Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's. Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control).
Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia may experience visual hallucinations and changes in alertness and attention. Other effects include Parkinson's disease-like signs and symptoms such as rigid muscles, slow movement and tremors.
Lewy body dementia signs and symptoms may include:
Lewy body dementia is characterized by the abnormal build-up of proteins into masses known as Lewy bodies. This protein is also associated with Parkinson's disease.
People who have Lewy bodies in their brains also have the plaques and tangles associated with Alzheimer's disease.
A few factors seem to increase the risk of developing Lewy body dementia, including:
As with other types of dementia there is no single test that can conclusively diagnose dementia with Lewy bodies. Today, DLB is a ‘clinical’ diagnosis, which means it represents a doctor's best professional judgment about the reason for a person's symptoms. The only way to conclusively diagnose DLB is through a post-mortem autopsy. Many experts now believe that DLB and Parkinson's disease dementia are two different expressions of the same underlying problems with brain processing of the protein alpha-synuclein. But most experts recommend continuing to diagnose DLB and Parkinson's dementia as separate disorders. The diagnosis is DLB when:
There are no treatments that can slow or stop the brain cell damage caused by dementia with Lewy bodies. Current strategies focus on helping symptoms.
If your treatment plan includes medication, it's important to work closely with your physician to identify the drugs that work best for you and the most effective doses. Treatment considerations involving medications include the following issues: Cholinesterase inhibiltors drugs are the current mainstay for treating thinking changes in Alzheimer's. They also may help certain DLB symptoms.
Antipsychotic drugs should be used with extreme caution in DLB. Although physicians sometimes prescribe these drugs for behavioural symptoms that can occur in Alzheimer's, they may cause serious side effects in as many as 50 percent of those with DLB. Side effects may include sudden changes in consciousness, impaired swallowing, acute confusion, episodes of delusions or hallucinations, or appearance or worsening of Parkinson's symptoms.
Antidepressants may be used to treat depression, which is common with DLB, Parkinson's disease dementia and Alzheimer's.The most commonly used antidepressants are selective serotonin reuptake inhibitors (SSRIs).
Clonazepam may be prescribed to treat REM sleep disorder.