How Is Lewy Body Disease Diagnosed
This type of dementia is diagnosed by taking a careful history of the pattern of symptoms, and by excluding other possible causes such as Vascular dementia and Alzheimer’s disease. A brain scan may reveal brain degeneration, but the Lewy bodies can only be identified by examination of brain tissue after death.
Lewy body disease;is similar to Alzheimer’s disease in many ways, and in the past it has sometimes been difficult to distinguish the two. It has only recently been accepted as a disease in its own right.;It can occur by itself or together with Alzheimer’s disease and/or Vascular dementia. It may be hard to distinguish;Lewy body disease;from Parkinson’s disease, and some people with Parkinson’s disease develop a dementia which is similar to that seen in Lewy body disease.
First Signs And Symptoms
Visual hallucinations may be one of the first symptoms that people develop, causing individuals to see things that are not there.
Visual hallucinations affect up to 80% of people with LBD.
Other hallucinations, such as hearing or smelling things that are not there, are less common but may also occur.
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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How Dementia With Lewy Bodies Is Managed
There is no cure for dementia with Lewy bodies or any;medication that will slow it down.
However, a few different medicines can be effective in controlling some of the symptoms. In particular,;acetylcholinesterase inhibitors have been shown to improve symptoms such as hallucinations and confusion in some people.
Supportive;treatments; such as;physiotherapy, occupational therapy, and speech and language;therapy; can help improve any problems with movement, everyday tasks, and communication.
Psychological therapies and specific;dementia activities, such as memory cafés, can also help;with memory loss, confusion, and feelings of disorientation.
Read more about treating dementia with Lewy bodies
The Ripple Effect Of An Lbd Diagnostic Test
Because of the similarities between them, research for other neurodegenerative diseases like Alzheimers and Parkinsons can help researchers answer questions and find the biomarkers that distinguish these brain diseases. In this way, Dr. Higginbothams research has the potential to impact treatment and diagnosis for degenerative brain diseases beyond Lewy body dementia.
Theres this growing knowledge that all of these neurodegenerative diseases actually overlap in pathophysiology a whole lot, says Dr. Higginbotham. And what were really trying to do with these big, global pictures of proteins is get not only at disease-level differences but also individual-level differences that we can then use to, just frankly, individualize treatment for patients.
While there is overlap between brain diseases, there are also differences among individual patients. As research continues to organize these complex data sets, Dr. Higginbotham believes theyll see more and more subtypes. We just want to make sure we get a diversity of people in research and a diversity of people who are engaged in research to be able to really work toward defining all that overlap and all that individuality, she says.
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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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How Families And Caregivers Can Best Support Their Loved One With Lewy Body Dementia
In the earliest stages of LBD, a persons cognitive abilities arent as affected, allowing them to live a mostly independent life. However, hallucinations and paranoia will become more pronounced through each stage of the disease, which can be challenging for caregivers.
Because Alzheimers and LBD are similar, many doctors may mistakenly prescribe antipsychotic medications to help with hallucinations, not knowing that these medications actually increase anxiety in their patients.;
As a caregiver of somebody with LBD, its your responsibility to inform doctors and medical professionals of your loved ones symptoms, as they may have difficulty communicating.
As your loved one enters into the middle and late stages of LBD, you will probably find it difficult to provide the same level of care required to provide a high quality of life for your loved one.
Its often during the middle and late stages when families consider moving their loved one into an assisted living or memory care community to provide high-quality, round-the-clock care thats necessary for their loved one.
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Cognitive Symptoms Of Lewy Body Dementia
LBD causes changes in thinking abilities. These changes may include:
- Visual hallucinations, or seeing things that are not present. Visual hallucinations occur in up to 80 percent of people with LBD, often early on. Nonvisual hallucinations, such as hearing or smelling things that are not present, are less common than visual ones but may also occur.
- Unpredictable changes in concentration, attention, alertness, and wakefulness from day to day and sometimes throughout the day. Ideas may be disorganized, unclear, or illogical. These kinds of changes are common in LBD and may help distinguish it from Alzheimer’s disease.
- Severe loss of thinking abilities that interfere with daily activities. Unlike in Alzheimer’s dementia, memory problems may not be evident at first but often arise as LBD progresses. Other changes related to thinking may include poor judgment, confusion about time and place, and difficulty with language and numbers.
What Is Lewy Body Dementia Causes Symptoms And Treatments
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Lewy body dementia is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood. Lewy body dementia is one of the most common causes of dementia.
LBD affects more than 1 million individuals in the United States. People typically show symptoms at age 50 or older, although sometimes younger people have LBD. LBD appears to affect slightly more men than women.
Diagnosing LBD can be challenging. Early LBD symptoms are often confused with similar symptoms found in other brain diseases or in psychiatric disorders. Lewy body dementia can occur alone or along with other brain disorders.
It is a progressive disease, meaning symptoms start slowly and worsen over time. The disease lasts an average of five to eight years from the time of diagnosis to death, but can range from two to 20 years for some people. How quickly symptoms develop and change varies greatly from person to person, depending on overall health, age, and severity of symptoms.
In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease advances, people with LBD require more help due to a decline in thinking and movement abilities. In the later stages of the disease, they often depend entirely on others for assistance and care.
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Tests For Dementia With Lewy Bodies
There’s no single test for dementia with Lewy bodies.
The following may be needed to make a diagnosis:
- an assessment of symptoms for example, whether there are typical symptoms of dementia with Lewy bodies
- an assessment of mental abilities this will usually involve a number of tasks and questions
- blood tests to rule out conditions with similar symptoms
- brain scans, such as an MRI scan, CT scan or a SPECT scan these can detect signs of dementia or other problems with the brain
Lewy Body Dementia Natural Treatment
1. Avoid Food Triggers
Diet plays a key role in cognitive decline and disorders like LBD or DLB. Here are some foods to avoid to help prevent hte development of cognitive disorders.
2. Eat Foods that Heal
To;help Lewy body dementia, follow a;low-carb;diet;thats low in sugar yet nutrient-dense, high in good fats and loaded with anti-inflammatory foods. Healthy;fats help mental disorders like Lewy body dementia;because they facilitate proper thought-processing, hormone production and stress reduction mechanisms happening within the brain.
A ketogenic diet;has been shown to be neuroprotective and very helpful for the dementia that comes with Lewy body dementia. ;A ketogenic diet is made up of around 70 percent to 80 percent fat, which helps the brain.;On this kind of diet,;your body is;able to burn fat for energy and utilize fatty acids, two critical things for the brain and for the natural treatment of dementia.
Here are the foods you should consume to help treat or prevent LBD.
3. Take Beneficial Supplements
Melatonin is often used by Lewy body dementia patients to help with sleep problems. Fiber supplements are also commonly taken;and recommended if constipation is an issue. Probiotics can also help greatly when it comes to constipation and mood.
For brain health, the following can also be helpful:
4. Exercise
5. Pet Therapy
6. Massage;
7. Aromatherapy
Listening to soothing music on a regular basis can help to reduce and calm symptoms of LBD.
9. Daily Mental Stimulation
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What Are The Signs And Symptoms Of Parkinsons Disease Dementia
Parkinsons disease dementia cant be diagnosed conclusively by a single test. Instead, doctors may use multiple tests and consider a range of Parkinsons disease dementia criteria, including symptoms like:
- Feelings of disorientation or confusion
- Agitation or irritability
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Not all cases of cognitive impairment are severesome people with Parkinsons disease can still manage their work and personal life just fine. But once a person has Parkinsons disease dementia, it usually means that they can no longer go about their daily life as they once did.;
How Can We Manage Hallucinations
It may not be necessary to treat all hallucinations of a person with DLB. Hallucinations are often harmless, and it is okay to allow them to happen, as long as they are not disruptive or upsetting to the person or his/her surroundings. Sometimes, recognizing the hallucination and then switching the topic might be an efficient way of handling frustrations that occur because of a hallucination. If hallucinations need medical treatment, your provider may be able to discuss and suggest some options. However, most medications used to treat hallucinations may make movement symptoms worse.
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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.
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.
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What Is Dementia With Lewy Bodies
Dementia with Lewy Bodies may account for 10-15 per cent;of all cases of dementia. DLB can;be diagnosed wrongly and is often;mistaken for Alzheimer’s disease.;
DLB is sometimes known by other names.;These include Lewy body dementia, Lewy;body variant of Alzheimer’s disease, diffuse;Lewy body disease and cortical Lewy body;disease. All these terms refer to;the;same;condition.
What a short video about dementia with Lewy bodies:
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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Can You Prevent Lewy Body Dementia
If you have a family history of Lewy body dementia or Parkinson’s disease, it’s understandable to be concerned about developing Lewy body dementia. Like other types of dementia, there’s not a guaranteed way to completely prevent Lewy body dementia. However, understanding the factors that increase the risk helps us identify opposing strategies that can decrease this likelihood, and these strategies are generally connected with better physical health, as well.
Treatments For Parkinsons Disease Dementia And Dementia With Lewy Bodies
Treatments for DLB are similar to PDD and are aimed at symptom control. The motor symptoms of slowness, stiffness and walking difficulties can be treated with Levodopa. However, Levodopa can cause or exacerbate hallucinations, making it difficult to use it as a treatment for patients who have or are at risk of having hallucinations. Sometimes, clinicians will need to treat the hallucinations more aggressively in order for a patient to tolerate Levodopa given to help the motor symptoms. On the flipside, anti-psychotic medications to control hallucinations can worsen motor symptoms, so treating all the symptoms of LBD simultaneously can be a tricky balancing act.
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