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Lewy Body Dementia (LBD)

Microscopic Image of a Lewy Body (NIA)

Lewy body dementia (LBD) is the second most common form of dementia after Alzheimer’s disease. According to the National Institute on Aging (NIA), Lewy body dementia affects more than a million people in the United States. The name Lewy body comes from Dr. Friederich Lewy, a German neurologist who discovered in 1912 the abnormal clumps of alpha-synuclein protein that are characteristic of LBD. As these Lewy body clumps build up, they begin to form in the parts of the brain that deal with movement and memory function. This buildup leads to the death of neurons (nerve cells) in the brain. The result is memory loss, dementia and mood, movement and behavior disorders. LBD usually begins about age 50 or older and like Parkinson’s disease tends to affect men slightly more than women.

LBD is a Progressive Incurable Disease

At the present, LBD is a progressive and incurable disease. In its earliest stages people can still function. However, as the disease progresses, people lose the ability to care for themselves and in late stages they may become totally dependent on others for care.

LBD is Difficult to Diagnose

Currently, there is no kind of test that can accurately diagnose Lewy body dementia. Only in post-mortem samples can Lewy body dementia be accurately diagnosed. As a result, Lewy body dementia sometimes gets misdiagnosed as Alzheimer’s disease, Parkinson’s disease or schizophrenia.

Difference between Lewy Body Dementia and Alzheimer’s Disease

Early memory loss is more significant in Alzheimer’s disease, but hallucinations are more pronounced in the early stages of LBD.

Hall marks of Alzheimer’s disease are beta amyloid plaques and tangles of tau protein in the brain, whereas Lewy body dementia has clumps of alpha-synuclein protein in the brain.

Difference between Lewy Body Dementia and Parkinson’s Disease

People with both Parkinson’s disease and Lewy body dementia have abnormal clumps of alpha-synuclein protein in their brains.

However, motor problems come on early in Parkinson’s disease and dementia comes on very late in Parkinson’s disease or not at all. In Lewy body dementia, the dementia comes on early in the disease together with motor problems.

Idiopathic Normal Pressure Hydrocephalus (iNPH)

A curable form of dementia is sometimes misdiagnosed as Alzheimer’s, Parkinson’s or Lewy body dementia. Idiopathic Normal Pressure Hydrocephalus (iNPH) can be reversed with shunt therapy. See our blog post from April 11, 2018 to learn more about this reversible kind of dementia. It can be diagnosed with CT or MRI imaging.

Movement Problems in Lewy Body Dementia

Movement problems in Lewy body dementia are similar to Parkinson’s disease such as:

  • Tremor
  • Stiffness
  • Walking and balance problems
  • Slow movement

Psychiatric Problems in Lewy Body Dementia

  • Hallucinations
  • Behavior and personality changes
  • Changes in attention and alertness
  • REM sleep disturbances like acting out dreams – can also be found in Parkinson’s disease

Treatment for Lewy Body Dementia

There is no cure for Lewy body dementia, but doctors may prescribe medicines to treat symptoms. Some of the same drugs used to treat Parkinson’s may be prescribed, but too much Levadopa can make hallucinations worse. Also, anti-psychotic drugs usually make LBD worse and must be used with caution.

Risk Factors for Lewy Body Dementia

  • Aging
  • Genetic Risk
  • Parkinson’s Disease

Preventing Lewy Body Dementia

Prevention is mainly by following a healthy lifestyle like eating healthy foods, not smoking, getting regular exercise and cutting down on alcohol. Also, keeping blood pressure under control and managing blood sugar levels in diabetics. Eating fish may help, as a study published April 2, 2019 in Scientific Reports showed that a protein found in fish called beta parvalbumin (PV) stops the formation of alpha-synuclein in the lab. Salmon, cod, red fish and herring are good sources for this. Also, research shows that omega 3 fatty acids found in oily fish are also beneficial for preventing heart disease and strokes.

Where to Get Help for Lewy Body Dementia

The National Institute on Aging’s ADEAR Center offers information and free print publications about Lewy body dementia for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

1-800-438-4380 (toll-free)

Lewy Body Dementia Association

1-404-975-2322

1-844-311-0587 (toll-free LBD Caregiver Link)

The Michael J. Fox Foundation

The Need For Long-Term Skilled Nursing Care

Since Lewy body dementia is a progressive disease like Parkinson’s and Alzheimer’s, the need for long-term skilled nursing care may arise. The Van Duyn Center for Rehabilitation and Nursing in Syracuse, New York offers expert skilled nursing care and memory care at the hands of a warm and compassionate staff.

Conclusion

If you or your loved one have Lewy body dementia, make certain to have a CT or MRI scan because there is one kind of dementia iNPH that is curable. Sometimes iNPH can be misdiagnosed as Alzheimer’s, Parkinson’s or Lewy body dementia. Let us hope that research will find a cure for all of these progressive neurodegenerative diseases. In the mean time it might be helpful to add more fish to the diet.

 

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