits known as leviathan bodies are found in nerve cells in the brain that control movement, thinking, memory, and the flow of information. The loss of thinking, reasoning, and independent function in this case is irreversible.
Treatment Of Behavior And Mood Problems In Lewy Body Dementia
Behavioral and mood problems in people with LBD can arise from hallucinations, delusions, pain, illness, stress, or anxiety. They may also be the result of frustration, fear, or feeling overwhelmed. The person may resist care or lash out verbally or physically.
Medications are appropriate if the behavior interferes with the person’s care or the safety of the person or others. If medication is used, then the lowest possible dose for the shortest period of time is recommended.
The first step is to visit a doctor to see if a medical condition unrelated to LBD is causing the problem. Injuries, fever, urinary tract or pulmonary infections, pressure ulcers , and constipation can worsen behavioral problems and increase confusion.
Certain medications, such as anticholinergics and antihistamines may also cause behavioral problems. For example, some medications for sleep problems, pain, bladder control, and LBD-related movement symptoms can cause confusion, agitation, hallucinations, and delusions. Similarly, some anti-anxiety medicines can actually increase anxiety in people with LBD. Review your medications with your doctor to determine if any changes are needed.
Antidepressants can be used to treat depression and anxiety, which are common in LBD. Many of them are often well tolerated by people with LBD.
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Is Lewy Body Dementia Aggressive
One of the most difficult obstacles for seniors with LBD and their families is that the disease’s symptoms worsen and recover irregularly. Mental fog, aggressive behavior, mobility problems, and vivid hallucinations can all last seconds, minutes, hours, or days. There are no clear guidelines on when to start treating LBD aggressively, but your doctor should discuss with you options such as medication, dietary changes, exercise, support groups, and alternative therapies such as neurostimulation.
What Causes Lewy Body Dementia
A buildup of Lewy bodies causes both dementia with Lewy bodies and Parkinsons disease dementia. When Lewy bodies build up in neurons, they cause damage to certain areas of your brain.
Researchers dont know why some people develop LBD while others dont. Theres some thought that the combination of mutations in a persons genes, environmental risk factors and natural aging might lead to the development of LBD in some people. Research into specific causes is ongoing.
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. Theres 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 arent thought to be inherited .
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Symptoms Of Dementia With Lewy Bodies
People with dementia with Lewy bodies may have:
- hallucinations seeing, hearing or smelling things that are not there
- problems with understanding, thinking, memory and judgement this is similar to Alzheimer’s disease, although memory may be less affected in people with dementia with Lewy bodies
- confusion or sleepiness this can change over minutes or hours
- slow movement, stiff limbs and tremors
- disturbed sleep, often with violent movements and shouting out
- fainting spells, unsteadiness and falls
These problems can make daily activities increasingly difficult and someone with the condition may eventually be unable to look after themselves.
Managing Sleep Disorders In Lewy Body Dementia
Sleep problems may increase confusion and behavioral problems in people with LBD and add to a caregiver’s burden. A physician can order a sleep study to identify any underlying sleep disorders such as sleep apnea, restless leg syndrome, and REM sleep behavior disorder.
REM sleep behavior disorder, a common LBD symptom, involves acting out one’s dreams, leading to lost sleep and even injuries to individuals and their sleep partners. Clonazepam, a drug used to control seizures and relieve panic attacks, is often effective for the disorder at very low dosages. However, it can have side effects such as dizziness, unsteadiness, and problems with thinking. Melatonin, a naturally occurring hormone used to treat insomnia, may also offer some benefit when taken alone or with clonazepam.
Excessive daytime sleepiness is also common in LBD. If it is severe, a sleep specialist may prescribe a stimulant to help the person stay awake during the day.
Some people with LBD have difficulty falling asleep. If trouble sleeping at night persists, a physician may recommend a prescription medication. It is important to note that treating insomnia and other sleep problems in people with LBD has not been extensively studied, and that treatments may worsen daytime sleepiness and should be used with caution. Sleep problems can also be addressed by avoiding lengthy naps, increasing daytime exercise, and avoiding caffeine, alcohol, and chocolate late in the day.
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What Are The Types Of Lewy Body Dementia
The two types of Lewy body dementia dementia with Lewy bodies and Parkinson’s disease dementia are caused by the same underlying changes in the brain. Over time, these conditions may result in similar symptoms. The main difference is the timing of when thinking and movement symptoms begin.
In dementia with Lewy bodies, problems with thinking, unpredictable changes in attention and alertness, and visual hallucinations develop early in relation to movement symptoms, such as slow movement, difficulty walking, and muscle stiffness.
In Parkinson’s disease dementia, movement symptoms start first and are consistent with a diagnosis of Parkinsons disease. Later, problems with thinking and changes in mood and behavior develop. However, not everyone with Parkinsons disease will develop dementia.
It’s important to know which type of LBD a person has, both to tailor treatment to symptoms and to understand how the disease will likely progress. For example, some people with LBD may not experience significant movement problems, such as frequent falls and shaking, for several years, while others may have them early on. Knowing what to expect can help people with LBD and their families prepare for changes that may need to be made, for example, to help prevent falls.
Lewy Body Dementia: Causes Symptoms And Treatment Options
Often misdiagnosed as Alzheimers or Parkinsons disease, Lewy body dementia is in the top four most common types of dementia. It is a very complex condition, severely impairing not only cognition but motor skills as well, and difficult to diagnose. Learn more about Lewy body dementia and the signs and symptoms.
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At What Age Does Lewy Body Dementia Start
The elderly are usually among the victims. Dementia with Lewy bodies are often caused by a hard time moving your body, whereas dementia with other forms of dementia are caused by other factors. Within a year, you begin to experience thinking and memory problems similar to Alzheimers disease, as well as changes in behavior.
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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Coping With Cognitive Changes
Some medications used to treat Alzheimer’s disease also may be used to treat the cognitive symptoms of LBD. These drugs, called cholinesterase inhibitors, act on a chemical in the brain that is important for memory and thinking. They may also improve hallucinations, apathy, and delusions. The U.S. Food and Drug Administration has approved one Alzheimer’s drug, rivastigmine, to treat cognitive symptoms in Parkinson’s disease dementia. Several other drugs are being tested as possible treatments for LBD symptoms or to disrupt the underlying disease process.
Who Gets Dementia With Lewy Bodies
Around 5% of people with a diagnosis of dementia are recorded as having DLB, but there is good evidence that the condition is under-diagnosed. Scientists think DLB may account for up to 20% of all dementia.
Dementia with Lewy bodies affects men and women roughly equally. As with most other types of dementia, DLB becomes increasingly common over the age of 65. It can also affect people younger than this.
There is not much evidence that anything we might be exposed to during our lives increases the risk of DLB. Having a traumatic head injury may increase the risk of developing Parkinsons disease later in life, but its not known whether this also applies to DLB.
Almost all people who develop DLB have a sporadic form, which means that the main cause is unknown. Some genes may increase the risk of developing DLB.
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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.
What Happens In The Last Stage Of Lewy Body Dementia
People in the later stages of LBD are experiencing a steady physical deterioration. That was certainly the case with Dad. Even if he got over the flu, he’d never get over advanced LBD. Also likely due to muscle weakness is the difficulty LBD patients have controlling their bladder and bowel movements. As Dad lost more of his mental abilities, he needed help with these things even more. He would eventually require nursing home care.
As people in the later stages of LBD lose more brain tissue, they become more prone to seizures. This is because there aren’t as many neurons left to inhibit brain activity, so signals can get through from other parts of the brain that don’t normally communicate. The most common type of seizure experienced by people with LBD is called a “diffuse seizure.” These occur when large areas of the brain go into spasm at once, which causes muscles all over the body to contract without any apparent reason. Diffuse seizures can happen suddenly without warning and last for several minutes.
People who experience diffuse seizures often show no signs beyond surprise at hearing their name or another person’s. They will not remember what happened during the event. It’s important to recognize these symptoms for what they are: signs of a seizure. People who experience frequent seizures should consult with a neurologist to determine the cause and find appropriate treatment.
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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.
The Kensington Falls Church Memory Care Community
The Kensington Falls Church is an enhanced assisted living, Alzheimers care, dementia care, and memory care community located in Falls Church, Virginia.
Our Enhanced Assisted Living Residence license enables us to provide a higher continuum of healthcare thats not normally seen in other assisted living communities.
This includes employing a staff of registered nurses 24 hours a day who can administer medications and injections. This allows all of our residents to age in place, meaning they can stay in our community as long as theyd like, even as their healthcare needs change.
Our community is also uniquely capable of providing world-class care for people experiencing memory loss due to Alzheimers, Parkinsons, and Lewy body dementia.
We have two distinct memory care communities that provide care for people experiencing early to middle and late stages of dementia Haven and Connections.
Both our Haven and Connections neighborhoods are fully-secured environments that provide a higher level of care and supervision for our residents with memory loss.
Each community is specially designed to cater to the needs of our residents with memory loss, and feature wander technology to keep track of our residents, and also feature lots of sunlight in a homelife setting that fosters calm and comfort.
At the Kensington Falls Church, we extend Our Promise to you to love and take care of your family as we would our own.
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