Number Of People Affected
Parkinsons disease is thought to affect about 2 percent of Americans over 65. Of those, about 50 to 80 percent will go on to develop Parkinsons-related dementia.1 The Parkinsons Foundation estimates that nearly 1 million Americans will be living with Parkinsons by 2020. The disease affects 1.5 times more men than women.7
Approximately 5.8 million Americans are currently living with Alzheimers disease. That number is expected to increase to 14 million by 2050.8 There is little difference between numbers of men and women who develop Alzheimers, but there are more women with the disease, because women tend to live longer than men.3
Also Check: Medications For Parkinsons Patients
The Link To Parkinsons Disease
Most people with Parkinsons disease have Lewy bodies in their brains. Its these clusters that cause some or all of the motor symptoms of Parkinsons disease, as well as memory or cognitive problems, visual hallucinations, and problems with alertness.
We rarely know if a living patient has Lewy bodies with certainty, however. Its not until an autopsy that they can be seen, says Liana Rosenthal, M.D., assistant professor of neurology at the Johns Hopkins University School of Medicine. If we see Lewy bodies in someones brain during an autopsy, thats considered a pathologic certainty of Parkinsons disease, she says.
As with Parkinsons, Lewy body dementia is associated with a depletion of certain neurotransmitters in the brain. These are:
- Dopamine: This neurotransmitter helps transmit signals that control muscle movement. When the accumulation of Lewy bodies blocks dopamines production and transmission, the result is the hallmark movement issues of Parkinsons disease.
- Acetylcholine: This neurotransmitter does its work in the parts of the brain responsible for memory, thinking and processing. When Lewy bodies build up in these areas, they interfere with acetylcholine, causing symptoms of dementia.
What Is The Life Expectancy For People With Lewy Body Dementia
The average life expectancy of Lewy body dementia is five to eight years after the initial diagnosis. But some people with LBD live up to 20 years after their diagnosis.
This short average life expectancy could be due to a lack of knowledge regarding LBD among healthcare providers and the population and difficulty in distinguishing it from other similar conditions. This often leads to a delay in diagnosis, which delays the onset of specific therapy.
Recommended Reading: New Medication For Alzheimer’s
Lewy Body Dementia: Causes And Symptoms
Lewy body dementia is an umbrella term for two related types of dementia dementia with Lewy bodies and Parkinsons disease dementia. Dementia is a disease that progressively impairs a persons ability to think, reason, remember, and function. Although these two conditions have overlapping features, there are also important distinctions. Understanding LBD causes and symptoms and how its two subtypes, dementia with Lewy bodies and Parkinsons dementia, differ from one another is critical for proper diagnoses and shortening the time to start treatment.
Read about thediagnosis and treatment of Lewy body dementia.
Expect Changes In Behavior
There are several reasons why someone with LBD may become angry, act out with aggression, or seem depressed. Understand that it is a part of their disease. It is best not to meet anger with even more anger on your part.
Remain patient, identify the cause of their mood change, and do your best to respond. Your loved one may need changes to their environment or even medications to help treat symptoms.
Read Also: Can A Stroke Cause Dementia
Can Dementia Cause Rapid Weight Loss
Studies have shown that once dementia reaches its final stages, one in every two or three affected people will experience severe weight loss. The person with advanced dementia may be given all the food and drink they need to maintain their weight. Dementia is the most common cause of death in older people. It is estimated that around 1.5 million people in the UK are living with dementia at any one time.
How Is Lewy Body Dementia Related To Alzheimers Disease And Parkinsons Disease
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, providers first diagnose LBD as Parkinsons disease or Alzheimers disease based on its symptoms.
- Parkinsons disease dementia : Some people are diagnosed with Parkinsons disease if they first have symptoms of a movement disorder typical to Parkinsons. But their diagnosis is changed to PDD if dementia symptoms develop over the years.
- Alzheimers disease : Some people who have a memory or cognitive disorder are diagnosed with AD. But other distinctive symptoms may suggest co-existing dementia with Lewy bodies. Distinctive symptoms of LBD include changes in attention, alertness and cognitive ability movement issues visual hallucinations and more.
You May Like: Does Dementia Cause Head Pain
Introduction: What Is Lewy Body Dementia
People with Lewy Body Dementia , experience a progressive decline in their memory and ability to think, similar to Alzheimers disease. What is different about LBD is that the cognitive ability or alertness of a person with Lewy body dementia is more likely to fluctuate from one moment to the next, unlike Alzheimers and related diseases like vascular dementia. Individuals with LBD also often have visual hallucinations and delusions . On the surface, people with LBD often have movement problems resembling Parkinsons disease. This is because the same structures of the brain are affected in Lewy body dementia as in Parkinsons disease.
There are actually several subtypes and different names for Lewy body dementia, because LBD is a term for any brain disease caused by the buildup of the destructive protein alpha-synuclein. Types of LBD include:
Diffuse Lewy body disease Senile dementia of Lewy type Lewy body variant of Alzheimers Parkinsons disease dementia
Is There Treatment Available
At present there is no cure for Lewy body disease. Symptoms such as depression and disturbing hallucinations can usually be reduced by medication. However, medications to relieve hallucinations may increase muscle tremors and stiffness. Conversely, anti-Parkinson drugs may make hallucinations worse.
Emerging evidence suggests that cholinesterase inhibitor drugs may be quite helpful for some people with this condition.
People with this form of dementia are very sensitive to the side effects of neuroleptic drugs such as antipsychotic medications. It is essential all medications are supervised by a specialist to avoid these severe side effects.
Don’t Miss: How To Explain Alzheimer’s To Patient
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.
Lewy Body Dementia Research
Many avenues of research are being explored to improve our understanding of LBD. Some researchers are working to identify the specific differences in the brain between the two types of LBD. Others are looking at the disease’s underlying biology, genetics, and environmental risk factors. Still other scientists are trying to identify biomarkers , improve screening tests to aid diagnosis, and research new treatments.
Scientists hope that new knowledge about LBD will one day lead to more effective treatments and even ways to cure and prevent the disorder. Until then, researchers need volunteers with and without LBD for clinical studies.
NIH and other groups help people learn about clinical trials and studies and find research opportunities near them. Visit the following websites for details:
You May Like: Why Do Dementia Patients Not Sleep At Night
What Is Lewy Body Dementia And Why Is It So Hard To Diagnose
TW: This article contains mention of suicide. Please proceed thoughtfully.
Today marks the eighth anniversary of Robin Williams’s death. The legendary comedian and actor died of suicide in 2014 at age 63. Williams suffered from depression and was misdiagnosed with Parkinson’s disease, which played a role in the “frustration” and discomfort Williams experienced in life, according to his son Zak Williams who spoke last year on The Genius Life podcast about the misdiagnosis. It was later discovered after the comedian’s death that he actually had Lewy body dementia.
The brain disease impacted Williams’ thinking, memory, and movement control which got in the way of both his career and family life, his son said on the podcast. “There was a focus issue that frustrated him, there were issues associated with how he felt and also from a neurological perspective he didn’t feel great,” he says.
Dad, on the eighth anniversary of your passing, I’m remembering how incredibly kind and joyful you were. I deeply miss you you wonderful, hairy man and will be celebrating your life today. Love you so so much!
â Zak Williams
“What he was going through didn’t match one to one many Parkinson’s patients experience,” Zak said. “So, I think that was hard for him.”
So why was Williams misdiagnosed? According to experts, there are many similarities between Parkinson’s disease and Lewy body dementia. Keep reading to learn more about Lewy body dementia, including causes, symptoms, and treatment.
When Should I See My Healthcare Provider About Lewy Body Dementia
If you or a loved one are experiencing symptoms of Lewy body dementia, talk to your healthcare provider.
If youve been diagnosed with Lewy body dementia, youll need to see your healthcare team regularly to monitor your health and symptoms and to make sure your medications are working.
A note from Cleveland Clinic
Learning early that you have a diagnosis of Lewy body dementia allows you and your family to plan for a meaningful quality of life together and enables you to get your legal, financial and healthcare plans and desires in order. Your healthcare team will be ready to provide education, support and care for you or your loved one. Ask your team for information on local LBD support groups as well. Support groups can be very helpful for sharing care tips and providing comfort in knowing youre not alone.
Don’t Miss: Which Of The Following Symptoms Is Suggestive Of Alzheimer Disease
Prevalence Of Lewy Body Dementia
After Alzheimers disease, LBDs are the second most common cause of dementia in people over 65 years old. Scientists are unsure how common these dementias are. In one review of studies on dementia with Lewy bodies, its prevalence in total cases of dementia ranged from 0.3 percent to 24.4 percent, depending on the study. This inconsistency is probably because scientists are only just beginning to understand dementia with Lewy bodies and to differentiate it from Alzheimer’s disease. Another study estimates that at least 75 percent of individuals who live with Parkinsons disease for at least 10 years will develop dementia.
Treatment Of Lewy Body Dementia
There is no cure available for Lewy body dementia at this time. Currently, there are also no medications approved by the FDA that specifically target this form of dementia. However, many individuals with the disease seem to benefit from the use of cholinesterase inhibitors.
Cholinesterase Inhibitors
Cholinesterase inhibitors are a group of drugs commonly prescribed to individuals with Alzheimers disease and other forms of dementia in order to slow the progression of the disease. For individuals with dementia, brain function decreases in part because their brain cells are no longer able to communicate with one another as well as previously. Cholinesterase inhibitors act to increase levels of a neurotransmitter called acetylcholine. This is a chemical that helps brain cells communicate and function better, and acetylcholine also plays a significant role in memory and learning. In practical terms, one may find that their loved one can remember names and details or perform activities with fewer problems when taking these medications.
There are four main cholinesterase inhibitors on the market:1) Aricept® 2) Razadyne®, formerly known as Reminyl 3) Exelon® 4) Cognex® is another option, but is less commonly prescribed due to its serious potential side effects including nausea, weight loss and skin rash.
Aducanumab for Lewy Body Dementia?
You May Like: What Are The Early Signs Of Senile Dementia
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, Parkinsons disease dementia 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 Parkinsons disease, including dementia with Lewy bodies and Parkinsons:
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.
Read Also: Does My Mom Have Dementia
Comparison Of Motor Symptoms
On the Hoehn and Yahr scale as well as on UPDRS III and IV , the PDD group had significantly higher scores than the DLB group, but there was no significant difference in predominant motor subtype between both groups. The tremor severity was higher in the PDD group, but only regarding the tremor at rest, which was marginally significant . Compared to DLB patients, PDD patients also demonstrated a significantly higher score on hand and feet bradykinesia as well as a tendency towards increased rigidity.
Also Check: Last Stages Of Parkinsons Disease
What You Need To Know
- Lewy body dementia is a form of progressive dementia that affects a persons ability to think, reason, and process information.
- Diagnosing Lewy body dementia can be challenging an estimated 1.4 million Americans are living with the disease.
- LBD has three features that distinguish it from other forms of dementia:
- Fluctuating effects on mental functioning, particularly alertness and attention, which may resemble delirium
- Recurrent visual hallucinations
- Parkinson-like movement symptoms, such as rigidity and lack of spontaneous movement.
Lewy bodies are clumps of abnormal protein particles that, for reasons that are not fully understood, accumulate in the brain. These deposits cause a form of dementia called Lewy body dementia, or LBD which is what the late actor and comedian Robin Williams suffered from.
LBD is not the same as Parkinsons, but the two are closely related: LBD causes some or all of the motor symptoms of Parkinsons. More than 1 million people in the U.S. are affected by Lewy body dementia, according to the Lewy Body Dementia Association.
You May Like: How To Take Care Of People With Dementia
Dementia In Parkinsons Disease
The diagnosis of PDD was made based on the Movement Disorder Society Task Force criteria for dementia . The onset of established PD preceded the development of dementia by at least 12 months. In this study, the time of onset of dementia in PDD patients was at least 4 years after the diagnosis of PD. To ensure that any differences in group test profiles could be attributed to differences in the underlying nature of the disorders rather than to differences in age, educational level and/or global level of dementia, we selected 27 patients from a large cohort of 86 PDD patients, who matched a DLB patient with regard to age, education and Mini Mental Parkinson.