Lewy Body Dementia steals memory of sufferers
February 4th 2011 21:02
Second most common cause of dementia after Alzheimer's disease
Lewy bodies are a kind of abnormal protein in the brain. Formation of the deposits is associated with a decrease in a brain chemical, dopamine, which is responsible for smooth, coordinated movement. When the deposits are confined to the brain stem, patients develop symptoms of Parkinson’s disease.
In Lewy body dementia (LBD), the abnormal proteins are found throughout the brain. In these other brain areas, the protein deposits cause depletion of acetylcholine, a brain chemical needed for perception, cognitive thought and control of behaviors.
The term, LBD, typically refers to one of two different conditions, based on how the symptoms first appear. In dementia with Lewy bodies, patients initially have problems with memory or thought. The symptoms are similar to those seen in Alzheimer’s patients. Eventually, however, patients who have dementia with Lewy bodies develop characteristic changes in attention, alertness, cognitive ability, movement problems, hallucinations and sensitivity to certain medications. Patients also develop a sleep condition, called REM sleep disorder, in which they act out in their dreams (like punching, kicking, etc.).
The second group of patients with LBD initially starts out with Parkinson-like movement problems. This is called Parkinson’s disease dementia. These patients eventually develop memory and cognitive problems, hallucinations and other signs associated with LBD.
A very small number of patients with LBD will initially have hallucinations, behavior problems and trouble with complex thought processes. These patients are the most likely to receive an accurate initial diagnosis.
The Lewy Body Dementia Association estimates about 1.3 million Americans have LBD. The condition is most common in older people, with symptoms most commonly appearing between 50 and 85. Men are affected more often than women. Family history also appears to play a role in risk for LBD. Generally, patients live for about 7 years after diagnosis.
Getting a Diagnosis
James Galvin, M.D., Neurologist with NYU Langone School of Medicine in New York City, says many physicians are unfamiliar with LBD. Since the symptoms are similar to Alzheimer’s and Parkinson’s disease (depending upon the initial presentation), misdiagnosis is common. However, it’s important to have an accurate diagnosis because some medications work better for LBD. In addition, Galvin says certain medications used to treat behavioral symptoms can increase movement problems in patients with LBD and, in severe cases, cause high fever, serious muscle rigidity, muscle breakdown, kidney failure and death.
Galvin recommends that a close family member be present during a patient’s evaluation. Often patients, themselves, aren’t aware of/or understand the severity of their symptoms. Most don’t remember acting out during REM sleep.
The NYU-Langone Lewy Body Disease Center was created specifically to help patients with LBD. Galvin says the center will serve as a central repository for information and diagnostic expertise. Families and physicians can get assistance over the phone on any day of the week. Eventually, there will be a website with information and resources. The center also provides support and therapy for caregivers and family members. Galvin adds, the center also provides a large pool of patients for doctors to draw from for clinical trials to test new diagnostic tools and treatments
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