Lewy body dementia (LBD), the second most common form of dementia after Alzheimer's Disease, is a brain disorder that results in irreversible cognitive decline and movement problems similar to Parkinson's Disease. Lewy bodies are an alpha-synuclein protein that develops in areas of the brain involved in thinking and motor control. When they build up they can have a negative impact on the brain, affecting memory, thinking skills, movement, mood, and behavior. These abnormal proteins are also found in the brains of Alzheimer's patients, leading experts to believe there may be a Lewy body variant of Alzheimer's, or that a person can have both. The similarities among these types of dementia make diagnosis difficult.

Lewy body dementia refers to both dementia with Lewy bodies and Parkinson's disease dementia. Diagnosis depends on which symptoms occur first. In dementia with Lewy bodies, the patient starts with cognitive problems and later loses control of their movements.

Symptoms

While not every patient with LBD will experience every sign and symptom of this form of dementia, sudden or severely shifting changes in their behavior or cognitive functioning should be reported to a doctor. Common symptoms of LBD include:

  • Slow, rigid movements
  • Shaking
  • Balance issues
  • Fainting
  • Difficulty with concentration and alertness
  • Visual hallucinations
  • Daytime drowsiness
  • Fluctuating changes in personality or mood
  • Memory loss
  • Confusion
  • Problems sleeping

Causes

Although the definitive cause of dementia with Lewy bodies has not yet been determined, most scientists believe that, given the presence of Lewy bodies in the brains of both Parkinson's and Alzheimer's patients, the disorder may be related to either or both diseases.

It has been determined, however, that the greatest risk factor for LBD is advanced age, with typical onset appearing between the ages of 50 and 85. Genetics may also contribute to the risk of developing the disorder, but as of right now, there is no accurate test available that can predict if a person will develop LBD.

Treatment

This complex disease demands a comprehensive treatment plan since every patient is unique in how their symptoms are expressed and how they react to certain medications. Whatever the case, individuals with LBD should never take antipsychotics, as they are extremely sensitive to these drugs and taking them may worsen symptoms. Talk with a doctor about potential side effects before starting any medication, since Lewy body patients are more likely to have negative reactions to drugs used to treat individual symptoms (e.g. antidepressants, antispasmodics, tranquilizers and surgical anesthetics).

Due to the complications from taking medication, patients may consider other nondrug forms of therapy. Physical therapy-weight training, cardiovascular training, stretching, and balancing exercises can help improve mood and some motor symptoms. In advanced stages, speech therapy can be beneficial for improving pronunciation and muscular strength in swallowing difficulties. Any kind of therapy promoting independence and reducing anxiety, such as occupational or music therapy, can also help improve mood.

The complexity of this disease demands a strong patient support group. Working with family, friends and other people with LBD can provide the emotional support needed to improve patient outcomes and quality of life.