What Is Difference Between Senility And Dementia
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
The Difference Between Parkinson’s Disease And Lewy Body Dementia
One of the most confusing concepts to explain in the clinic is the difference between Parkinson’s Disease, Parkinson’s Disease Dementia and Lewy Body Dementia. Ultimately people with Parkinson’s can look very similar with motor and non-motor problems. This is particularly tricky when PwP first present but the easiest way to consider Lewy Body Dementia is like having a very aggressive progression of Parkinson’s where patients are dementing in the first year of their condition whereas this process is much slower when patients develop Parkinson’s Disease Dementia. Indeed, clinically Lewy Body Dementia patients look like they have a cross between Parkinson’s and Alzheimer’s, which is actually close to what is seen down the microscope when researchers study the brain. Understanding the differences between Parkinson’s Disease and Lewy Body Dementia is not only difficult for patients and their families but has led some professional groups to try and lump all of these patients together under one umbrella, which probably does little to help individual families appreciate what the future holds.
Hopefully this video will help you to gain a more complete understanding of the differences between Parkinson’s Disease, Parkinson’s Disease Dementia and Lewy Body Dementia.
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.
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Difference Between Alzheimers And Senile Dementia
ALZHEIMERS VS. SENILE DEMENTIA
Old age and the loss of mental faculties are an unfortunate but harsh reality. Alzheimers disease is, perhaps, the most common and debilitating of this type of affliction. However, most people are unaware that Alzheimers disease is only one disease under the larger umbrella that is Senile Dementia. Alzheimers maybe the most infamous, but there are many other forms of this condition.
Senile Dementia can be considered as an all-encompassing term utilized to indicate the deterioration and eventual loss of intellectual acuity related to advanced aging, and is caused by degeneration of ones brain cells. Alzheimers disease is often confused as either the same or alternatively it is often considered to be something entirely different from it. Yes and no yes, Alzheimers disease is a condition that qualifies as Senile Dementia, but Alzheimers is actually one of the forms of it. Other forms of Senile Dementia include Fronto-temporal Dementia, Lewy Body disease, Parkinsons disease, and Vascular Dementia. Alzheimers, meanwhile, is the most common of these. It should also not be confused with normal senility.
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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
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How Can Doctors Diagnose Lewy Body Dementia
Being Patient: How can doctors accurately diagnose someone with Lewy body dementia?
Dag Aarsland: As always, the most important thing is to talk carefully with a patient and carer who knows the patient and discuss what symptoms they have experienced. Doctors should ask whether they are having hallucinations, as well as whether they have tremors, slow movements, gait problems or balance issues. If the symptom profile resembles Lewy body disease, then we have some imaging and tests that can be used to secure the diagnosis, although its not mandatory. You can make the diagnosis by just interviewing and examining the patient.
Being Patient: Those living with Alzheimers often experience hallucinations in the later stages. With Lewy body dementia, do patients experience hallucinations early on?
Dag Aarsland: They do happen early on. With some patients, they may be the first symptom, but usually, patients have memory or other cognitive problems and hallucinations. Hallucinations in a person with very early dementia or even before dementia should make doctors suspicious that the patient does not have Alzheimers disease, but Lewy body disease.
What Are The Symptoms
The symptoms of dementia with Lewy body disease include:
- Difficulty with concentration and attention
- Extreme confusion
- Difficulties judging distances, often resulting in falls.
There are also three cardinal symptoms, two of which must be present in order to make the diagnosis:
- Visual hallucinations
- Fluctuation in mental state so that the person may be lucid and clear at one time and confused, disoriented and bewildered at other times. Typically this fluctuation occurs over a period of hours or even minutes and is not due to any underlying acute physical illness.
Some people who have Lewy body disease may also experience delusions and/or depression.
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Alzheimers Treatments Vs Dementia Treatments
While no cure for Alzheimers is currently available, there are a range of options designed to help manage the condition, such as medications for behavioral changes, memory loss, sleep changes, and depression. In addition, Long Island Alzheimer’s and Dementia Center offers several highly-effective therapies for each stage of Alzheimers:
Similar to Alzheimers disease, there are many forms of treatment available to treat the condition that causes dementia. Long Island Alzheimer’s and Dementia Centers innovative programs address each stage, including pre-diagnosis, and are customized to the diagnosed individuals progression.
Dementia With Lewy Bodies And Parkinson Disease Dementia
, MD, PhD, Department of Neurology, University of Mississippi Medical Center
Dementia with Lewy bodiesParkinson disease dementia
Dementia is chronic, global, usually irreversible deterioration of cognition.
Dementia with Lewy bodies is the 3rd most common dementia. Age of onset is typically > 60.
Lewy bodies are spherical, eosinophilic, neuronal cytoplasmic inclusions composed of aggregates of alpha-synuclein, a synaptic protein. They occur in the cortex of some patients who have dementia with Lewy bodies. Neurotransmitter levels and neuronal pathways between the striatum and the neocortex are abnormal.
Lewy bodies also occur in the substantia nigra of patients with Parkinson disease, and dementia may develop late in the disease. About 40% of patients with Parkinson disease develop Parkinson disease dementia, usually after age 70 and about 10 to 15 years after Parkinson disease has been diagnosed.
Because Lewy bodies occur in dementia with Lewy bodies and in Parkinson disease dementia, some experts think that the two disorders may be part of a more generalized synucleinopathy affecting the central and peripheral nervous systems. Lewy bodies sometimes occur in patients with Alzheimer disease, and patients with dementia with Lewy bodies may have neuritic plaques and neurofibrillary tangles. Dementia with Lewy bodies, Parkinson disease, and Alzheimer disease overlap considerably. Further research is needed to clarify the relationships among them.
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Moving To A Care Home
As your dementia progresses looking after yourself or having someone care for you at home may not be enough especially towards the later stages of the disease.
Dementia is a difficult disease for family and friends and looking after someone with dementia can be exhausting. When this happens a care home can provide the level of care needed.
Going into care can be expensive but there is help out there. Your local council may be able to help with partial or full funding depending on the capital you own.
Alzheimers & Frontotemporal Dementia
There are both similarities and differences between Alzheimers dementia and frontotemporal dementia. Some examples:
- While Alzheimers usually occurs from the 7th decade of life, frontotemporal dementia often manifests itself earlier .
- The progression of frontotemporal dementia is on average somewhat faster than that of Alzheimers.
- Alzheimers disease rarely occurs in families, whereas frontotemporal dementia is common .
- The hallmark of Alzheimers is a memory disorder. In contrast, frontotemporal dementia develops relatively rarely. Other symptoms are in the foreground here, such as neglect and poor personal hygiene. In the case of Alzheimers, however, personality changes are usually only clearly noticeable at a late stage.
- Frontotemporal dementia is very often associated with reduced drive, euphoria / disinhibition and a lack of insight into the disease. Such symptoms are rare in Alzheimers disease.
- Disturbances in facial recognition, language and speech, as well as incontinence usually appear late in Alzheimers disease, and early in frontotemporal dementia.
- In Alzheimers dementia, movements and actions are already disturbed in the early stages of the disease. Frontotemporal dementia is rarely associated with such apraxia.
- Alzheimers patients rarely show restlessness and only in later stages. People with frontotemporal dementia, on the other hand, are often restless even in the early stages.
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Clinical History And Testing
Diagnostic tests can be used to establish some features of the condition and distinguish them from symptoms of other conditions. Diagnosis may include taking the person’s medical history, a physical exam, assessment of neurological function, testing to rule out conditions that may cause similar symptoms, brain imaging, neuropsychological testing to assess cognitive function,sleep studies, or myocardial scintigraphy. Laboratory testing can rule out other conditions that can cause similar symptoms, such as abnormal thyroid function, syphilis, HIV, or vitamin deficiencies that may cause symptoms similar to dementia.
Dementia screening tests are the Mini-Mental State Examination and the Montreal Cognitive Assessment. For tests of attention, digit span, serial sevens, and spatial span can be used for simple screening, and the Revised Digit Symbol Subtest of the Wechsler Adult Intelligence Scale may show defects in attention that are characteristic of DLB. The Frontal Assessment Battery, Stroop test and Wisconsin Card Sorting Test are used for evaluation of executive function, and there are many other screening instruments available.
If DLB is suspected when parkinsonism and dementia are the only presenting features, PET or SPECT imaging may show reduced dopamine transporter activity. A DLB diagnosis may be warranted if other conditions with reduced dopamine transporter uptake can be ruled out.
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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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.
How Does Lewy Body Dementia Differ From Alzheimers Disease
Most are familiar with Alzheimerâs disease, but chances are, if you ask anyone on the street what Lewy body dementia is, they wonât have a clue. The prevalence of dementia with Lewy bodies is unknown, but dementia experts believe that LBD accounts for between 10% and 15% of all dementia cases.
As with other forms of dementia, LBD is a progressive brain disorder. It occurs when abnormal deposits of a protein called alpha-synuclein build up in the areas of the brain responsible for regulating behavior, cognition and movement. These deposits are called Lewy bodies. According to the Michael J. Fox Foundation for Parkinsonâs Research, there is compelling evidence from recent studies that alpha-synuclein may also play a role in the development of both familial and sporadic cases of Parkinson’s disease. In fact, LBD shares symptoms with both Alzheimerâs and Parkinsonâs disease.
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Lbd Pharmacologic Treatment Options
No pharmacologic treatments have been approved to treat Lewy body dementia in the United States. However, the following medications are used off-label to treat LBD symptoms.
*Donepezil has been approved to treat LBD in Japan and the Philippines, and rivastigmine has been approved to treat Parkinsons disease dementia in the United States and Europe.
No medications have been approved to manage LBD behavioral symptoms, and many common psychotropic medications can have deleterious side effects in patients with LBD. In general, all classic neuroleptic medications, such as haloperidol, should be avoided. When possible, nonpharmacologic approaches should be attempted to alleviate these symptoms. If necessary, careful use of atypical antipsychotic medications can be tried but require close monitoring. Attention to physical ailments such as constipation and pain should be the first priority because they can trigger behavioral changes. Mood symptoms are common in patients with LBD. Selective serotonin reuptake inhibitors, which help increase the amount of serotonin in the brain, appear to reduce irritability, agitation, and depression. RBD frequently is treated with melatonin or clonazepam.
Epidemiology And Natural History Of Dlb And Pdd
Approximately 12% of those aged above 65 years are diagnosed with DLB worldwide , affecting approximately 5% of all dementia cases in those over the age of 75 . Its incidence is 0.71.4 new cases/100,000 person-years or 3.5/100,000 person-years . For PDD, the cumulative prevalence is of 75% of PD patients surviving more than 10 years , 83% after 20 years , and up to 95% by age 90 years , with an overall prevalence of 31.1% and incidence rates from 0.43 to 1.13/100,000 person-years , indicating that, annually, approximately 10% of a PD population will develop dementia . The data concerning age at disease or dementia onset are highly variable. Whereas in the Olmsted County study DLB patients were younger at symptom onset than those with PDD and had more hallucinations and cognitive fluctuations, others have reported younger age at disease onset in PDD , or no essential differences between disorders .
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Assessment Is Key For Optimal Management
- An early symptom of Alzheimers disease is decline in cognition, most typically manifesting as short-term memory loss. Early symptoms of Lewy body dementia are characterized by cognitive, behavioral, movement, and autonomic changes.
- Common early signs of Lewy body dementia include visuospatial disturbances, vivid hallucinations, bradykinesia and rigidity and postural hypotension, loss of smell, and constipation.
- Strategies for managing symptoms in these two conditions vary.
- Screening and early dementia diagnosis provide opportunities to pursue health behaviors that can reduce risk, for earlier medication initiation to help moderate symptoms, to slow progression, and for long-term care planning.
What Is Dementia With Lewy Body Disease
Dementia with Lewy body disease is a condition that causes changes in thinking, behavior, and movement. DLB usually starts with thinking and behavior changes that are followed by problems with movement. The movement problems in DLB are similar to those seen in people with more classical Parkinsons disease.
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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.
What Is Vascular Dementia
Vascular dementia is characterized by brain cell death due to a decreased blood supply. This second most common type of dementia is caused by damage to the vascular system within the brain. The early and middle stage cognitive symptoms include difficulties with judgement, problem solving, planning, following procedures, recalling recent events, fluency, and visuospatial skills. Patients may also experience mood swings, depression, anxiety, and/or apathy. The late stage symptoms include more severe disorientation, communication problems, memory loss, irritability, disturbed sleep pattern, agitation, and/or aggressive behavior. Some patients may also present with delusions, hallucinations, and difficulties with walking and eating.
The following are the different types of vascular dementia :
- Stroke-related Dementia
This occurs when the blood supply to a brain part is suddenly blocked, usually by a clot. The severity depends on the temporary or permanent interruption of blood flow.
- Post-stroke Dementia
Around 20% of major stroke patients develop post-stroke dementia a large volume of brain tissue wastes away due to the lack of oxygen.
- Single-infarct and Multi-infarct Dementia
This is caused by a single or several smaller strokes. A small area of brain tissue is affected since the blood flow interruption only lasted for a few minutes.
- Subcortical Dementia
- Mixed Dementia
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