Lewy Body Dementia or “LBD”
- Written by Gayle Horton Gayle Horton
Written By: Gayle Horton
Lewy Body dementia affects 1.3 million people in the USA and it is no longer considered a rare disease. My experience has been that this disease is frequently diagnosed as Parkinson’s or Alzheimer’s. The progression of symptoms is about one to two years prior to making a formal diagnosis.
Frederich H. Lewy a scientist discovered abnormal protein deposits that disrupted the brain’s normal functioning in the early 1900’s. These Lewy body proteins deplete the neurotransmitters called dopamine which affect the brain stem, and then cause Parkinson’s like symptoms. These abnormal proteins are diffused throughout other areas of the brain, including the cerebral cortex causing a disruption of perception, thinking and behavior.
Lewy Body dementia symptoms differ from person to person. The symptoms may fluctuate as often as moment to moment or day by day. The difficultly for a doctor using a standard mental assessment to diagnose cognitive changes, with the LBD patient they may score in the normal range on certain tests. The family becomes very confused about the doctor’s inability to diagnose the patient when they see symptoms change dramatically hour by hour.
Most LBD patients complain of visuospatial difficulties including depth perception, difficulty with their directional sense or illusions. They may have problems with fluctuating blood pressure, variable heart rate, sexual disturbance, excessive sweating, fainting, dry eyes and mouth.
Progressive dementia with deficits in attention and executive function are typical symptoms of LBD. Significant memory impairment may not be evident in the early stages. Recurrent complex and detailed visual hallucinations, along with fluctuating cognition and changes in the attention span and alertness are all symptoms of Lewy Body dementia.
Frequently doctors diagnose a person with Parkinson’s, and within one year of watching the decline in cognition, the doctor changes the diagnosis to Alzheimer’s disease, when in fact the person has Lewy Body dementia.
Medications called cholinesterase inhibitors are considered standard treatment for the cognitive symptoms in LBD. Another factor to be considered when starting medications for patient’s with LBD is the severe sensitivity to anti-psychotic drugs and other medications. These medications can worsen the Parkinsonism and decrease the cognition and increase hallucinations.
For more detailed information please go to the Lewy Body Dementia Association web site. LBD support groups around the country can provide additional resources and support for families. As a Geriatric Nurse, I coach families to push the medical professionals to consider Lewy Body dementia when a patient is not improving with standard forms of treatment for Parkinson’s or Alzheimer’s.