According to the National Institute of Neurological Disorders and Stroke, Lewy Body dementia (LBD), is the second most frequent cause of dementia in elderly adults. Lewy Body dementia is a neurodegenerative disorder associated with lewy bodies (abnormal structures) found in certain areas of the brain.
Lewy bodies are tiny spherical protein deposits found in nerve cells. Their presence in the brain affects the brain’s normal function, interrupting the action of the important chemical messengers, including acetylcholine and dopamine. Lewy bodies contain the protein alpha-synuclein, which is also associated with Parkinson’s disease.
Lewy Body Dementia: Symptoms
Lewy body dementia patients typically present with the following symptoms:
- Delirium, confusion, attention deficit and hallucinations – especially visual hallucinations.
- Mild rigid-akinetic parkinsonism and intermittent loss of consciousness with falling.
- Sensitivity to neuroleptic drugs.
Particularly characteristic of LBD is a fluctuation in the severity of the condition on a day-to-day basis. At times the person will be alert and then suddenly experience acute episodes of confusion. These may last hours or days. He or she may also experience hallucinations that become more pronounced when he or she is most confused. The LBD patient also exhibits symptoms of Parkinson’s disease.
Additionally, REM Sleep Behavior Disorder (RBD) is common in persons with LBD. During periods of REM sleep, the patient may move, gesture and/or speak.
Finally, sensitivity to neuroleptics is another indication of LBD. Some anti-psychotic medications can exacerbate Parkinson’s symptoms or increase the LBD sufferer’s confusion. Accurate diagnosis of LBD is critical to developing a safe treatment plan.
Lewy Body Dementia: Diagnosis
An accurate diagnosis of lewy body dementia relies on careful examination of the history and pattern of symptoms, and by ruling out other dementias with similar characteristics.
Fluctuating confusion, persistent visual hallucinations and spontaneous parkinsonism are three core diagnostic features of LBD. The presence of at least two of these symptoms is a likely indicator of the disease.
Memory tests and blood tests may also be performed. A brain scan may reveal brain degeneration, but the actual presence of lewy bodies can be confirmed only by autopsy after death. Dementia with lewy bodies is in many ways similar to Alzheimer’s disease, and it is sometimes difficult to distinguish between the two.
Lewy Body Dementia: Treatment
Treatments and therapies for lewy body dementia are focused on symptom control. Certain drugs prescribed for Alzheimer’s and Parkinson’s disease are often used to manage symptoms such as rigidity. However, while medications may help to reduce tremor and loss of muscle movement, they may actually exacerbate other symptoms such as hallucinations and delusions. Similarly, neuroleptic drugs prescribed for psychiatric symptoms may aggravate movement symptoms. In general, atypical antipsychotic medications are more successful than the former generation of drugs
Lewy Body Dementia: Resources
Alzheimer’s Disease Education and Referral (ADEAR) Center
PO Box 8250
Silver Spring, MD 20907-8250
Alzheimer’s Association National Office
225 N. Michigan Ave., Fl. 17
Chicago, IL 60601
24/7 Nationwide Contact Center: 800-272-3900
American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, Maryland 20871
Tel: 800-437-2423 or (301) 948-3244
Fax: (301) 258-9454
870 Market Street
San Francisco, CA 94102
Tel: 415-732-7040 or 888-598-3789
International Federation for Spina Bifida and Hydrocephalus
Tel: +32 (0)2 502 0413
Fax: +32 (0)2 502 1129
The Lewy Body Dementia Association, Inc.
912 Killian Hill Road, S.W.
Lilburn, GA 30047
National Institute of Mental Health (NIMH)
National Institutes of Health, DHHS
6001 Executive Blvd. Rm. 8184, MSC 9663
Bethesda, MD 20892-9663
Tel: 301-443-4513/301-443-8431 (TTY) 866-615-NIMH (-6464)