What to Know In regards to the 2d Leading Type of Dementia
Let’s first transparent up one not unusual false impression about dementia: It isn’t one particular illness however a time period that encompasses all kinds of stipulations that significantly impact mind purposes necessary for daily lifestyles. Most folks find out about Alzheimer’s—the commonest of those stipulations—however the 2nd maximum not unusual is Lewy physique dementia (LBD), which is especially difficult to diagnose, consistent with the National Institute on Aging.
Lewy physique dementia impacts roughly 1.4 million folks within the United States, consistent with the Lewy Body Dementia Association. Because signs of LBD continuously overlap with Alzheimer’s and likely psychiatric issues, some victims fail to spot early interventions or obtain scientific remedy that’s useless and even destructive. The most famed instance is the past due comic Robin Williams, who suffered from undiagnosed LBD earlier than he gave up the ghost in 2014.
“Most patients with Lewy body dementia are between the ages of 60 and 80 when diagnosed, with men more commonly affected than women,” says Hitesh Patel, M.D., a board-certified neurologist at Saddleback Memorial Medical Center in California.
Here’s what else mavens say you wish to have to find out about Lewy physique dementia, its signs, and the way it’s lately handled.
What is Lewy physique dementia?
Lewy physique illness reasons dementia on account of bizarre clumps of a definite protein within the mind, explains Elise Caccappolo, Ph.D., a board-certified medical neuropsychologist and the director of the Neuropsychology Service at Columbia University. These are referred to as Lewy our bodies, named for the neurologist who found out them within the early 1900s, Frederich H. Lewy, M.D. The protein, alpha-synuclein, accumulates in nerve cells within the spaces of the mind that keep an eye on reminiscence, motor regulate, and considering.
This form of dementia is revolutionary (that means it has a tendency to regularly worsen because the Lewy our bodies unfold). It’s very similar to Alzheimer’s within the sense that it will probably reason reminiscence decline and visual-spatial consciousness problems, says Caccappolo, however it will probably additionally reason signs associated with Parkinson’s illness when the protein clumps can intrude with the neurotransmitter dopamine, which is helping transmit indicators that reason muscle motion, consistent with physicians from Stanford Health Care.
Experts from the National Institute on Aging divide LBD into two varieties:
- Dementia with Lewy our bodies. With this type of LBD, an individual develops cognitive signs at the similar time as or no less than a yr earlier than motion issues.
- Parkinson’s illness dementia. Parkinson’s illness dementia is the kind of LBD this is known when considering talents fall by way of the wayside after an individual has lived with motion problems for a while (a yr or extra).
What are the indicators and signs of Lewy physique dementia?
LBD can specific itself in many various techniques. According to Dr. Caccappolo and the mavens at Mayo Clinic, the commonest signs are:
- Increased issue to problem-solve or multi-task
- Poor or fluctuating consideration (which will impact reminiscence)
- Increased issue to problem-solve or multi-task
- Poor visual-spatial consciousness (reminiscent of difficulties using)
- Movement problems like muscle stiffness, tremors, sluggish motion, and shedding one’s sense of stability
- Sleep issues
In some instances, an individual may additionally enjoy:
- Poor law of physique purposes like: blood drive, middle charge, bladder and bowel regulate
- Depression or apathy
“Due to the wide spectrum of physical [and cognitive] symptoms and the levels at which they can occur, LBD is often misdiagnosed initially,” says Dung Trinh, M.D., a board-certified internist focusing on geriatrics and Chief Medical Officer at Irvine Clinical Research.
For example, about 80% of folks identified with LBD enjoy recurrent visible hallucinations, consistent with the National Institute of Neurological Disorders and Stroke. “These hallucinations are often recurrent and very detailed, and typically appear as adults, children or animals,” says Lisa Skinner, a behavioral specialist and circle of relatives counselor within the box of Alzheimer’s and similar dementias in addition to the creator of Truth, Lies & Alzheimer’s: Its Secret Faces. But as a result of psychiatric signs are skilled early within the illness procedure, “many patients are often misdiagnosed with a psychiatric disorder,” adds Dr. Patel.
LBD often gets confused with Alzheimer’s, too, but with LBD, changes in attention span and alertness are usually the first noticeable signs, whereas people with Alzheimer’s typically first experience their memory decline, according to Dr. Patel.
Hallucinations and REM sleep behavior disorder—which can cause people to punching, kicking, yelling and screaming while sleeping—are also typically unique to LBD in the realm of dementia, says Dr. Caccappolo. “These dream enactment behaviors usually precede the LBD, sometimes by decades,” adds Brendan Kelley, M.D., a professor and clinical vice-chair in the department of neurology at UT Southwestern Medical Center.
How is Lewy body dementia diagnosed?
Part of the reason why LBD is so difficult to diagnose is because “there is no definitive test for LBD,” says Dr. Caccappolo. Instead medical doctors continuously have to move about ruling out different sicknesses as they assess medical signs, lab findings, mind imaging, and neuropsychological exams, she provides. Oftentimes, this calls for the experience of a geriatric psychiatrist, neurologist, or a neuropsychologist.
Based on the findings, the physician may give an LBD diagnosis, but like Alzheimer’s, there’s currently no way to 100% confirm it without a brain autopsy, according to the National Institute of Aging. That’s a problem, because some medications used to treat Alzheimer’s and Parkinson’s can make symptoms worse, says Dr. Trinh. For example carbidopa-levodopa, which is typically used to treat Parkinson symptoms like muscle stiffness and slow movement, can increase confusion and hallucinations in LBD patients.
The good news is the National Institute Aging claims that doctors are increasingly getting more accurate at diagnosing LBD and identifying symptoms much earlier so that their patients get the right care.
How is Lewy body dementia treated?
While there is not any “cure” for LBD, “there are medications [and therapies] that can be very helpful for managing symptoms, ” says Caccappolo. For example, she finds that treatments like:
- Cholinesterase inhibitors can help with agitation, apathy, hallucinations and memory changes.
- Antidepressants like SSRIs can help with mood changes.
- Cognitive remediation therapy, which guides patients in cognitively stimulating exercises, can somewhat improve memory and executive functioning.
Physical and/or occupational therapy can also assist in preventing falls and helping people maintain physical autonomy in their day-to-day tasks for as long as possible, according to Skinner. While general counseling, can help a person come to terms with their diagnosis, discuss their feelings, or navigate depression or anxiety.
With her clients, Skinner also recommends that they “stay as active as they can, physically, mentally, and socially,” whether or not that’s following a secure, doctor-approved workout regimen, preserving involved with circle of relatives, or becoming a member of a neighborhood membership. “Engaging in meaningful activities can be enjoyable and increase self-esteem and confidence.”
What causes Lewy body dementia?
Researchers are still trying to figure out why Lewy bodies develop in the brain. Even though the brain naturally has alpha-synuclein protein throughout its structure, its normal function is not well understood, nor can scientists explain what causes them to clump together and cause problems, according to the Alzheimer’s Association.
Unlike with Alzheimer’s, experts at the Lewy Body Dementia Association say that LBD is not usually hereditary.
“An individual’s risk is increased if [they have] a family member with LBD or Parkinson’s disease,” says Caccappolo. But “there is a very small genetic component to LBD.”
So, while it’s important to be aware of, say, the fact that your grandpa or grandma suffered from LBD, it’s not a strong predictor of whether or not you’ll have it, too.
Is there any way to prevent Lewy body dementia?
There’s no proven way to prevent the onset of LBD or any form of dementia, but there are certain lifestyle habits you can adopt to boost your brain health for as long as possible, according to Dr. Caccappolo.
“These include decreasing/managing stress as much as possible, following a regular sleep routine, maintaining a healthy diet, exercising when possible, staying socially and intellectually active, and managing overall health,” she says.
What should I do if I notice myself or someone I love is showing signs of cognitive decline?
Early detection and a proper diagnosis can help you find the best treatments to manage troubling symptoms ASAP. “If an individual has experienced changes in cognition or motor functioning for a few months or longer, I’d recommend making an appointment with a neurologist,” says Caccappolo.
Getting the proper diagnosis can also give the patient and their caregivers the opportunity to learn about the symptoms of LBD, “so they can better accept aspects of the disease, especially those that are beyond the patient’s control,” adds Caccappolo.
For many, there’s some relief in knowing why troubling symptoms or behaviors are showing up. From there, the appropriate healthcare decisions and lifestyle arrangements can be made to maximize the quality of life for the person living with LBD and those taking care of them.
Overall, this procedure will also be difficult to navigate, and that’s why organizations just like the Lewy Body Dementia Association and the Lewy Body Dementia Resource Center have enhance crew directories and assist traces to help alongside the best way. LBD may nonetheless be shrouded in thriller, however there are complete communities and researchers operating in combination to be sure that nobody is left at the hours of darkness.
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