What Are The Symptoms Of Lewy Body Dementia
Lewy body dementia symptoms may resemble those of other neurological disorders, like Alzheimers disease and Parkinsons disease. LBD affects each person differently, and symptoms vary in severity.
Common symptoms of LBD include:
- Visual hallucinations, or seeing things that are not there.
- Reduced alertness, attention and ability to concentrate.
- Parkinsonism, a movement disorder with symptoms including slowness, tremors, stiffness, balance problems, soft voice, difficulty swallowing, reduced facial expression and shuffling walk.
- Visuospatial difficulties, including decreased depth perception, trouble recognizing familiar objects and impaired hand-eye coordination.
- Delusions, or beliefs with no basis in reality.
- Changes in behavior and mood including anxiety, agitation, aggression, apathy, depression and paranoia.
- Changes in sleep patterns.
Other symptoms include:
- Acting out while sleeping. Your loved one may act out their dreams during a phase of sleep cycle called rapid eye movement . Sometimes this happens years before their LBD diagnosis. Often called REM sleep behavior disorder , this condition is described as frequent movements, such as flailing or punching, with yelling or speaking while sleeping. People living with RBD often have difficulty separating dreams from reality when they wake up.
- Changes in normal body functions. Body temperature may waver, blood pressure may fluctuate and loss of bowel and bladder control.
What Is High Blood Pressure
High blood pressure, also known as hypertension, is diagnosed when your blood pressure is consistently above 140/90 mmHg. It is a serious condition that is a major cause of heart attack and stroke worldwide. By 2025, it is estimated that 1.56 billion people globally will be diagnosed with high blood pressure.
The known risk factors for high blood pressure include lack of exercise, being overweight or obese, an unhealthy diet that is high in salty food, alcohol consumption that exceeds the recommended maximum, drinking a lot of caffeine, smoking, a family history of high blood pressure, use of steroid medication, kidney disease and being of African or Caribbean descent.
The Drugs Tied To Lower Dementia Incidence
In their study the findings of which now appear in the Journal of Alzheimers Disease the researchers analyzed data from 12,405 people, aged 60 or over, with dementia who attended one of 739 general practices in Germany as patients in 20132017.
The team had access to all of these participants blood pressure values, as well as their medication records.
Also, they compared these data with those of 12,405 participants without dementia who had visited a general practice in the same time period.
The researchers considered three models in their analysis of the data:
- people who had taken antihypertensive medication at some point in their lives compared with people who had never taken antihypertensive drugs
- people who had followed an antihypertensive therapy for 3 years compared with people who had done so for under 3 years
- people who had followed such a therapy for 5 years compared with people who had taken antihypertensive drugs for under 5 years
The team found that those who took certain antihypertensive drugs including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers seemed to have a lower risk of dementia.
Moreover, among those who took calcium channel blockers which are another type of blood pressure drug for a longer period of time, the incidence of dementia also decreased.
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What Can I Expect If I Or My Loved One Have A Diagnosis Of Lewy Body Dementia
Each persons experience with Lewy body dementia is unique to them. How slowly or quickly the disease progresses is impossible to know, but may be influenced by your general health and any existing diseases you may have. Because LBD is a progressive disease, difficulties with mind and body functions get worse over time. Currently, there is no known way to stop the progression of the disease. After diagnosis, most people with LBD live between five and seven years. Some people with LBD live up to 20 years after their diagnosis.
However, theres always hope. Research on LBD, dementia with lewy bodies, Alzheimers disease, Parkinsons disease with dementia are ongoing. New medications are being developed and new approaches to treatment are being investigated.
What Do Blood Pressure Numbers Mean
Blood pressure is measured using two numbers:
The first number, called systolic blood pressure, measures the pressure in your arteries when your heart beats.
The second number, called diastolic blood pressure, measures the pressure in your arteries when your heart rests between beats.
If the measurement reads 120 systolic and 80 diastolic, you would say, 120 over 80, or write, 120/80 mmHg.
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How High Blood Pressure Affects Risk For Dementia
Alzheimers disease and dementia affect nearly 10% of adults in the U.S., and with an aging population, that percentage is likely to increase. While much of the research on dementia has focused on reversing or slowing it down, by the time a patient starts showing symptoms of cognitive decline it may be too late.
Two new studies published recently in the Journal of the American Medical Association hint at a more accessible way to intervene earlier in life to prevent dementia: controlling blood pressure. The first study analyzed records of more than 4,700 people over 24 years and saw that people with hypertension in midlife and late-life had higher risk of developing dementia than those with normal blood pressure. The second showed that lowering blood pressure to a new standard of 120/80 mm Hg also reduced the progression of vascular disease in the white matter of the brain, which can be seen by MRI scans.
Shyam Prabhakaran, MD, MS, the chair of the department of neurology at the University of Chicago Medicine, wrote an editorial in JAMA accompanying the two new studies. We spoke to him about how these studies add to a growing body of research that high blood pressure is linked to dementia, and how they hint at a promising new avenue for preventing cognitive decline.
Is this the first time blood pressure has been linked to dementia?
Blood pressure control in midlife is actually a way to prevent dementia. This is a true paradigm shift.
Antihypertensive Therapy And Dementia
Given the association between hypertension and the development of dementia, a reasonable hypothesis is that antihypertensive therapy may protect against the development of dementia. However, the association with hypotension in later life and the risk of AD in particular, raises the possibility that this treatment may in fact contribute to the development of dementia. Several observational studies have longitudinally examined the effect of AH treatment on cognitive function and dementia .
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How Exactly Is Lewy Body Dementia Related To Alzheimers Disease And Parkinsons Disease
Lewy body dementia is a broad, general term for dementia in which lewy bodies are present in the brain. Dementia with lewy bodies and Parkinsons disease dementia are two related clinical disorders that make up the general broader category of Lewy body dementia. Sometimes LBD is first diagnosed as Parkinsons disease or Alzheimers disease based on its symptoms.
- Parkinsons disease dementia : You might be diagnosed with Parkinsons disease if you start out with a movement disorder typical to Parkinsons but then have your diagnosis changed to PDD when dementia symptoms develop.
- Alzheimers disease : You might start out with memory or cognitive disorder that leads to a diagnosis of AD. Over time, other distinctive symptoms begin to appear and your diagnosis is then changed to dementia with lewy bodies. Distinctive symptoms of LBD include the changes in attention, alertness and cognitive ability changes in walking and movement visual hallucinations REM sleep behavior disorder and severe sensitivity to some antipsychotics used to treat hallucinations.
Estimated Mechanisms Of Mid
Mid-life hypertension has been shown to be a risk for vascular dysfunction. Brain aging is considered to be induced not via neural aging, but via dysfunction of a coordinated and interactional system of neurons, astrocytes, and microvessels in the brain called the neurovascular unit. A chronic hypertensive state induces cerebrovascular degeneration such as vascular remodeling, vascular hypertrophy, atherosclerosis, endothelial dysfunction and increased blood brain barrier permeability, resulting in disorder of the neurovascular unit . These results indicate that vascular degenerative disease causes neurodegenerative disease such as dementia including Alzheimers disease. Therefore, recently Qiu et al. introduced the concept of dementia in the elderly as a condition of total life course events via vascular injury in mid-life, and cardio- or cerebrovascular disease in later life .
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Hypertension Brain Architecture And Size
The researchers found that high blood pressure didnt drive an increase in amyloid protein in the brain. Instead, high blood pressure at age 53, as well as rises in blood pressure between 43 and 53, were linked to increased blood vessel damage around age 70.
It was the uptick in blood pressure at younger ages between ages 36 and 43 that showed a connection to smaller brain volume. Smaller brain size can be a sign of poor brain health.
In short, high blood pressure at a younger age may affect your overall brain health, but may not necessarily drive the build-up of amyloid or tau proteins.
We now know that damage caused by high blood pressure is unlikely to be driven through the hallmark Alzheimers protein amyloid, but through changes in blood vessels and the brains architecture, said Jonathon Schott at UCL Queen Square Institute of Neurology in the press release.
Dr. Carol Routledge, director of research at Alzheimers Research UK, added in the press release that, the findings shed new light on the mechanism by which hypertension could damage the brain. As the participants in this study are identical ages and have been followed throughout life, the researchers can gain robust insights into the factors influencing their brain health.
Bring Down Blood Pressure Now
While more research investigates the brain benefits of blood pressure meds, you can play it smart by taking healthy lifestyle steps to keep blood pressure in a healthy range. Here are some of the best strategies.
That means nixing processed foodseven canned vegetables, which are oftenhigh in sodium. Among the most successful blood-pressure-lowering diets area Mediterranean diet or DASH .Both diets are high in fruits, vegetables,whole grains, low-fat dairy, poultry, fish and nuts, but low in harmful fats, red meat,sweets and sugary drinks. The effects can be quick, with blood pressurereductions in just two weeks.
Shed extra weight.
In one analysis of 25 clinical trials, losing an average of 11 poundsshaved 4.4 points offsystolic blood pressure and 3.6 points offdiastolic. Other studies have found that modest weight loss canprevent hypertension in overweight people, even if they dont reduce theamount of sodium in their diet.
Check blood pressure at home.
Monitoring your blood pressure at home can improve blood pressuremanagement more than just seeing your doctor. You can purchase automaticblood pressure cuffs for as little as $35 ask your doctor for arecommendation. Many pharmacies and drugstores also offer free bloodpressure readings.
Johns Hopkins Home Care
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How Does High Blood Pressure Cause Vascular Dementia
Uncontrolled high blood pressure can damage the blood vessels, making them weaker or narrower, and more likely to burst or become blocked. This restricts the blood supply to parts of the brain, so not enough oxygen and nutrients can reach the brain cells, damaging that part of the brain.
There are three main ways high blood pressure can affect the blood supply to the brain and cause vascular dementia:
- Damage to the blood vessels in the brain the blood vessels can become narrow and stiff, known as small vessel disease. This is the most common cause of vascular dementia
- Stroke a stroke is where a blood vessel in the brain becomes blocked or bursts, cutting off the blood supply to part of the brain and causing damage. This is known as post-stroke dementia
- TIA , also known as a mini stroke a series of mini strokes can gradually cause damage. This is known as multi infarct dementia
Analyzing Dementia Risk Over A Lifetime
The study used data from Insight 46, part of the MRC National Survey of Health and Development. The project tracks 500 birth cohort participants throughout their lifetime to identify dementia risks and signs as they get older.
In the latest study, researchers examined 502 participants who were all born in the same week of 1946. The participants didnt have dementia when the study began.
The researchers tracked the participants blood pressure levels at different ages throughout their life: 36, 43, 53, 6064 and 69 years old. Most of the participants also underwent brain scans, which checked for amyloid proteins in the brain, a sign of Alzheimers. The brain scans also examined the size of the brain and blood vessel health.
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The Relationship Between High Blood Pressure And Dementia
So, how does lowering high blood pressure reduce our risk of cognitive impairment and dementia? Most people who have dementia dont have just a single cause. Two or even three different problems in the brain cause their cognitive impairment and lead to their decline in function. One study estimates that the fraction of dementia risk attributable to cerebrovascular disease that is, strokes was nearly 25% in people who developed significant memory loss late in life. These researchers also found that the dementia risk attributable to Alzheimers disease was considerably higher, nearly 40%.
My reading of the literature is that lowering blood pressure reduces dementia risk because it reduces the risk of stroke. Its the strokes not high blood pressure by itself that cause cognitive impairment. Note, however, that the strokes may be so tiny that one doesnt even know that they have them. But developing a lot of these tiny strokes will greatly increase our risk of dementia.
What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Not smoking
- Managing stress
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
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A Blockage In The Brain Means Less Oxygen To The Brain
We breathe in oxygen because our brains need it to survive. That oxygen is transported to the brain via the blood. When those artery walls that pump blood start to thicken, the arteries become partially blocked. This means less oxygenated blood is passing through, and the brain isnt receiving the necessary amount of oxygen it needs. Over time, this lack of oxygen causes brain cells to die.
How Is Lewy Body Dementia Treated Is There A Cure
There is no cure for Lewy body dementia . Medications and nonmedical therapies, like physical, occupational and speech therapies, manage symptoms as much as possible.
Medications called cholinesterase inhibitors help manage the cognitive symptoms of LBD. Memantine may also be helpful. Symptoms of Parkinsonism, like tremors, are usually treated with levodopa, a drug commonly used to treat Parkinsons disease.
You or your loved one may also benefit from treatments like physical therapy or speech therapy. These treatments help retain physical function and improve muscle strength.
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Dementia Risk Starts Early With High Blood Pressure
Bottom Line: The odds were 45% higher!
Source: Study Association Between Systolic Blood Pressure and Dementia in the Whitehall II Cohort Study: Role of Age, Duration, and Threshold Used to Define Hypertension by researchers at the French National Institute of Health and Medical Research in Paris and University College London, published in European Heart Journal.
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Youve just turned 50the prime of your life. Your children are growing up, your career is established, and you may even be able to slip in a bit of recreation and relaxation. But hows your blood pressure?
You may have assumed that you havent yet hit the age when you need to be that concerned about your blood pressuremuch less your future risk for dementia. But that may not be true, according to the recent research published in European Heart Journal.
Background: Previous studies have established that high blood pressure during midlife increases risk for dementia in later life. However, in the earlier research, midlife had not been clearly definedit could be, for example, anytime from ones mid-30s to 60s. So researchers wondered: Is there a particular time when elevated blood pressure begins to have a meaningful impact on ones odds of developing dementia years or even decades later? A recent UK study sheds new light on the question.
Blood Pressure And Overall Health
Hypertension, or high blood pressure, occurs when the force of blood pushing against the walls of your blood vessels is too high. As blood pressure becomes chronic, arteries throughout the body develop buildup called atherosclerosis, which can lead to a host of health issues.
While some of these health issues are well known such as heart attacks and strokes, high blood pressure can also lead to other conditions that may be less well known such as vision loss and sexual dysfunction.
If youre worried about high blood pressure or whether you could be at risk for reverse dipping, talk with your doctor. You may be able to wear an ambulatory blood pressure monitor that will measure your blood pressure over 24 hours.
If you have high blood pressure, its important to remember that taking preventive measures such as eating a balanced diet and staying active or taking medication can help keep high blood pressure and related conditions in check.
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