About Alzheimer's

Lewy Body Dementia

Understanding Alzheimer's >> Types of Dementia | 04.23.15

What is Lewy Body Dementia?

Dementia with Lewy Bodies (DLB) is a neurodegenerative brain disorder characterized by protein inclusions (known as Lewy bodies) that interfere with brain cell activity. The symptoms are similar to those of Alzheimer’s and Parkinson’s-related dementia.

For those with DLB, Parkinson’s disease symptoms usually occur at the same time as dementia symptoms, or within a year. Delusions and hallucinations are common, as well as dizziness and frequent falls. Fluctuations in attention and extended periods of confusion can also occur.

How is DLB diagnosed?

Since the actual presence of Lewy bodies in the brain can only be determined from a physical examination of the brain tissue, the diagnosis of DLB relies on a careful analysis of a person’s symptoms and physical condition. The assessment procedure is similar to the diagnosis for Alzheimer’s and other dementias. It usually involves a medical exam, lab tests, a neurological and psychological assessment, and possibly brain imaging tests.

As with Alzheimer’s, part of the goal is ruling out other potential causes for the symptoms, such as nutritional deficiencies, infectious diseases, metabolism issues, neurological conditions or other factors.

Common signs and symptoms of Lewy Body Dementia

Cognitive symptoms

Lack of attention and concentration

Periods where the patient seems confused, sleepy or unresponsive (fluctuations)

Difficulties with visual-spatial thinking (reading a clock, etc.)

Impaired ability to plan and organize everyday tasks

Inability to name common objects

Slowed thinking, speaking or acting

Psychiatric symptoms

Hallucinations

Delusions

Apathy

Depression

Sleep disorders (extremely vivid dreams, talking during sleep, acting out dreams)

Neurological symptoms

Parkinson’s symptoms

Incontinence

Frequent falls

Fainting

Orthostatic hypotension (dizzy spells)

What causes DLB?

The precise cause of DLB is not fully understood, but researchers have found similarities to other neurodegenerative dementias in the form of a signature type of protein deposit in the brain cells of persons with the condition. These rounded protein aggregates—made up of alpha-synuclein, ubiquitin and neurofilament—are the Lewy bodies that give the disease its name. (Friedrich H. Lewy was the neurologist who first observed these proteins in the brain of a deceased Parkinson’s patient.)

Lewy bodies are present in the cortex and brainstem of people with DLB, where they interfere with nerve cell function and lead to the death of the cells themselves. There are clear connections between Parkinson’s disease and Lewy Body dementia; however, unlike Parkinson’s, DLB does not appear to be an inherited condition.

How is DLB treated?

At the present time, there is not cure for DLB. Certain medications, like the cholinesterase inhibitors used to treat some Alzheimer’s symptoms, may be useful in some patients to help mitigate the periods of confusion (fluctuations), hallucinations and delusional states caused by the disease. Antidepressants may also be used to treat depression symptoms.

 

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