Introduction to Lewy Body Dementia
Stand at attention for an off-kilter sign of this particular kind of dementia. Nearly 7 million Americans have been diagnosed with dementia, which gradually destroys memory, thinking skills, and the capacity to perform basic tasks. While Alzheimer’s disease remains the most common form of dementia, another prevalent type of cognitive decline includes a singular symptom.
What is Lewy Body Dementia?
Lewy body dementia (LBD) is the third-most common form of dementia. Unlike Alzheimer’s, in which sufferers have issues forming new memories, people with Lewy body dementia can create new memories but have a hard time retrieving them. “LBD has many core clinical features that distinguish this form of dementia from Alzheimer’s disease,” Dr. Jonathan Fellows from the Michigan Institute for Neurological Disorders (MIND) told The Post. “Patients can experience fluctuations in their cognition, alertness and attention, which can vary from day to day or even from hour to hour.”
The ‘Lewy Lean’
Fellows noted that there is one troubling, telltale sign of LBD — and it made seem familiar if you’ve noticed a loved one always seems to be leaning forward when they stand. “The ‘Lewy lean’ is a term used to describe gait and balance problems associated with LBD,” he said. “Patients can have several different variations, including a persistent lean to one side when sitting, standing, or walking; difficulty standing upright; difficulty walking straight; and increased falls associated with loss of balance.”
The so-called Lewy lean typically expresses itself in the disease’s later stages.
Progression and Diagnosis
According to Fellows, LBD progresses more rapidly than Alzheimer’s, averaging 5 to 8 years from diagnosis to death compared to 8 to 10 years for Alzheimer’s disease. For those who notice the ‘Lewy lean’ in a friend or family member, Fellows encourages them to seek care from a medical professional, as it could be a sign of LBD or other neurological issues. “This type of imbalance certainly can be seen with a degenerative brain condition such as LBD, but also can be seen with other neurologic problems, including Parkinson’s disease, stroke, neuropathy, or multiple sclerosis.”
Symptoms and Treatment
LBD patients can also present with detailed visual hallucinations that often appear early in the disease process. DimaBerlin – stock.adobe.com
Fellows shared that LBD patients can also present with detailed visual hallucinations and sleep disturbances that often appear early in the disease process. “A common early feature of LBD includes REM sleep behavior disorder, where patients have vivid dreams and act out their dreams with yelling, kicking, or punching during sleep. This sleep disorder often precedes the cognitive symptoms by many years.” As there is no cure for LBD, treatment focuses on symptom management. auremar – stock.adobe.com
Because the disease shares features with both Alzheimer’s and Parkinson’s disease, therapies are used interchangeably. “Cholinesterase inhibitors, such as rivastigmine or donepezil, although not FDA approved for this condition, can be used to help with cognition, attention, and hallucinations,” the doc said.
Managing Symptoms
The autopsy of Robin Williams revealed the beloved actor and comedian was suffering from LBD before his death by suicide in 2014. Getty Images
“Symptoms similar to those of patients with Parkinson’s disease can sometimes be managed with levodopa therapy, such as Sinemet.” Atypical antipsychotic medication is used to treat symptoms like hallucinations, delusions, and agitation. However, Fellows emphasized that traditional antipsychotics should be avoided as they can exacerbate LBD symptoms. LBD patients who are suffering from REM sleep behavior disorder can utilize melatonin or clonazepam. “All of these medications used to treat symptoms of DLB can be discussed with your neurology provider.”
Risk Factors
Risk factors of dementia include lower levels of education, hearing loss, high blood pressure, tobacco use, obesity, depression, diabetes, excess alcohol intake, traumatic brain injury, air pollution, social isolation, vision loss, high cholesterol, a sedentary lifestyle, and sleep issues.
Conclusion
Lewy body dementia is a significant concern for millions of Americans, with its unique set of symptoms, including the ‘Lewy lean’, distinguishing it from other forms of dementia like Alzheimer’s. Understanding the progression, diagnosis, symptoms, and treatment options for LBD is crucial for providing adequate care and support to those affected.
FAQs
- Q: What is Lewy body dementia?
A: Lewy body dementia (LBD) is the third-most common form of dementia, characterized by its unique set of symptoms, including fluctuations in cognition, alertness, and attention, and the presence of the ‘Lewy lean’. - Q: What is the ‘Lewy lean’?
A: The ‘Lewy lean’ refers to gait and balance problems associated with LBD, including a persistent lean to one side when sitting, standing, or walking, difficulty standing upright, and increased falls. - Q: How does LBD progress?
A: LBD progresses more rapidly than Alzheimer’s, averaging 5 to 8 years from diagnosis to death. - Q: What are the treatment options for LBD?
A: Treatment for LBD focuses on symptom management, using therapies such as cholinesterase inhibitors, levodopa therapy, and atypical antipsychotic medication. - Q: What are the risk factors for dementia?
A: Risk factors for dementia include lower levels of education, hearing loss, high blood pressure, tobacco use, obesity, depression, diabetes, and other health issues.
