Lewy body dementia is a progressive neurodegenerative disorder that develops slowly and can cause symptoms such as hallucinations, difficulty concentrating, tremors, muscle stiffness, and memory loss.
This type of dementia is caused by the buildup of proteins known as Lewy bodies in brain tissue. It is more common in men and typically affects people over the age of 60.
Treatment for Lewy body dementia is managed by a neurologist and usually involves a combination of medication, physical therapy, and occupational therapy.
Main symptoms
The main symptoms of Lewy body dementia include:
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Loss of reasoning ability
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Frequent visual hallucinations
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Problems with comprehension, thinking, memory, and judgment
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Mental confusion or disorientation
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Excessive sleepiness or disrupted sleep
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Slow movements, stiffness in the arms or legs, or tremors
Other possible symptoms include balance problems, falls due to difficulty judging distances, and fainting.
In the early stages, memory may remain intact, but as the disease progresses, memory problems and memory loss typically appear.
How lewy body dementia affects a person
In most cases, Lewy body dementia first causes changes in mental abilities.
As the disease advances, movement difficulties develop, and episodes of confusion become more severe.
Mood changes are also common, with symptoms such as depression and apathy.
How a diagnosis is confirmed
The diagnosis of Lewy body dementia is carried out by a neurologist, geriatrician, or psychiatrist after a complete evaluation of symptoms, medical and family history, and a physical exam.
The doctor may also order blood tests such as vitamin B12 levels, thyroid hormones, VDRL for syphilis, or HIV testing to rule out conditions with similar symptoms.
Additional tests may include CT scan, MRI, PET scan, or a sleep study.
Difference between lewy body dementia and Alzheimer’s disease
Lewy body dementia and Alzheimer’s disease share some similar symptoms, but they tend to appear at different stages of the illness.
In Alzheimer’s disease, memory problems usually occur at the onset, while in Lewy body dementia memory loss tends to appear later.
Hallucinations generally develop in advanced Alzheimer’s disease but are common early in Lewy body dementia.
Another key difference is the cause: Alzheimer’s disease results from amyloid protein buildup in the brain, while Lewy body dementia is caused by the accumulation of proteins called Lewy bodies.
Possible causes
Lewy body dementia occurs due to the buildup of proteins such as ubiquitin and alpha-synuclein, called Lewy bodies, within the cytoplasm of neurons in the brainstem, cerebral cortex, and limbic system.
The exact cause of Lewy body formation is not fully understood, but factors such as genetics, environmental influences, aging, and sex appear to play a role, with men being more commonly affected.
Lewy bodies are also present in other conditions, such as Parkinson’s disease. When they cause cognitive symptoms, the condition is classified as Lewy body dementia.
Types of lewy body dementia
Lewy body dementia can be classified as:
1. Lewy body dementia
This type is marked by the buildup of Lewy bodies in the brainstem and cerebral cortex, and sometimes in the limbic system, leading to symptoms.
2. Parkinson’s disease
Parkinson’s disease is considered a type of Lewy body dementia. In this case, Lewy bodies first accumulate in the brainstem and may later affect the cerebral cortex, eventually causing dementia.
Treatment options
Although there is no cure for Lewy body dementia, treatment managed by a neurologist, geriatrician, or psychiatrist can help relieve symptoms and improve quality of life.
The main treatment options include:
1. Medications for lewy body dementia
Medications may be prescribed to help manage symptoms. The main options include:
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Antipsychotics such as quetiapine or olanzapine to reduce hallucinations
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Acetylcholinesterase inhibitors such as donepezil or rivastigmine to improve concentration, memory, and reduce hallucinations and behavior changes
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Antiparkinsonian medications such as carbidopa and levodopa to reduce tremors, muscle stiffness, and slow movements
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Antidepressants such as sertraline or citalopram to improve symptoms of depression and help regulate behavior
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Sleep aids such as clonazepam or melatonin to help regulate sleep
All medications should only be taken under medical supervision with regular monitoring.
2. Physical therapy
Physical therapy is recommended to maintain muscle strength and flexibility and to support cardiovascular health through guided exercises.
It should always be performed under the supervision of a physical therapist.
3. Occupational therapy
Occupational therapy helps maintain independence by teaching strategies to perform daily tasks within the person’s limitations.
4. Speech therapy
Speech therapy can help improve communication abilities and address difficulties with eating or swallowing. It should be guided by a licensed speech therapist.
5. Complementary therapies
To help manage symptoms such as sadness, anxiety, or agitation, complementary therapies may be used, including aromatherapy, music therapy, or massage.
Other beneficial strategies include engaging in brain exercises, avoiding smoking, and following a healthy, balanced diet rich in fruits and vegetables.
It is important to emphasize that complementary therapies are supportive and should never replace medical treatment.