What Is Lewy Body Dementia?

helpguide.org

What is Lewy Body Dementia?

This site's entry appears to be  updated as changes in Neurological and other studies are discovered so it's a good one to reference. I also like the way the information is presented -- organized and major points summarized in an easily read and followed presentation format.

MOST IMPORTANT:  LBD is a progressive disease and unlike Alzheimer's with its more visually observent mental challenges and Parkinson's with more physical challenges, LBD can be more hidden due to the brain having the ability to "mask" many symptoms and for the individual to retain the ability to "manipulate" or "cover up" more symptoms until the later stages of the disease. 

As with my Mom, her brain seemed to continue to adjust and her vast depth of memories and capabilities in some areas seemed to overcome the diminished capabilities she was experiencing.

My personal belief is the loss in the reasoning, the executive functioning, when the person is quite elderly or does not live alone, is often not noticed as readily but thought of as common and usual to growing older when in fact it is a marker overlooked by the person dealing directly with the disease and those closest to them.

Here's a brief summary but please click through to the website for more specific and current info:

"Lewy bodies are abnormal microscopic protein deposits in the brain that disrupt the brain's normal functioning causing it to slowly deteriorate. The effects include a degradation of cognitive functioning, similar to Alzheimer's disease, or a degradation of motor control, similar to Parkinson's disease. Lewy bodies are named after Frederick Lewy who first observed their effects.

Lewy Body Dementia can start differently in people. Sometimes those with LBD initially have a movement disorder that looks like Parkinson's but later they also develop dementia symptoms. Others have a memory disorder that looks like Alzheimer's but they later develop hallucinations and other behavior problems. Over time most people with LBD develop a spectrum of problems that include great variations in attention and alertness from day to day, recurrent visual hallucinations, shuffling gait, tremors, and blank expression, along with various sleep disorders.

Signs of Lewy Body Dementia

• Mental decline. Lewy Body patients may experience reduced alertness and lowered attention span.
• Recurrent visual hallucinations or depression. Hallucinations, usually related to people or animals, occur in most LBD patients. Depression is also common.
• Increasing problems handling the tasks of daily living. Tasks that used to be simple may become difficult for a person with Lewy Body Dementia.
• Repeated falls and sleep disturbances. This includes insomnia and acting out dreams.
• Fluctuations in autonomic processes. This includes blood pressure, body temperature, urinary difficulties, constipation, and difficulty swallowing.

Some of the motor symptoms found in both Parkinson’s and Lewy Body Disease's patients include:

• tremors
• muscle stiffness
• difficulties with balance
• shuffling gait
• stooped posture
• slow movements
• restless leg syndrome

Some of the cognitive symptoms found in both Alzheimer's and Lewy Body's patients
include:

• behavioral changes
• decreased judgment
• confusion and temporal/spatial disorientation
• difficulty following directions
• decreased ability to communicate

Diagnosis and treatment of Lewy Body Dementia

Being diagnosed with an incurable illness, especially one that involves dementia, can be an overwhelming experience. Because the treatment for Lewy Body dementia focuses primarily on symptom management, it's helpful to take as proactive an approach as possible right away. This means working with your physician to control symptoms and make lifestyle changes to accommodate the effects of the disease.

How is Lewy Body Dementia diagnosed?

Since the Lewy bodies themselves can be identified only by autopsy, an accurate diagnosis relies heavily on physician awareness of the defining characteristics of the disease. A brain scan can detect mental deterioration, but not the actual Lewy bodies.

Once other possible conditions have been ruled out, the optimal route for diagnosis is a thorough medical history that focuses on the pattern of symptoms and looks particularly for the hallucinations and sleep disturbances that are common to LBD patients.

Dementia with Lewy bodies and neuroleptics

Neuroleptics are strong tranquillizers usually given to people with severe mental health problems. They are sometimes also prescribed for people with dementia. However, if taken by people with LBD, neuroleptics may be particularly dangerous. This class of drugs induce Parkinson-like side-effects, including rigidity, immobility, and an inability to perform tasks or to communicate. Studies have shown that they may even cause sudden death in people with LBD. If a person with LBD must be prescribed a neuroleptic, this should be done with the utmost care, under constant supervision, and should be monitored carefully and regularly.

According to Lewy Body Dementia Association: Up to 50% of patients with LBD who are treated with any antipsychotic medication may experience severe neuroleptic sensitivity, such as worsening cognition, heavy sedation, increased or possibly irreversible parkinsonism, or symptoms resembling neuroleptic malignant syndrome (NMS), which can be fatal. (NMS causes severe fever, muscle rigidity and breakdown that can lead to kidney failure).

Proactive ways to help someone manage Lewy Body Dementia

Taking a proactive approach to managing the symptoms of LBD is important and small things can make a big difference.

• Become informed. Learn as much as you can about Lewy Body Dementia and how it is likely to affect your loved one specifically, given his or her health history, age, and lifestyle.
• Create a routine. It may help people with Lewy Body Dementia to have predictable routines, especially around meal times and sleep times.
• Establish a nighttime ritual. Try to establish bedtime rituals that are calming and away from the noise of television, meal cleanup, and active family members. Limit caffeine, discourage napping, and encourage exercise.
• Modify tasks. Break tasks into easier steps and focus on success, not failure.
• Walk together. Taking a walk with the patient with LBD is a win-win activity. Being outdoors and exercising is vital for the health and state of mind—of both of you.
• Strengthen senses. Have a doctor evaluate each the patient’s five senses in order to identify and treat any abnormalities. Then ask about exercises to improve them.
• Make behavioral changes. To help minimize the risk of fall-related injuries, you can help stabilize blood pressure. Help your loved one stay well hydrated, exercise, take in adequate sodium (salt), avoid prolonged bed rest, and stand up slowly."

PLEASE NOTE:  Proactive ways to help above are far easier to enact in a home care environment than in a Facility where schedule, routine and institutional rights supersede individual rights.

UNTIL THE TIME when we have more transparency either voluntary or mandated by the general public advocacy and insistence, Seniors in facilities are subject to the "business" of providing a living environment where profit and/or the "business" of Senior living is more important than the humanity.