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.
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.
Lewy Body Dementia Medicines
Acetylcholinesterase inhibitors have been proven as effective medication for hallucinations, confusion and sleepiness in some people with LBD.
Memantine can be used by people with moderate-to-severe LBD for people that cannot take AChE inhibitors.
Levodopa is a drug that can help people with Lewy body dementia who struggle with their mobility. It can, however, worsen some other symptoms.
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Understanding Lewy Body Dementia
Lewy body dementia symptoms are so similar to those of other forms of dementia that LBD can be misdiagnosed. This might make more sense when you consider that there are many types of dementia.
It may help to think of dementia as one large “umbrella” that slowly robs people of their ability to think, talk, remember, and use their bodies. Many diseases crowd underneath this umbrella, including:
- Alzheimers disease
- Struggle with incontinence
With dementia with Lewy bodies, cognitive changes may appear earlier than, about the same time, or shortly after any physical changes surface.
Treatment For Lewy Body Dementia At Priory
Priory provides high quality treatment interventions that aim to maximise independence and maintain quality of life for those living with Lewy body dementia, as part of our dedicated Brain Injury Services. We can provide expert support, delivered across our specialist sites throughout the UK.
Our approaches for patients who are experiencing a PNC are based on a model of person-centred care and are aimed at minimising the impact of the behavioural and psychological symptoms of dementia . Our treatment approaches encompass all aspects of neurological support, including:
Treatment is delivered within a broad variety of environments, ranging from hospital settings to transitional living homes. We can care for patients at all stages of their condition right through to delivering bespoke end of life care support, based on individual needs and preferences. The breadth of the service allows our network to offer comprehensive care pathways, ensuring that all services have consistency in their approach and adhere to national guidelines.
Priory is experienced in providing a range of specialist complex care services for people with Lewy body dementia. We are dedicated to supporting both the patient and family, with the intention of maximizing quality of life and maintaining functional independence for as long as possible.
- Comprehension and understanding
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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.
Types Of Lewy Body Dementia
It’s important to know which type of LBD a person has, both to tailor treatment to particular symptoms and to understand how the disease will likely progress. Clinicians and researchers use the “one-year rule” to help make a diagnosis. If cognitive symptoms appear at the same time as or at least a year before movement problems, the diagnosis is dementia with Lewy bodies. If cognitive problems develop more than a year after the onset of movement problems, the diagnosis is Parkinson’s disease dementia.
Regardless of the initial symptoms, over time, people with either type of LBD often develop similar symptoms, due to the presence of Lewy bodies in the brain. But there are some differences. For example, dementia with Lewy bodies may progress more quickly than Parkinson’s disease dementia.
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The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
How Is Lewy Body Dementia Treated
- Acetyl cholinesterase inhibitors: These work by increasing the levels of a chemical called acetylcholine in the brain, which improve the ability of the brain cells to send signals to each other
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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.
Symptom #: Visuospatial Difficulties
Two eyes located on the front of the head are common among predators or omnivores such as ourselves. The simple reason is that it works. The two eyes can work together to allow for triangulation, helping us to judge direction and distance with ease. This is down to the brainâs ability to process the information that is coming from the eyes.
With a failing brain, though, this ability will gradually be lost. The patient can struggle to judge direction and distance, making it difficult for them to get around. Even reaching for a glass can become difficult for them and they can require help from other people even to do the simplest of things.
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Memory And Thinking Problems
You may experience forgetfulness, slowed thinking and difficulty concentrating. You might find it harder to follow conversations, and remember some words and names. This can make communication difficult.
You may also find it increasingly difficult to make decisions, plan activities and solve problems. This can make everyday activities harder.
Strengths And Limitations Of This Study
We identified residents with two or more LBD signs and categorised them as at risk for inappropriate treatment due to misdiagnosis. A strength of this study was its large N, with data collected by nurses who followed a consistent questionnaire protocol and a long follow-up of 6 years . In addition, we used medical records across all 40 NHs with data from 96% of the residents, including observational data, electronic medical and medication records.
A limitation is the cross-sectional nature of the initial data collection. In addition, the participants were at different stages of their disease and data on severity of dementia, comorbidity and function was not possible to collect. Therefore, the Cox regression models were only adjusted for age and gender.
Although our use of a non-validated questionnaire may also be considered a limitation, over 90% of the residents with a formal LBD diagnosis, according to computerised medical records, were categorised in the 24 LBD group, suggesting that the instrument has face validity.
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Behavioral And Mood Symptoms Of Lewy Body Dementia
Changes in behavior and mood are possible in LBD and may worsen as the persons thinking abilities decline. These changes may include:
- Apathy, or a lack of interest in normal daily activities or events and less social interaction
- Anxiety and related behaviors, such as asking the same questions over and over or being angry or fearful when a loved one is not present
- Agitation, or restlessness, and related behaviors, such as pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability
- Delusions, or strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living.
- Paranoia, or an extreme, irrational distrust of others, such as suspicion that people are taking or hiding things
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
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Outlook For Dementia With Lewy Bodies
How quickly dementia with Lewy bodies gets worse varies from person to person.
Home-based help will usually be needed, and some people will eventually need care in a nursing home.
The average survival time after diagnosis is similar to that of Alzheimer’s disease around 6 to 12 years. But this is highly variable and some people live much longer than this.
If you or a loved one has been diagnosed with dementia, remember that you’re not alone. The NHS and social services, as well as voluntary organisations, can provide advice and support for you and your family.
Dementia With Lewy Bodies : What Is It And What Causes It
Dementia with Lewy bodies is a type of dementia caused by Lewy bodies, which are clumps of protein in the cells of the brain. Read more about what DLB is, and who gets the condition.
Dementia with Lewy bodies
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What Are The Signs And Symptoms Of Lewy Body Dementia
The most common symptoms of LBD include changes in thinking abilities, movement, sleep, and behavior. The degree of symptoms can vary widely and people with LBD may not have every symptom. Common symptoms include:
- Trouble with attention, planning, multitasking, problem-solving, and reasoning. Memory problems are also common but may not be noticeable early on.
- Problems with visual and spatial abilities, such as judging distance and depth or misidentifying objects.
- Unpredictable changes in concentration, attention, alertness, and wakefulness.
- Visual hallucinations, which occur in up to 80% of people with LBD, often early on.
- Movement changes, such as tremor or muscle stiffness, known as parkinsonism.
- Sleep disorders, including rapid eye movement sleep behavior disorder in which a person seems to act out dreams while asleep, excessive sleep or lack of sleep, and restless leg syndrome.
- Depression, lack of interest, anxiety, ideas not based in reality, and other changes in mental health.
- Sensitivity to heat and cold, dizziness, poor sense of smell, and other changes in automatic functions of the body.
Individuals with mild symptoms can often function close to normally. As the disease progresses and thinking and movement abilities decline, people with LBD will need more help and may depend on caregivers full time.
Treating Dementia With Lewy Bodies
There’s currently no cure for dementia with Lewy bodies, but treatments can help manage the symptoms.
First of all, your future health and social care needs will need to be assessed and a care plan drawn up.
This is a way of ensuring you receive the right treatment for your needs. It involves identifying areas where you may need some assistance, such as:
- what support you or your carer need for you to remain as independent as possible
- whether there are any changes that need to be made to your home to make it easier to live in
- whether you need any financial assistance
Read more about care plans
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When To See Your Gp
See your GP if you think you have early symptoms of dementia, especially if you’re over 65.
If you’re worried about someone else, encourage them to see their GP. You could suggest that you go with them.
The GP can do some simple checks to try to find the cause of your symptoms. They will refer you to a memory clinic or another specialist for further tests if needed.
Key Changes In Personality
Perhaps the most heart-breaking symptoms of LBD stems from significant and drastic personality changes in patients. Suddenly an independent spouse may develop anxiety or abandonment issues.
Severe depression, anxiety, and panic attacks can develop in correlation with these symptoms. Extreme shifts in mood, losing passion for certain hobbies, and even loss of sense of humor can be both alarming and devastating to friends and loved ones.
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Diagnosing Dementia With Lewy Bodies
If you think you may have early symptoms of dementia, it’s a good idea to see your GP. If you’re worried about someone else, encourage them to make an appointment, and perhaps suggest that you go along with them.
Your GP can do some simple checks to see if there is chance you could have dementia, and they can refer you to a memory clinic or another specialist clinic if necessary.
At one of these clinics, you will be asked about your symptoms and have a physical check-up and memory test. You may also have blood tests and brain scans.
The results of these checks and tests will give your doctor a good idea as to whether your symptoms are caused by dementia with Lewy bodies, another type of dementia, or something else entirely.