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Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein chosen alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the encephalon whose changes, in turn, can pb to problems with thinking, movement, beliefs, and mood. Lewy trunk dementia is one of the most common causes of dementia.

LBD affects more than than i million individuals in the United States. People typically show symptoms at age fifty or older, although sometimes younger people have LBD. LBD appears to affect slightly more men than women.

Diagnosing LBD tin exist challenging. Early LBD symptoms are often confused with similar symptoms found in other encephalon diseases or in psychiatric disorders. Lewy body dementia can occur alone or along with other brain disorders.

Information technology is a progressive illness, meaning symptoms starting time slowly and worsen over time. The disease lasts an average of five to eight years from the time of diagnosis to death, simply tin can range from ii to 20 years for some people. How speedily symptoms develop and modify varies profoundly from person to person, depending on overall wellness, age, and severity of symptoms.

In the early stages of LBD, symptoms can be mild, and people tin function fairly normally. As the disease advances, people with LBD crave more aid due to a refuse in thinking and movement abilities. In the afterward stages of the disease, they ofttimes depend entirely on others for assistance and care.

Some LBD symptoms may respond to treatment for a menstruation of time. Currently, there is no cure for the illness. Enquiry is improving our understanding of this challenging status, and advances in science may one day atomic number 82 to better diagnosis, improved care, and new treatments.

What are the causes of Lewy torso dementia?

The precise crusade of LBD is unknown, but scientists are learning more nearly its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the encephalon that produce two important chemicals that human action as messengers between brain cells (chosen neurotransmitters). Ane of these messengers, acetylcholine, is important for retentivity and learning. The other, dopamine, plays an important role in beliefs, knowledge, movement, motivation, slumber, and mood.

Scientists are also learning well-nigh take a chance factors for LBD. A risk factor is something that may increment the chance of developing a disease. Some risk factors tin can be controlled while others cannot. Age is considered the greatest chance gene. No specific lifestyle cistron has been proven to increase one's adventure for LBD.

Other known run a risk factors for LBD include certain diseases and health conditions, specially Parkinson'due south disease and REM slumber behavior disorder, which have been linked to a higher risk of LBD.

Having a family unit member with LBD also may increment a person's risk, though LBD is non considered a genetic illness. Variants in three genes — APOE, SNCA, and GBA — have been associated with an increased risk, but in most cases, the cause is unknown.

What are Lewy body dementia signs and symptoms?

People with LBD may non accept every symptom associated with the disease. Any sudden or major change in functional ability or behavior should exist reported to a doctor.

The most mutual symptoms include changes in cognition, movement, sleep, and behavior.

Cognitive symptoms of Lewy body dementia

LBD causes changes in thinking abilities. These changes may include:

• Visual hallucinations, or seeing things that are not present. Visual hallucinations occur in upwardly to eighty percent of people with LBD, often early. Nonvisual hallucinations, such every bit hearing or smelling things that are not present, are less common than visual ones only may also occur.
• Unpredictable changes in concentration, attention, alacrity, and wakefulness from day to solar day and sometimes throughout the day. Ideas may be disorganized, unclear, or casuistic. These kinds of changes are common in LBD and may aid distinguish it from Alzheimer's disease.
• Severe loss of thinking abilities that interfere with daily activities. Different in Alzheimer's dementia, memory issues may non be evident at first but oft arise as LBD progresses. Other changes related to thinking may include poor judgment, confusion about time and place, and difficulty with language and numbers.

Motion problems and Lewy torso dementia

Some people with LBD may not experience significant movement problems for several years. Others may have them early on on. At start, move symptoms, such as a alter in handwriting, may be very mild and easily overlooked. Motility problems may include:

• Muscle rigidity or stiffness
• Shuffling walk, slow movement, or frozen stance
• Tremor or shaking, most usually at remainder
• Balance problems and repeated falls
• Stooped posture
• Loss of coordination
• Smaller handwriting than was usual for the person
• Reduced facial expression
• Difficulty swallowing
• A weak vocalization

Lewy torso dementia and sleep

Sleep disorders are common in people with LBD, but are often undiagnosed. A slumber specialist can help diagnose and treat sleep disorders. Sleep-related disorders seen in people with LBD may include:

• REM sleep beliefs disorder
• Excessive daytime sleepiness (sleeping two or more hours during the day)
• Insomnia
• Restless leg syndrome

Behavioral and mood symptoms of Lewy body dementia

Changes in behavior and mood are possible in LBD and may worsen as the person'south thinking abilities reject. These changes may include:

• Depression
• Apathy, or a lack of interest in normal daily activities or events and less social interaction
• Anxiety and related behaviors, such as asking the same questions over and over or being aroused or fearful when a loved 1 is not present
• Agitation, or restlessness, and related behaviors, such equally pacing, hand wringing, an inability to become settled, constant repeating of words or phrases, or irritability
• Delusions, or strongly held simulated behavior or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are yet living.
• Paranoia, or an extreme, irrational distrust of others, such every bit suspicion that people are taking or hiding things

Other symptoms of Lewy body dementia

People with LBD can likewise experience significant changes in the part of the nervous organization that regulates automated functions such every bit those of the eye, glands, and muscles. The person may have:

• Changes in body temperature
• Problems with blood pressure
• Dizziness
• Fainting
• Frequent falls
• Sensitivity to heat and cold
• Sexual dysfunction
• Urinary incontinence
• Constipation
• A poor sense of smell

Types of Lewy body dementia and diagnosis

LBD refers to either of two related diagnoses — dementia with Lewy bodies (DLB) and Parkinson'southward disease dementia. Both diagnoses have the same underlying changes in the brain and, over fourth dimension, people with either diagnosis develop similar symptoms. The difference lies largely in the timing of cerebral (thinking) and motion symptoms.

In DLB, cerebral symptoms develop inside a twelvemonth of movement symptoms. People with DLB have a pass up in thinking ability that may look somewhat like Alzheimer's disease. But over time, they also develop motility and other distinctive symptoms of LBD.

In Parkinson's illness dementia, cognitive symptoms develop more than than a year after the onset of motility symptoms (for instance, tremor or muscle stiffness). Parkinson's disease dementia starts as a movement disorder, with symptoms such every bit slowed movement, musculus stiffness, tremor, and a shuffling walk. These symptoms are consistent with a diagnosis of Parkinson's illness. Afterwards on, cerebral symptoms of dementia and changes in mood and behavior may arise.

Not all people with Parkinson's illness develop dementia, and information technology is difficult to predict who volition. Many older people with Parkinson'southward develop some degree of dementia.

Talking to both patients and caregivers helps doctors make a diagnosis. Information technology is of import to tell the physician nearly any symptoms involving thinking, movement, sleep, beliefs, or mood. Besides, hash out other health problems and provide a listing of all electric current medications, including prescriptions, over-the-counter drugs, vitamins, and supplements. Sure medications can worsen LBD symptoms.

Caregivers may be reluctant to talk about a person'southward symptoms when that person is nowadays. Enquire to speak with the doctor privately if necessary. The more information a medico has, the more authentic a diagnosis can be.

Treatment and care for Lewy torso dementia

While LBD currently cannot be prevented or cured, some symptoms may respond to handling for a period of time. An LBD treatment programme may involve medications, concrete and other types of therapy, and counseling. A program to brand any home safety updates and identify any equipment tin make everyday tasks easier.

A skilled care squad oftentimes can suggest ways to improve quality of life for both people with LBD and their caregivers.

Building a Lewy trunk dementia care squad

After receiving a diagnosis, a person with LBD may benefit from seeing a neurologist who specializes in dementia and/or movement disorders. Your primary doctor can work with other professionals to follow your treatment plan. Depending on an individual's item symptoms, physical, spoken communication, and occupational therapists, too as mental health and palliative care specialists, can be helpful.

Support groups are some other valuable resources for people with LBD and their caregivers. Sharing experiences and tips with others in the same situation tin help people find practical solutions to 24-hour interval-to-twenty-four hour period challenges and get emotional and social support.

Lewy torso dementia medications

Several drugs and other treatments are available to treat LBD symptoms. It is important to work with a knowledgeable health professional person considering certain medications can make some symptoms worse.

Coping with cognitive changes

Some medications used to treat Alzheimer'southward disease also may be used to treat the cognitive symptoms of LBD. These drugs, called cholinesterase inhibitors, human action on a chemic in the brain that is of import for memory and thinking. They may as well improve hallucinations, apathy, and delusions. The U.S. Nutrient and Drug Administration has approved one Alzheimer's drug, rivastigmine, to care for cognitive symptoms in Parkinson's disease dementia. Several other drugs are beingness tested equally possible treatments for LBD symptoms or to disrupt the underlying disease process.

Treating motion symptoms in Lewy body dementia

LBD-related movement symptoms may be treated with medications used for Parkinson'due south illness, called carbidopa-levodopa. These drugs tin help make it easier to walk, become out of bed, and motion around. However, they cannot stop or reverse the illness itself. Side effects of this medication tin include hallucinations and other psychiatric or behavioral problems. Because of this take a chance, physicians may recommend non treating mild movement symptoms with medication. Other Parkinson'south medications are less usually used in people with LBD due to a higher frequency of side effects.

People with LBD may benefit from physical therapy and exercise. Talk with your doctor about what physical activities are all-time.

Managing sleep disorders in Lewy body dementia

Sleep problems may increase confusion and behavioral problems in people with LBD and add to a caregiver's burden. A physician can society a slumber study to place any underlying slumber disorders such equally sleep apnea, restless leg syndrome, and REM slumber behavior disorder.

REM sleep beliefs disorder, a common LBD symptom, involves acting out one's dreams, leading to lost slumber and even injuries to individuals and their sleep partners. Clonazepam, a drug used to control seizures and relieve panic attacks, is often effective for the disorder at very depression dosages. However, it tin can have side furnishings such as dizziness, unsteadiness, and problems with thinking. Melatonin, a naturally occurring hormone used to treat insomnia, may likewise offer some benefit when taken alone or with clonazepam.

Excessive daytime sleepiness is also common in LBD. If it is severe, a slumber specialist may prescribe a stimulant to aid the person stay awake during the day.

Some people with LBD have difficulty falling asleep. If trouble sleeping at night persists, a physician may recommend a prescription medication. It is important to note that treating indisposition and other sleep problems in people with LBD has not been extensively studied, and that treatments may worsen daytime sleepiness and should exist used with circumspection. Sleep problems tin can as well be addressed by avoiding lengthy naps, increasing daytime practice, and avoiding caffeine, alcohol, and chocolate belatedly in the twenty-four hour period.

Treatment of behavior and mood issues in Lewy torso dementia

Behavioral and mood issues in people with LBD can arise from hallucinations, delusions, pain, illness, stress, or feet. They may likewise exist the consequence of frustration, fear, or feeling overwhelmed. The person may resist care or lash out verbally or physically.

Medications are appropriate if the behavior interferes with the person'due south care or the safe of the person or others. If medication is used, then the lowest possible dose for the shortest period of time is recommended.

The get-go pace is to visit a doctor to see if a medical condition unrelated to LBD is causing the problem. Injuries, fever, urinary tract or pulmonary infections, pressure level ulcers (bed sores), and constipation can worsen behavioral problems and increase defoliation.

Sure medications, such as anticholinergics and antihistamines may also cause behavioral problems. For instance, some medications for sleep problems, hurting, bladder command, and LBD-related movement symptoms tin can cause confusion, agitation, hallucinations, and delusions. Similarly, some anti-feet medicines tin can actually increase anxiety in people with LBD. Review your medications with your dr. to determine if any changes are needed.

Cholinesterase inhibitors may reduce hallucinations and other psychiatric symptoms of LBD, but they may have side effects, such equally nausea, and are non always effective. Even so, they can be a good first choice to treat behavioral symptoms. Cholinesterase inhibitors practice not affect behavior immediately, so they should be considered as part of a long-term strategy.

Antidepressants can exist used to treat depression and anxiety, which are mutual in LBD. Many of them are ofttimes well tolerated by people with LBD.

In some cases, antipsychotic medications are necessary to treat LBD-related behavioral symptoms to amend the quality of life and safety of the person with LBD and his or her caregiver. These types of medications must exist used with circumspection because they tin can worsen movement symptoms and crusade severe side effects, such as confusion, farthermost sleepiness, and low blood pressure that can result in fainting. In rare cases, a potentially deadly condition chosen neuroleptic cancerous syndrome can occur. Symptoms of this condition include loftier fever, muscle rigidity, and muscle tissue breakdown that can lead to kidney failure. Report these symptoms to your medico immediately.

Antipsychotic medications increase the run a risk of death in all elderly people with dementia but can be especially unsafe in those with LBD. Doctors, patients, and family members must weigh the risks of antipsychotic use against the risks of physical harm and distress that may occur every bit a result of untreated behavioral symptoms.

Other handling considerations

LBD affects the part of the nervous system that regulates automatic actions like blood pressure and digestion. One common symptom is orthostatic hypotension, a drop in blood force per unit area when standing up that tin can cause dizziness and fainting. Elementary measures such every bit leg elevation, elastic stockings, and, when recommended by a doctor, increasing common salt and fluid intake, can help. If these measures are non enough, a md may prescribe medication.

People with LBD are frequently sensitive to prescription and over-the-counter medications for other medical conditions. People with LBD should tell their doctors about every medication they take, including prescription and over-the-counter medicines, vitamins, and supplements. If surgery is planned and the person with LBD is told to terminate taking all medications beforehand, ask the doctor to consult the person's neurologist to develop a plan for careful withdrawal. In addition, talk with the anesthesiologist in advance to discuss medication sensitivities and risks unique to LBD. People with LBD who receive certain anesthetics may become dislocated or delirious and have a sudden, significant turn down in functional abilities, which may become permanent.

Depending on the process, possible alternatives to full general anesthesia may include a spinal or regional block. These methods are less probable to result in defoliation after surgery. Caregivers should likewise discuss the apply of stiff pain relievers later on surgery because people with LBD can become febrile if these drugs are used too freely.

Lewy torso dementia inquiry

Many avenues of inquiry are existence explored to amend our agreement of LBD. Some researchers are working to identify the specific differences in the brain betwixt the two types of LBD. Others are looking at the disease's underlying biology, genetics, and environmental take chances factors. Nevertheless other scientists are trying to identify biomarkers (biological indicators of disease), meliorate screening tests to assist diagnosis, and research new treatments.

Scientists promise that new knowledge nigh LBD will one twenty-four hour period pb to more effective treatments and even ways to cure and prevent the disorder. Until and so, researchers need volunteers with and without LBD for clinical studies.

NIH and other groups assistance people larn near clinical trials and studies and find research opportunities nigh them. Visit the following websites for details:

• Alzheimers.gov (search using the category "Related Dementias")
• Lewy Body Dementia Association
• ClinicalTrials.gov

For more information nearly Lewy body dementia

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers data and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Centre staff answer phone, electronic mail, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov portal for information and resources on Alzheimer's and related dementias from across the federal government.

Lewy Body Dementia Association
404-935-6444
800-539-9767 (LBD Caregiver Link)
www.lbda.org

Michael J. Fox Foundation for Parkinson'south Research
800-708-7644
world wide web.michaeljfox.org

Parkinson'south Foundation
800-473-4636
helpline@parkinson.org
www.parkinson.org

This content is provided by the NIH National Establish on Aging (NIA). NIA scientists and other experts review this content to ensure information technology is accurate and up to date.

Content reviewed: July 29, 2021

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Source: https://www.nia.nih.gov/health/what-lewy-body-dementia-causes-symptoms-and-treatments

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