Stages Of Lewy Body Dementia Our Journey
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For more meaningful terms between professionals, caregivers and patients, a more detailed process in 7 stages, has been described for Alzheimers disease. A more detailed breakdown is helpful, as it allows carers to plan for the level of care that may be required as the illness progresses. The 7 stages of Alzheimers are based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicines Silberstein Ageing and Dementia Research Center.
Some questions many people have are what are the 7 stages of Lewy body dementia? or how does Lewy body dementia progress? or what are the advanced Lewy body dementia symptoms? Unfortunately throughout my research into dementia with Lewy bodies , although I have come across various breakdowns, I have never come across a similar definitive breakdown of the stages of dementia with Lewy bodies.
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How Does Lewy Body Disease Progress
Lewy body disease differs from Alzheimer’s disease in that the progression of the disease is usually more rapid. However, like Alzheimer’s disease it is a degenerative condition, eventually leading to complete dependence. Death is usually a result of another illness, such as pneumonia or an infection. The average lifespan after the onset of symptoms is about seven years.
Dementia Affects Brain Areas Associated With Swallowing
Inability to swallow food is termed as dysphagia. The prevalence of dysphagia among elderly can be as high as 40 percent. This percentage is even higher among people with dementia .
But why is that?
Different types of dementia eventually lead to the shrinkage of the parts of the brain that coordinate swallowing. Consequently, the patients find it extremely hard to swallow as their disease progresses.
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What Are The Treatments For Lewy Body Dementia
There is no cure for LBD, but treatments can help with the symptoms:
- Medicines may help with some of the cognitive, movement, and psychiatric symptoms
- Physical therapy can help with movement problems
- Occupational therapy may help find ways to more easily do everyday activities
- Speech therapy may help with swallowing difficulties and trouble speaking loudly and clearly
- Mental health counseling can help people with LBD and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
- Music or art therapy may reduce anxiety and improve well-being
Support groups can also be helpful for people with LBD and their caregivers. Support groups can give emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.
NIH: National Institute of Neurological Disorders and Stroke
Symptoms Of Dementia With Lewy Bodies
People with dementia with Lewy bodies may have:
- hallucinations seeing, hearing or smelling things that are not there
- problems with understanding, thinking, memory and judgement this is similar to Alzheimer’s disease, although memory may be less affected in people with dementia with Lewy bodies
- confusion or sleepiness this can change over minutes or hours
- slow movement, stiff limbs and tremors
- disturbed sleep, often with violent movements and shouting out
- fainting spells, unsteadiness and falls
These problems can make daily activities increasingly difficult and someone with the condition may eventually be unable to look after themselves.
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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.
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.
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Approximate Lewy Body Dementia Phases Symptoms And Considerations
Lewy Body Dementia Stage 1 Possibilities
Most caregivers are concerned/worried that something is not right. Symptoms from later stages can also appear this early on the continuum. At the end of this phase, cognitive impairment is difficult to deny.
Symptoms and subtle changes may include:
- Increased daytime sleep: two-plus hours
- Hallucinations
- Vision affected
- Hearing affected
- Speech difficulty
- Physical coordination diminished
- Cog-wheeling
- Posture altered
- Chronic runny nose
- Ability to learn new tasks affected
- Short term memory impacted
- Thinking/learning/ problem solving difficulties suggest dementia
- Mood: Depressed/Anxiety
- Able to engage independently in leisure activities
- Handwriting is affected
- Impairments with financial responsibilities
- May still be able to maintain employment
- May be able to hide symptoms
- Socialization still possible
- May accuse spouse of infidelity
Lewy Body Dementia Stage 2 Possibilities
Caregivers consult with an elder law attorney by this point: at very least have a Power of Attorney and Medical Power of Attorney document on the patient. Protect assets: family, friends, caregivers may be able to take financial advantage of LO. Caregivers need to familiarize themselves with all finances and assets to possibly consult with a financial advisor.
Symptoms are usually clearer by this point:
Increased difficulty with:
Lewy Body Dementia Stage 3 Possibilities
Lewy Body Dementia Stage 4 Possibilities
Lewy Body Dementia Stage 5 Possibilities
Strength to all!
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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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.
How Can We Support The Sleep/wake Cycle Of Dlb
For people with DLB who are confused about the day-night cycle, some daily strategies can be helpful. At night, starting a lights out routine that happens at the same hour every day, where all curtains are closed and lights are turned off, can help the person understand that it is sleep time. During the day, opening the curtains, allowing patients to spend as much time in the daylight as possible, avoiding naps, and organizing stimulating activities, can be helpful. Having lots of calendars and clocks in every room might also help a person with DLB be less confused about the time of day.
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What Complications Are Associated With Medications Used To Treat Lewy Body Dementia
Up to 50% of people living with Lewy body dementia can have severe side effects when treated with certain antipsychotic medications. These are known as the typical or traditional antipsychotics and include such drugs as thoridazine, haloperidol, chlorpromazine and perphenazine. This class of older, first-generation antipsychotics can cause sedation and make cognitive symptoms and movement problems worse. A life-threatening reaction to an antipsychotic medication, called neuroleptic malignant syndrome, is possible. Symptoms include rigid muscles, changing blood pressure, high fever, confusion and fast heart rate. Contact your healthcare provider immediately if you or your loved are taking an antipsychotic and develop these symptoms.
Visual hallucinations and behavioral changes may be treated with the newer, atypical antipsychotic medications pimavanserin , quetiapine or clozapine . However, because all antipsychotic medications both older, typical medications and newer atypical medications can increase the risk of death in elderly patients with dementia, you and your healthcare provider should carefully discuss the risks and benefits and using these medications.
Other medications, like antidepressants or sedative antihistamines, may increase confusion in people with LBD.
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.
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What Is Lewy Body Dementia And What Causes It
Lewy body dementia is a type of progressive dementia. According to Norma Loeb, the founder of the Lewy Body Dementia Resource Center, it is the second most common form of progressive dementia behind Alzheimer’s.
Excess deposits of the protein alpha-synuclein, known as Lewy bodies, clump up inside neurons, causing damage to certain parts of the brain and, as a result, a decline in cognition and movement.
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There are two forms of Lewy body dementia: Dementia with Lewy bodies and Parkinson’s disease dementia. The early warning signs of both are key: DLB takes place when people develop cognitive issues, including memory loss, while patients with Parkinson’s disease dementia initially develop movement issues such as muscle stiffness, gait and tremors.
Over time, their symptoms will become more and more similar. Other symptoms of LBD include depression, anxiety, sleep disorders, insomnia, and hallucinations. Patients often develop hallucinations of people or small animals, Loeb said.
Individuals with LBD may live anywhere between two to 20 years from diagnosis to death, according to the National Institute of Neurological Disorders and Stroke.
Why Is It Difficult To Diagnose Lewy Body Dementia
Lewy body dementia’s similarities to Alzheimer’s and Parkinson’s pose a challenge for doctors.
Because early symptoms of DLB are similar to Alzheimer’s, and Parkinson’s disease dementia akin to Parkinson’s, individuals often get diagnosed with the more common disorder as opposed to LBD.
“It can take quite some time to get the correct diagnosis and it is not unusual, unfortunately, for it to take 1 to 3 years,” Loeb said.
Loeb points out that it is key for family members of patients to keep track of all symptoms, as even unexpected symptoms are often linked to LBD. In the case of Robin Williams, Schneider Williams pointed out that “a sudden ad prolonged spike in fear and anxiety can be an early indication of LBD.”
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How To Get Extra Help And Support
Apply for a needs assessment from the adult social services department of your local council. This will help to identify where you might benefit from help, such as with meals or housework.
A needs assessment should be done face to face. Its a good idea to have a relative or friend with you, if youre not sure what your needs might be. They can also take notes for you.
Read more about applying for a needs assessment
Find out about dementia-specific services near you from Alzheimers Society online directory Dementia Connect. Age UK provide a range of services and local support.
Join an online forum, such as Alzheimers Society Talking Point. Online forums are a good way to share your experiences of living with dementia and advice on how to continue living independently.
Read more about help and support for people with dementia.
Are There Medicines To Treat Dlb
Though there is no cure for DLB yet, there are medications that help manage the symptoms. These medications are called cholinesterase inhibitors, and they can help if a person with DLB is having memory problems. Some examples of these medicines are donepezil, rivastigmine and galantamine. If a person with DLB has movement symptoms they may be treated with medications used for Parkinsons disease, such as levodopa. Sleep problems may be managed by sleep medications including melatonin.
Because people with DLB are usually very sensitive to medications, any new medication, even one that is not being used for the brain, needs to be reviewed with the persons provider to avoid potential contraindication.
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How Is Parkinsons Disease Dementia Diagnosed
No single test can diagnose Parkinsons disease dementia. Instead, doctors rely on a series or combination of tests and indicators.
Your neurologist will likely diagnose you with Parkinsons and then track your progression. They may monitor you for signs of dementia. As you get older, your risk for Parkinsons dementia increases.
Your doctor is more likely to conduct regular testing to monitor your cognitive functions, memory recall, and mental health.
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Are You Aware Of Some Of The Less Common Symptoms Of Lewy Body Dementia
Learn about lewy body dementia and parkinson’s disease here. Read on to learn more about dementia causes and sympto. Trusted health information from the national institutes of health there are two types of lewy body dementia : Are you aware of some of the less common symptoms of lewy body dementia? Do you know a friend or family member who is experiencing a decline in their mental abilities? Lewy body dementia causes thinking, movement, and mood issues and is a common form of dementia. Home brain & nervous system centertopic guide what is lewy body. Trusted health information from the national institutes of health lewy body dementia is one of the most common types of dementiabut also. The johns hopkins team of lbd specialists offers unique expertise backed by years of research to help you manage this condition. Learn how dementia with lewy bodies and parkinson’s disease dementia are alike and different from each other. Parkinson’s disease can result in problems with memory and th. See how lewy body dementia affects our brains and causes symptoms. 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.
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