What is Lewy body dementia?
Dementia with Lewy bodies is a type of dementia that is related to and overlaps with Alzheimer’s and Parkinson’s diseases, and is also known by a variety of names such as Lewy body dementia, diffuse Lewy body disease, cortical Lewy body disease, and senile dementia of Lewy type. There is currently no treatment, so it gradually becomes worse and leaves the patient unable to care for their own needs. As such, most treatments focus primarily on palliative care. It is estimated that 10-15% of dementia patients have Lewy body dementia.
In early stages it is often confused with Alzheimer’s or vascular dementia, but where Alzheimer’s has a slow progression, Lewy body dementia has a rapid onset and decline within the first few months. It is also separated from Parkinson’s by the time frame it takes, with Parkinson’s disease with dementia being diagnosed when the dementia develops more than a year after the onset of Parkinson’s, and Dementia with Lewy bodies being diagnosed if the dementia symptoms begin concurrently or within a year of Parkinson’s symptoms.
Signs and symptoms of Lewy body dementia
The symptoms of those suffering from Dementia with Lewy bodies vary from person to person, with core features including: fluctuating cognitive ability of great variation from day to day, or hour to hour, visual hallucinations, and motor features associated with Parkinson’s disease. These motor features include: shuffling gait, low speech volume, difficulty swallowing, sialorrhea, and stiffness of movements.
Visual hallucinations are present in roughly 75% of people with Lewy body dementia and most often involve the perception of people or animals. The hallucinations are not necessarily disturbing and may actually amuse or entertain the sufferer. There may also be difficulties with vision, including mistaking what is seen. For example, they may believe a closet is a bathroom.
We also have more information on the Signs and Symptoms of Dementia.
Management of Lewy body dementia
Treatments for Dementia with Lewy bodies are split into pharmaceutical and caregiving.
With pharmaceutical management, there must be a balance between treatment of motor symptoms and of cognitive symptoms. By treating motor symptoms, medication can make hallucinations and psychosis worse. Alternatively, treating cognitive symptoms such as hallucinations and psychosis can make motor symptoms worse. Due to these issues, it is important for medical professionals to have a full understanding of the condition suffered by each individual person.
Due to the debilitating nature of Lewy body dementia care giving is very important and must be managed specific to the needs to each person and the stage of the disease they suffer from. The environment must be catered to the person, as must their schedule, activities, and communications. Changes in environment or schedule may cause behavioral changes, beyond what is usually expected from a patient.
They may also suffer from big variations between good days and bad days, due to the nature of the disease or due to physical problems as well. When a person with Lewy body dementia becomes agitated it is best look for possible physical problems, then looking for possible environment problems.
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