Lewy body dementia (DLB) is increasingly being seen as one of the most common forms of dementia. Like vascular dementia, it is believed to be the second most common type after Alzheimer’s.
In this type of dementia the cause of the brain damage is different to Alzheimer’s and abnormal protein deposits (intracytoplasmic proteins) called Lewy bodies are the hallmark of this disease.
Unlike Alzheimer’s DLB appears to affect men and women equally but like Alzheimer’s mostly affects the over 65 year old age group.
Symptoms of Lewy Body dementia
Symptoms of DLB can be difficult to distinguish from Alzheimer’s disease and Parkinson’s disease. Researchers are now questioning whether DLB may be a variant of Parkinson’s disease. Like Alzheimer’s, DLB is progressive but with fluctuating cognitive symptoms (occurring in about 80% of those affected) that may last hours or weeks. People with DLB experience psychotic symptoms with visual hallucinations being the most common. The hallucinations are often recurrent and are often characterized by animals and people. Behavioral disturbances treated with antipsychotic medications can cause similar problems to those seen in cases of delirium.
Parkinson type muscle rigidity and shaking are a feature of DLB, so repeated falls are common.
Treatments for Lewy Body Dementia
Although, like Alzheimer’s, there is no cure for DLB there are treatments aimed at controlling the cognitive, psychiatric, and motor symptoms of the DLB. Acetylcholinesterase inhibitors donepezil and rivastigmine used in Alzheimer’s disease, can be used to treat the cognitive symptoms of DLB. Some people with DLB benefit from the use of levodopa (commonly used in Parkinson’s disease) for their rigidity and loss of spontaneous movement.
Careful use of antipsychotic medications such as haloperidol (Haldol, Serenace), olanzapine (Zyprexa), promazine quetiapine (Seroquel), may be helpful but may be outweighed by neuroleptic sensitivity.
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