Running Head: OVERVIEW OF LEWY BODY DISEASE
Dementia with Lewy Bodies
Jennifer Gau
27th November 2018
“Lewy Body Dementia is one of the most common forms of progressive dementia” (Lewy Body Dementia, n.d.). My father is affected with Lewy Body Dementia. Having never really understanding the disease and the real effects it has on my dad. Did not occur to me until now. The symptoms, the treatments and the prognosis for this disease is so intriguing. The information in this essay is only a scratch on the surface of what Lewy Body Dementia is and what goes into this disease. People still do not fully understand this disease but continue to research it to try and find out more about it.
The symptoms of Lewy Body Dementia are not the same for everyone and the severity of the symptom may vary from person to person (Symptoms of Lewy Body Dementia, 2018). Sometimes Lewy Body Dementia symptoms can be confused for Alzheimer Disease symptoms. One thing that makes Lewy Body Dementia stand out is that they may hallucinate. This happens very rarely in other dementias, if someone is hallucinating and they have never before take them immediately to the doctor (Wonderlin, 2016). Another symptom of Lewy Body Dementia is sleep disorders they can vary from REM sleep behavior disorder, excessive daytime sleepiness, insomnia and restless leg syndrome (Symptoms of Lewy Body Dementia, 2018). They can also experience symptoms related to Parkinson's disease such as; slow and rigid movements and fluctuating impairments. For people that experience fluctuating impairment they may seem very different from day to day and their attention and alertness may also vary (Wonderlin, 2016). Within these symptoms people will have behavioral and mood symptoms as well. They may have depression, anxiety, paranoia, delusions, agitation. They may also have cognitive fluctuations. These consist of changes in the patients concentration, attention, alertness and wakefulness. Lewy Body Dementia patients may also zone out for long periods at multiple times throughout the day, have drowsiness, sleep for hours even if they got enough sleep before, very disorganized thoughts and ideas and very unclear thinking (Symptoms of Lewy Body Dementia, 2018). As there cognition declines these symptoms may worsen (Symptoms of Lewy Body Dementia, 2018). Since Lewy Body Dementia affects the nervous system of the body the person may have fainting, dizziness, problems with their blood pressure and changes in body temperature (Symptoms of Lewy Body Dementia, 2018). Remember that not every single person will experience the same symptoms and people may experience it at different times.
To diagnose Lewy Body Dementia is not the easiest thing ever. The reason is there are no test directly catered for Lewy Body Dementia (Agronin, 2017). Even though it is difficult there are still diagnostic evaluations that includes physical and neurological examinations. This consist of neuropsychological test and mental status test. The patient's attention, language, functional ability, memory, and executive functioning are taken into account. Doctors also will order them to have a CT or MRI scan with blood test and other laboratory tests (Diagnosis, n.d). Usually the brain scans just show benign brain shrinkage or small vascular changes. When looking for Lewy Body Dementia the brain should show less atrophy of the hippocampus and medial temporal lobe. They also perform PET scans which can show the loss of activity in the occipital lobes, still it there are no test yet that directly scan the Lewy bodies in the brain (Agronin, 2017). The author Argonin mentions, “With neuropsychological testing, individuals with DLB-not unlike AD-show impairment in memory, word use, attention, visuospatial ability, and executive function” (Agronin, 2017). He is saying that when testing for Lewy Body Dementia it can sometimes be confused with Alzheimer's Disease. Since it’s close to Alzheimer's it is very hard to identify which is which but with the right amount of testing discovering if someone has Lewy Body Dementia will be easy.
“The exact underlying cause of Lewy Body Dementia is poorly understood” (Lewy Body Dementia, 2015). The article “Lewy Body Dementia” mentions that the symptoms are thought to occur from clumps of protein which are called alpha-synuclein, they accumulate in the regions of the brain that involve thinking, memory and movement. The clumps are associated with a loss of certain neurons in the brain and these produce two important neurotransmitters (Lewy Body Dementia, 2015). The two that are affected are the acetylcholine which is important for memory and learning and also dopamine that plays the most important role in movement, motivation, sleep, and mood (Lewy Body Dementia, 2015). Not knowing the real cause of this disease is troubling hopefully things will change as technology increases.
Since Lewy Body Dementia is a multi-system disease it typically has to have a intensive treatment approach (Treatment, n.d.). This means the patient with has to undergo many forms of treatment. Treatments cannot slow or stop the damage of Lewy bodies in the brain, so the treatments are more directed to help with the symptoms (Dementia with Lewy Bodies, n.d.). There are therapies offered to help, this includes physical, speech and occupational therapy. The physical therapy offered for people with Lewy Body Dementia is therapy intended for the cardiovascular system, strengthening, flexibility and gait training which helps with your ability to stand and walk. While speech therapy is intended to help with poor enunciation it can also improve muscle strength and help with people who have swallowing difficulties. Lastly occupational therapy is to help patients maintain their skills it also promotes function and independence (Treatment, n.d.). Lewy Body Disease is not preventable because no one still understands the real cause of it.
Of course medications are part of the treatment process to, there are many different types of medications that help with the symptoms of Lewy Body Dementia. Each patient reacts to each medication differently so it can be tricky finding the right medication for the patient. One medication that doctors may prescribe to the patient with Lewy Body Dementia is a drug called clonazepam which is used to help treat the REM sleeping disorder (Dementia with Lewy Bodies, n.d.). REM sleep disorder is a condition where the person acts out there dreams and it can sometimes be violent, causing harm to themselves and others (Symptoms of Lewy Body Dementia, 2018). With clonazepam it can help the REM sleeping disorder. Another medication that doctors may prescribe to patients are antidepressants which is used to treat depression since it is very common when it comes to patients with Lewy Body Dementia. The most common antidepressant prescribed is selective reuptake inhibitors (Dementia with Lewy Bodies, n.d.). Doctors may also prescribe cholinesterase inhibitors which are used to treat hallucinations which is a common occurrence for patients with Lewy Body Disease (Treatment, n.d.). Lastly doctors may also prescribe a drug called antipsychotic medications. These are also used to treat hallucinations and some mental disorders (Treatment, n.d.). The thing is these drugs may cause serious side effects to the patient, “50 percent of those with DLB” (Dementia with Lewy Bodies, n.d.). The side effects of this medication include episodes of confusion, delusions or hallucinations, trouble swallowing and changes of one's consciousness. All medications should be prescribed at a low dosage and then monitored closely to be certain that the medications are actually improving the patient's life and not adding unwanted side effects. Therefore some things just have to be tolerated without the use of medications (Agronin, 2017). Still no medication can help treat Lewy Body Dementia and they are more catered to help make the symptoms bearable for the patient.
Since there has been no real treatment found yet for Lewy Body Dementia the patient will eventually die. The average time for the disease is 5 to 7 years. It is possible for a patient to live for 2 to 20 years, but it depends on many factors such as the patient’s health, age and the severity of the symptoms they are experiencing (Diagnosis, n.d.). But as time goes on the patients Lewy Body Dementia will just keep getting worse and worse (Dementia with Lewy Bodies, n.d.). Within the disease there are stages the thing is defining these stages is difficult. The reason being is everything is different for each patient that has Lewy Body Dementia. It could be there symptoms are different there medications, there lifestyle many factors contribute to the stages of Lewy Body Dementia (Diagnosis, n.d.). Hopefully patients with Lewy Body Dementia will learn to maintain a healthy lifestyle to help prolong their life.
Managing the disease consist of many things. The three most important things that a patient with Lewy Body Dementia wants to do is improving their lifestyle, avoid falling and causing injuries and constantly watching and trying to improve their symptoms (Agronin, 2017). The three most important things that help maintain Lewy Body Dementia is physical activity, mental activity, and having a good diet (Smith, 2014). As Smith states, “Regular physical activity is essential to maintaining good health-not just for you body, but also your mind” (Smith, 2014). Physical activity should be part of our daily lives in general but for most Americans that is not the case. “Recent studies indicate that almost 80 percent of all Americans fail to meet the guidelines for physical activity recommended by the Centers for Disease Control and Prevention and the American College of Sports Medicine” (Smith, 2014). Physical activity is something you do to get your body moving whether it be aerobics, sports, running anything like that is considered physical activity. Smith mentions that the “CDC and the ACSM recommend that adults get about two and a half hours of moderate-intensity aerobic activity each week” (Smith, 2014). Patients also need to participate in mental activities also to manage there Lewy Body Dementia. “Medical studies have shown that cognitive simulation-talking about the news with a friend, doing crosswords, playing music, or making art-can help you maintain your memory and potentially prevent against dementia” (Smith, 2014). Doing things like reading a book, taking music lessons, learning a new language, and making art and many more activities are all things a person with Lewy Body Dementia can do to help increase mental activity. “The substances you put into your body can have a profound effect on your cognitive function and memory” (Smith, 2014). Patients with Lewy Body Dementia should to avoid sugar and processed foods, salty foods,and “bad” fats, eat more fruits and vegetables, gluten-free grains, “good” fats, and more lean proteins and nuts.
“Dementia with Lewy bodies (DLB) accounts for 20% of all cases of dementia in old age” (The Genetic Characterization of Dementia, 2018). With it being such a prominent disease many people experience it but there is still no real treatment for it. Hopefully as researchers study this disease more they can find a real cure for it. It took me awhile to accept the fact that my dad has Lewy Body Dementia. Knowing that it will never go away and will most likely be the cause of his death. Now knowing all the things that factor into Lewy Body Dementia, my knowledge of it has grown and hopefully spreading this knowledge will help not just my dad but other families that are in a similar situation.
Work Cited
10 Things You Should Know about LBD. (n.d.). Retrieved November 16, 2018, from https://www.lbda.org/go/10-things-you-should-know-about-lbd
Agronin, M. E. (2017). The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer's Disease and Other Neurocognitive Disorders. Lanham, MD: Rowman & Littlefield.
Lewy Body Dementia. (2015, November 6). Retrieved November 9, 2018, from https://rarediseases.info.nih.gov/diseases/3243/lewy-body-dementia
Dementia with Lewy Bodies. (n.d.). Retrieved November 10, 2018, from https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies
Diagnosis. (n.d.). Retrieved November 22, 2018, from https://www.lbda.org/go/diagnosis-0
Treatment. (n.d.). Retrieved November 16, 2018, from https://www.lbda.org/go/treatment-0
Smith, Pamela Wartian. (2014). What You Must Know About Memory Loss & How You Can Stop It. Garden City Park, NY: Square One.
Symptoms of Lewy Body Dementia. (2018, June 27). Retrieved November 22, 2018, from https://www.nia.nih.gov/health/symptoms-lewy-body-dementia
The Genetic Characterization of Dementia – Full Text View. (2018, April 5). Retrieved November 9, 2018, from https://clinicaltrials.gov/ct2/show/NCT01867359
Wonderlin, R. (2016). When Someone You Know Is Living in a Dementia Care Community: Words to say and things to do. Baltimore, MD: Johns Hopkins University Press.