While Alzheimer’s disease makes up 60-80% of dementia cases, there are two other types accounting for much of the rest: vascular and Lewy Body dementias. Vascular dementia relates to sudden changes in cognitive ability, which may occur after a stroke has blocked key blood vessels to or in the brain. This article focuses on Lewy Body dementia (LBD) since it is related to Parkinson’s disease and Nebraska has the highest per capita incidence of Parkinson’s in the U.S.
Different dementias result in a specific set of cognitive and behavioral changes. Related medications for easing symptoms vary in both effectiveness and severity of side effects. The more you know, the better equipped you are to positively affect quality of life for the person with dementia.
Lewy Body Dementia basics
LBD is a brain disorder affecting around 1.3 million Americans. Lewy bodies are abnormal deposits of a protein (alpha-synuclein) which cause changes in chemicals in the brain, in turn leading to problems with cognition, movement, mood and behavior. LBD has 2 types, dementia with Lewy bodies (DwLB), and Parkinson’s disease dementia (PDD). The key divide is the timing of the appearance of movement disorders.
With DwLB, cognitive problems appear first, often a year prior to movement difficulties. Early on, a person’s decline in cognitive ability may make the disease look like Alzheimer’s, but later, when movement and other symptoms appear, a doctor is better able to diagnose DwLB.
Realistic and detailed visual hallucinations
Ability to think, stay focused and alert varies greatly from day to day;
Ability to judge depth and identify objects also affected
Two or more hours of daytime sleepiness, despite sufficient sleep the night before
Problem-solving difficulties, rather than memory issues
Movement is slow, with rigid muscles, difficulty in walking
Act out dreams; thrashing and talking while dreaming, falling out of bed; all signs of REM sleep disorder
In PDD, movement disorders appear first and are followed by thinking symptoms a year or more later. Symptoms:
Movement disorder symptoms (muscle stiffness, a shuffling walk, tremor, freezing, slowed movement, tiny handwriting, weak voice), typically result in a diagnosis of Parkinson’s disease
50-80% of people with Parkinson’s eventually develop PDD
The highest risk factors for LBD are Parkinson’s disease and REM sleep disorder.
It’s not considered a genetic disease and there is currently no cure.
Some LBD symptoms can be treated. Primary care physicians most often refer patients to a neurologist for optimal disease and medication management. Of course, Parkinson’s disease medications are used when it is present, but some PD treatments, like deep brain stimulation, cannot be used when LBD is present.
For every dementia, a heart-healthy diet and exercise support the best quality of life and may slow progression of the disease. Find a physician you like and can partner with to help you and your family safely manage mood, behavior and movement changes. Call on resources of family, friends, professional caregivers, and support groups. Learn all you can about the disease and its progression so you can plan ahead and live fully.