What is Lewy body dementia (LBD)?
Lewy body dementia, also known as LBD or dementia with Lewy bodies, is a neurodegenerative brain disease where Lewy bodies (abnormal protein deposits) form in the sections of the brain that control cognition, motor control and behavior.
Lewy body dementia affects more than 1.4 million people in the United States and is the second most common form of dementia after Alzheimer’s disease. There is not a cure for Lewy body dementia, so treatment is focused on treating individual symptoms.
Causes of Lewy body dementia
The cause of Lewy body dementia is unknown, but it is thought to be related to the abnormal buildup of Lewy bodies in the nerve cells.
Risk factors for Lewy body dementia
There are only a few risk factors associated with Lewy body dementia including:
- Age — people over the age of 60 are at higher risk of developing Lewy body dementia.
- Gender — men are more likely to develop Lewy body dementia.
- Family history — if you have a family history of Lewy body dementia, you are more likely to develop the condition as well.
- Depression — early research studies show a link between depression and Lewy body dementia
Symptoms of Lewy body dementia
Symptoms of Lewy body dementia include:
- Hallucinations — visual hallucinations are often a first sign of Lewy body dementia; patients may see objects, people or animals that are not there.
- Impaired thinking — cognitive function may be impaired, so patients with Lewy body dementia may have challenges thinking clearly, memory loss, poor attention span and feel confused.
- Difficulty walking — patients with Lewy body dementia may shuffle, become rigid or walk more slowly.
- Difficulty sleeping — patients with Lewy body dementia report acting out dreams while they are sleeping.
- Changes in behavior — changes in behavior, such as loss of attention span, loss of motivation or speech problems, can occur in patients with Lewy body dementia.
- Tremors — Parkinson’s disease-like tremors can occur in patients with Lewy body dementia.
Symptoms start slowly and intensify as the disease progresses. In late stages of the disease, patients with Lewy body dementia may need assistance to perform day-to-day activities.
Diagnosis of Lewy body dementia
It is difficult to diagnose Lewy body dementia because symptoms are similar to other progressive brain disorders such as Alzheimer’s disease. If you think you or a loved one has Lewy body dementia, schedule an appointment with a Mercy Health neurologist for testing.
Your neurologist will perform a full physical and neurological exam as well as take a full medical history. During the neurological exam, your doctor will examine your reflexes, walking, muscle tone, eye movements and balance. He or she will also assess your mental abilities and memory compared to others in the same age group.
Other testing to diagnose Lewy body dementia includes:
- Blood tests — a blood test can rule out other conditions or deficiencies that may be causing your symptoms.
- Diagnostic imaging — MRI (magnetic resonance imaging), PET (positive emission tomography), CT (computed tomography) scans are used to rule out other conditions such as a stroke or brain tumor that may be causing your symptoms.
After the doctor has all the information from the testing, he or she will make a diagnosis if he or she determines you have a progressive decline in ability to think along with repeated hallucinations, symptoms of Parkinson’s disease, sleep disorders where you are acting out dreams, and/or declining cognitive function.
Treatment for Lewy body dementia
There is not a cure for Lewy body dementia, so the goal of treatment is to relieve symptoms. Because of the complexity of the condition, a multi-disciplinary approach to treatment is necessary, and you may have numerous doctors from multiple specialties working together to develop the most appropriate treatment plan for your case.
The two main treatment types are medication and non-medical therapy.
Medication for LBD
For medication, your doctor may prescribe medications that can relieve cognitive, movement, visual hallucination, REM sleep behavior and neuroleptic sensitivity symptoms. Medications such as dopamine agonists or anticholinergic medications can cause adverse side effects and should be avoided.
Many patients experience side effects from using medicine to manage their Lewy body dementia. If a medication's side effects outweigh the benefits, non-medical therapies may be effective.
Non-medical therapies for LBD
- Physical therapy and exercising — physical therapy can help Lewy body dementia patients improve their gait and cardiovascular health as well as strengthen their bodies.
- Speech therapy — for patients who are having trouble with speech volume and enunciation, speech therapy can help improve muscle strength in the vocal cords.
- Occupational therapy — occupational therapy helps patients maintain functional skills, which can impact their feeling of independence.
- Modify the environment and simplify routines — patients with Lewy body dementia do better with structure and simplified routines in their day.