In the United States, about 1.3 million people have had Lewy body dementia, according to the Lewy Body Dementia Association. A common type of progressive dementia, Lewy body dementia causes problems with memory and judgment, and patients can have confusion.
These cognitive changes result from abnormal protein formations called Lewy bodies. Lewy body dementia affects the outer layer of the brain called the cortex and an interior brain structure called the substantia nigra.
Healthy cells die in these regions of the brain, which affects normal functioning. Lewy bodies can appear in the cells that remain. The National Institute of Neurological Disorders and Stroke noted that the protein found in Lewy bodies, called alpha-synuclein, is linked to other disorders, including Parkinson’s disease.
In addition to the cognitive problems, Lewy body dementia has three characteristics. The first characteristic is shifts in the patient’s level in alertness and attention. For example, the patient may have long periods of time in which she stares off into space or the patient may feel drowsy often.
The second characteristic is frequent visual hallucinations, in which the patient sees something that does not exist. Examples of visual hallucinations include seeing people and animals, though some patients may see colors or shapes. The MayoClinic.com noted that the hallucinations may be one of the first symptoms.
The third characteristic are Parkinsonian motor symptoms — motor symptoms that would be seen in a patient with Parkinson’s disease — such as rigidity and a shuffling walk.
Patients with Lewy body dementia can have other symptoms as well. The Family Caregiver Alliance stated that about 50 percent of patients have rapid eye movement (REM) sleep behavior disorder, in which they have excessive movement when they are asleep, experience vivid dreaming, and talk while sleeping. Other symptoms of Lewy body dementia include delusions and depression.
No cure exists for Lewy body dementia, so treatments focus on managing the symptoms of the disorder. For example, to treat the cognitive problems with Lewy body dementia, the doctor may prescribe a cholinesterase inhibitor, such as donepezil, which is used for Alzheimer’s disease.
The National Institute of Neurological Disorders and Stroke pointed out that while patients can have hallucinations, doctors tend to not prescribe them antipsychotics, as these medications carry the risk of worsening motor symptoms.
The MayoClinic.com added that different modifications can also help patients, such as breaking tasks into easier steps, avoiding the act of correcting the patient when she makes a mistake, and reducing clutter and noise around the patient.
References
Lewy Body Dementia Association. What Is LBD?. Web. 12 September 2011
http://www.lbda.org/node/7
National Institute of Neurological Disorders and Stroke. Dementia: Hope Through Research. Web. 12 September 2011
http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm
Family Caregiver Alliance. Dementia with Lewy Bodies. Web. 12 September 2011
http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=570
National Institute of Neurological Disorders and Stroke. Dementia with Lewy Bodies Information Page. Web. 12 September 2011
http://www.ninds.nih.gov/disorders/dementiawithlewybodies/dementiawithlewybodies.htm
MayoClinic.com. Lewy Body Dementia. Web. 12 September 2011
http://www.mayoclinic.com/health/lewy-body-dementia/DS00795/METHOD=print
Reviewed September 13, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith