Lewy body dementia can also affect the alertness levels of its victims, causing long periods of staring into space or daytime drowsiness. Eventually, the disease can progress to a Parkinson’s disease-like state, wherein the afflicted person has tremors, rigid muscles and slowed movements.
As with all Alzheimer’s, the cause is believed to be related to a clogged system. Protein deposits called Lewy bodies can develop in various regions of the brain, affecting nerve cells that control memory, thinking and motor control.
That causes the external symptoms, which include hallucinations (which can be visual, auditory, olfactory or tactile); movement disorders, including a shuffling gait; and body functions that go askew from normal function, featuring drops in blood pressure, affected pulse, digestive issues and sweating. As a result of the issues, locomotion may be affected, patients may experience dizziness, and bowel issues may become significant.
In addition, the Lewy Body Dementia patient may have sleep issues, with the disorder causing the patient to act out their dreams in their sleep; and cognitive issues, including confusion and memory loss. Speech may also be disorganized in the latter stages of the disease.
THE CAUSE
Researchers don’t know what causes Lewy Body Dementia, but believe it stems from the same roots as Alzheimer’s and Parkinson’s disease because of the presence of similar proteins in the brains. Lewy Body Dementia patients exhibit the same tangle and plaques in the brain that are associated with Alzheimer’s disease.
Who is at risk? Several factors seem to be prominent among those who suffer from the disease. Particularly at risk are men over age 60 who have had one more family members with Lewy Body Dementia.
Because there is no cure, sufferers usually get progressively worse, with death occurring about eight years after the onset of symptoms.
DIAGNOSIS
Family doctors presented with the symptoms of the disease often refer the patient to a dementia specialist, typically a neurologist familiar with brain and mental health issues. A complete exam will usually be required, and the doctor will want to know about all medications, vitamins and supplements the patient takes, plus levels of physical activity. It is a good idea to take a close friend or family member to the appointment to talk to the doctor about symptoms that the patient may not have realized or noticed.
A formal diagnosis of Lewy Body Dementia is usually done when there is a progressive decline in the ability to think, accompanied by two or more of the following: alertness issues, hallucinations, Parkinson’s-like symptoms, sleep problems, and inability to regulate blood pressure, pulse, or body temperature.
During the examination, the doctor will try to rule out other possible explanations for the physical and mental symptoms. These can include Parkinson’s, tumors, strokes or other brain issues that may cause similar issues to Lewy’s Body Dementia. To do so, the doctor will look at the patient’s reflexes, balance, eye movements and sense of touch, all of the indicative of brain issues.
In addition to the physical tests and oral exam, some doctors ask the patient to take a short test to measure thinking and memory skills. This is a 10-minute test that is usually performed in the doctor’s office and then compared to a baseline profile performance of other people who match the patient’s age and education levels. This will help the doctor determine whether any impairment is a normal part of aging or indicative of a more serious issue.
If a patient’s confusion fluctuates, the doctor may perform an EEG to make sure that seizures or Creutzfeldt-Jakob disease are a possible cause. The latter is a degenerative brain disease that causes dementia. There may also be a request for an MRI, CT or other scan to look at brain activity, and a sleep evaluation to monitor that activity.
TREATMENTS
Although there is no cure for Lewy Body Dementia, there are medications that may slow the progression. These include such Alzheimer’s disease medications as rivastigmine (Exelon), which increase the chemical messengers in the brain that are believed to aid memory. That can help with alertness issues, and may reduce the hallucinations of Lewy’s.
Some Parkinson’s disease medications, such as Sinernet, can help with the issues of rigid muscles and slow shuffling, while antipsychotic medications, such as Seroquel, Zyprexa and others, may help with easing the hallucinations and delusions of Lewy’s. The medications are administered cautiously, as some Lewy’s Body Dementia patients have severe reactions to the medications, increasing their confusion and Parkinson’s symptoms.
Because of that possibility of severe reactions, some patients and their doctors decide to take a non-drug approach to treatment. Many patients are comfortable with the hallucinations and can adjust to them, even recognizing when a hallucination is occurring in some cases. Patients may also declutter and destress their lives, allowing less distractions that may influence alertness. Modification of daily routines to reduce patient confusion is another possibility, as is modifying the caregiver’s response to behaviors like hallucinations, emphasizing the need to reassure the sufferer rather than criticize or correct.
Because Lewy’s Body Dementia has different progression rates, techniques and treatments will vary. But all patients are encouraged to get more exercise, which seems to help with physical function and mental alertness. Social activities and maintenance of regular routines are all helpful in stabilizing conditions and slowing progression of Lewy Body Dementia.
Some alternative therapies, including music therapy, aromatherapy, and massages, have also proved helpful in slowing the disease. The key is keeping the patient engaged and stimulated, which combat the depression and isolation that can speed the disease’s progression and affect general health.