What Causes Dementia With Lewy Bodies
Lewy bodies are named after the German doctor who first identified them. They are tiny deposits of a protein that appear in nerve cells in the brain. Researchers don’t have a full understanding of why Lewy bodies appear, or exactly how they contribute to dementia. However, this is linked to two factors:
- low levels of important chemicals that carry messages between nerve cells
- a loss of connections between nerve cells, which then die.
Lewy bodies are the cause of DLB and Parkinson’s disease. They are two of several diseases caused by Lewy bodies that affect the brain and nervous system and get worse over time. These are sometimes called Lewy body disorders.
The way someone is affected by DLB will depend partly on where the Lewy bodies are in the brain:
- Lewy bodies at the base of the brain are closely linked to problems with movement . These are the main feature of Parkinson’s disease.
- Lewy bodies in the outer layers of the brain are linked to problems with mental abilities , which is a feature of DLB.
People with a Lewy body disorder can have problems with movement and changes in mental abilities at the same time.
A person with Parkinson’s disease is at high risk of going on to develop dementia as their condition progresses. Dementia may be more likely in a person who has developed Parkinson’s later in life or who has been living with it for several years.
Genes Causative Of Other Neurodegenerative Diseases
As DLB may clinically and pathologically resemble Alzheimers or Parkinsons diseases, speculation as to whether AD- or PD-causing genes may also be involved in the pathogenesis of DLB prompted the study of these genes in small cohorts of mainly sporadic DLB cases. However, due to the phenotypic similarities between diseases, it is still unclear whether the mutations identified play a role in DLB or simply occur in misdiagnosed cases. This issue is complicated further by the heterogeneity of phenotype that can be associated with some of these mutations .
Screening For Memory Loss
Because of the importance of early detection, cognitive screening is now a required component of the Medicare/Medicaid annual wellness visit. Several measures are available that nurses can use to briefly assess for risk of cognitive decline. For example, the Quick Dementia Rating Scale is a 5-minute informant interview that addresses ten cognitive domains: memory and recall, orientation, decision-making and problem-solving abilities, activities outside the home, function at home and hobbies, toileting and personal hygiene, behavior and personality changes, language and communication abilities, mood, and attention and concentration. The QDRS format helps to avoid problems such as patient anxiety with cognitive testing, which can lead to refusing to be tested. The scale also can be completed by family members. Scores of the 30-item scale range from 0 to 30 . The QDRS has strong reliability and validity when correlated with other common cognitive assessment tools, such as the Clinical Dementia Rating scale and the Mini-Mental State Exam the Mini-Mental State Exam requires payment for use. In addition, the QDRS provides enough information to stage dementia severity, and it can be used by clinicians to determine the need for more formal testing.
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Signs And Symptoms Of Lewy Body Dementia
As with Alzheimers disease or Parkinsons disease, the symptoms of Lewy body dementia worsen over time, with intellectual and motor functions deteriorating, typically over several years. Despite the overlaps, however, there are symptoms that indicate the disorder is indeed LBD and not another condition.
While patients with LBD lose cognitive function, they are less prone to the short-term memory loss associated with Alzheimers disease. More commonly, they experience greater problems with executive functions of planning, decision-making, and organization, as well as difficulties with visual perception, such as judging and navigating distances. This can cause you to fall or faint frequently or become lost in familiar settings. Lewy body dementia can also cause sleep disturbances, including insomnia and daytime sleepiness.
If you have Lewy body dementia, you will also exhibit at least two of four core features:
Changes or fluctuations in awareness and concentration. You swing from a state of alertness to appearing drowsy, confused, or staring into space. These episodes can be unpredictable and last anywhere from a few seconds to several hours.
Spontaneous Parkinsons-like motor symptoms, such as slowness of movement, rigid muscles, tremor, lack of facial expression, or abnormal gait.
Recurrent visual hallucinations or delusions, such as seeing shapes, colors, people, or animals that arent there or conversing with deceased loved ones.
Alzheimers And Dementia With Lewy Bodies
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Alzheimers and Dementia with Lewy bodies are two separate but similar conditions. Alzheimers affects the brains ability to store new information in the form of memories which accounts for the conditions characteristic memory loss. DLB, on the other hand, targets a different set of cognitive functions specifically problem-solving and reasoning. Although there are tests that can be conducted to more conclusively determine the presence of these conditions, in general, both Alzheimers and DLB are diagnosed through observation and tracking the progression of an individuals symptoms.
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What Are The Symptoms Of Lewy Body Dementia
Typical features of someone who is diagnosed with LBD are:
- Varying levels of confusion or alertness that varies significantly from one time of day to another or from one day to the next
- Changes in thinking and reasoning
- Persistent detailed visual hallucinations
- Movement problems similar to those of Parkinsonâs disease such as balance problems and rigid muscles
- Malfunctions of the autonomic nervous system
- Memory loss that may be significant but less prominent than in Alzheimer’s
- Rapid eye movement sleep disorder
How Is Lbd Different From Parkinsons Or Alzheimers
These diseases are similar in a lot of ways. But there are some key differences in the symptoms that affect people with LBD and when those symptoms happen.
LBD may not cause short-term memory loss like Alzheimerâs. People with both conditions have trouble with thinking, alertness, and paying attention. But in LBD, those problems come and go. The disease can also cause hallucinations, often in the first few years someone has LBD. People with Alzheimerâs usually donât have hallucinations until the later stages.
People with LBD also often act out their dreams and make violent movements when theyâre asleep. Itâs called REM sleep behavior disorder. Sometimes, itâs the first sign that someone has LBD.
LBD and Parkinsonâs disease both cause movement problems, like stiff muscles and tremors. But most people with Parkinsonâs donât have problems with their thinking and memory until the very later stages of their disease. Sometimes, they donât have it at all. In the type of LBD known as Parkinsonâs disease with dementia, these problems begin much sooner.
People with LBD also need different drugs for their condition than the ones that treat Parkinsonâs or Alzheimerâs.
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Building A Lewy Body Dementia Care Team
After receiving a diagnosis, a person with LBD may benefit from seeing a neurologist who specializes in dementia and/or movement disorders. Your primary doctor can work with other professionals to follow your treatment plan. Depending on an individual’s particular symptoms, physical, speech, and occupational therapists, as well as mental health and palliative care specialists, can be helpful.
Support groups are another valuable resource for people with LBD and their caregivers. Sharing experiences and tips with others in the same situation can help people find practical solutions to day-to-day challenges and get emotional and social support.
Rem Sleep Behavior Disorder
LBD: People with LBD sometimes experience REM sleep behavior disorder, a dysfunction where they physically act out the situations in their dreams. Some research suggests that REM sleep behavior disorder can be one of the earlier predictors of LBD.
Alzheimers:REM sleep behavior disorder is not typically present in Alzheimers, although other types of sleep disturbances may occur.
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Movement Problems And Lewy Body Dementia
Some people with LBD may not experience significant movement problems for several years. Others may have them early on. At first, movement symptoms, such as a change in handwriting, may be very mild and easily overlooked. Movement problems may include:
- Muscle rigidity or stiffness
Featured Conditions Lewy Body Dementia Also Known As Dementia With Lewy Bodies Is The Second Most Common Type Of Progressive Dementia After Alzheimer’s Disease
Learn how alzheimer’s disease and lewy body dementia are alike and different from each other, including their prevalence, prognosis, and symptoms. Do you know a friend or family member who is experiencing a decline in their mental abilities? Trusted health information from the national institutes of health there are two types of lewy body dementia : See how lewy body dementia affects our brains and causes symptoms. Protein deposits, called lewy bodies, de. Symptoms of lewy body dementia commonly include changes in thinking, behavior, movement, and sleep. Featured conditions lewy body dementia, also known as dementia with lewy bodies, is the second most common type of progressive dementia after alzheimer’s disease. Trusted health information from the national institutes of health lewy body dementia is one of the most common types of dementiabut also. Are you aware of some of the less common symptoms of lewy body dementia? Read on to learn more about dementia causes and sympto. Learn how dementia with lewy bodies and parkinson’s disease dementia are alike and different from each other. Knowing what to expect can help you identify and appropriately treat lbd. Home brain & nervous system centertopic guide what is lewy body.
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Parkinson’s Disease Can Result In Problems With Memory And Th
Read on to learn more about dementia causes and sympto. If this decline is interfering with their daily life, they could be experiencing dementia. Learn how alzheimer’s disease and lewy body dementia are alike and different from each other, including their prevalence, prognosis, and symptoms. Learn about causes, treatment, diagnosis, complication, and life expectancy. Philips respironics issued a recall for some cpap and bilevel pap devices and mechanical ventilators. Do you know a friend or family member who is experiencing a decline in their mental abilities? See how lewy body dementia affects our brains and causes symptoms. Trusted health information from the national institutes of health lewy body dementia is one of the most common types of dementiabut also. Learn how dementia with lewy bodies and parkinson’s disease dementia are alike and different from each other. Home brain & nervous system centertopic guide what is lewy body. Trusted health information from the national institutes of health lewy body dementia is a complicated memory and movement disease affecting more than 1 million america. Are you aware of some of the less common symptoms of lewy body dementia? Symptoms of lewy body dementia commonly include changes in thinking, behavior, movement, and sleep.
The johns hopkins team of lbd specialists offers unique expertise backed by years of research to help you manage this condition.
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Caring For Someone With Lewy Body Dementia
Caring for someone with LBD, or any form of dementia, is hugely challenging. Just as LBD can impact every aspect of a person, caring for someone with the disease can impact every aspect of your daily life. Youll likely face tests of stamina, problem solving, and resiliency. However, your caregiving journey can also be an intensely rewarding experience as long as you take care of yourself and get the support that you need.
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What Affects The Speed Of Progression
The speed at which dementia progresses varies a lot from person to person because of factors such as:
- the type of dementia for example, Alzheimers disease tends to progress more slowly than the other types
- a persons age for example, Alzheimers disease generally progresses more slowly in older people than in younger people
- other long-term health problems dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well managed
- delirium a medical condition that starts suddenly .
There is no way to be sure how quickly a persons dementia will progress. Some people with dementia will need support very soon after their diagnosis. In contrast, others will stay independent for several years.
Lewy Body Dementia When The Heffalumps And Woozles Look Real
Those with dementia may have a brain that works much differently than ours. But if we link our hands together, we can overcome anything.
Alzheimers is the most common dementia. And overall, Vascular Dementia is the second most common. But Dementia with Lewy Bodies is the second most common degenerative dementia.
What makes it distinctive? The visual hallucinations.
When Do Lewy Body Dementia Symptoms Start?
- Its more likely after 60.
- Its more likely in men than women.
- And its more likely if you have a family history of it.
What Are the Symptoms of Lewy Body Dementia?
Recurring hallucinations tend to show up first.
- Often they involve shapes, animals, people. But its not just something they see.
- Sufferers can hear, smell, even touch illusions.
- Grappling with whats real and whats not leads to struggles in being alert to whats actually going on around them.
As the disease progresses, so do symptoms.
- Muscles become rigid, movement slows, tremors start, walking looks like a shuffle.
- The body struggles to regulate normal nervous system functions, leading to issues with
- blood pressure, pulse, sweating
- digestion, constipation
- falls, dizziness
What Causes Lewy Body Dementia?
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What Causes Lewy Body Dementia
In people with LBD, abnormal clumps of a protein called alpha-synuclein accumulate in areas of the brain involved in thinking, memory, and movement. The clumps are called “Lewy bodies” after the doctor who discovered them. They build up inside neurons, or nerve cells, in the brain and cause the neurons not to work well and eventually die. Certain chemicals in the brain that act as messengers between cells are also affected. What causes these changes in the brain is not yet fully understood.
Most cases of LBD are not inherited and rarely does more than one family member have the disease. Certain genetic variants may increase the chance of developing dementia with Lewy bodies, but having a genetic variant does not mean that a person will definitely develop the disease.
Two Of The Following Are Present :
- Fluctuating cognition: Mental problems varying during the day, especially attention and alertness.
- Visual hallucinations: Detailed and well-formed visions, which occur and recur.
- RBD: Physically acting out dreams while asleep.
A DLB diagnosis is even more likely if the individual also experiences any of the following: repeated falls, fainting, brief loss of consciousness, delusions, apathy, anxiety, problems with temperature and blood pressure regulation, urinary incontinence, and chronic constipation, loss of smell, or sensitivity to neuroleptic medications that are given to control hallucinations and other psychiatric symptoms.
Finally, the timing of symptoms is a reliable clue: if cognitive symptoms appear before or within a year of motor symptoms, DLB is more likely the cause than Parkinsonâs disease. Signs of stroke or vascular dementia usually negate the likelihood of DLB.
Testing is usually done to rule out other possible causes of dementia, motor, or behavioral symptoms. Brain imaging can detect brain shrinkage and help rule out stroke, fluid on the brain , or subdural hematoma. Blood and other tests might show vitamin B12 deficiency, thyroid problems, syphilis, HIV, or vascular disease. Depression is also a common cause of dementia-like symptoms. Additional tests can include an electroencephalogram or spinal tap .
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Stages And Progression Of Lewy Body Dementia
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
If you or someone you know has recently been diagnosed with Lewy body dementia, you might be wondering what to expect as the disease progresses. Is there a fairly typical progression like Alzheimer’s disease where it begins in early stages that are fairly uniform, then moves to middle stages and then to late stages? In Lewy body dementia, the answer is a bit more complicated.
What Are Lewy Bodies
The microscopic findings in brain tissue from LBD patients are different from those in people with AD. The important distinction is that in LBD there are small Lewy bodies inside the brains cells. These Lewy bodies are neither plaques nor tangles, but rather synuclein, the same protein found in brains of people with Parkinsons disease. The clinical disease of LBD reflects the widespread distribution of Lewy bodies, which are especially dense in parts of the brain most specialized for movements, memories, reasoning, and emotions.
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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.