Monday, August 8, 2022
Monday, August 8, 2022
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Parkinson’s With Lewy Body

Is Lewy Body Dementia Hereditary & What Is The Life Expectancy Of A Person With Lewy Body Dementia

Parkinson’s Disease – Lewy Body Disorders: Carol Persad

Most patients suffering from Lewy Body Dementia prefer visiting a primary care physician at the initial stage. Diagnosing the disorder can be a real problem if the symptoms grow severe.

There are many families that have been affected by Lewy Body Dementia . However, it has been seen that very few individuals and even medical professionals are aware of the diagnostic criteria and symptoms. Some even dont have the idea whether or not the disease exists. Therefore, you should know about Lewy Body Dementia not only to save yourself but also your loved ones, families and friends. Lewy body dementia is a type of progressive dementia that comes only after Alzheimers disease dementia.

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How Can I Help Myself

Adapting your daily routine, making changes to your environment and physical activity where possible can all help to manage DLB.

Keeping physically active and mentally stimulated is very important if you have DLB. Avoiding stress can also help as stress is likely to worsen memory problems, so try to take each day at a steady pace. Allow time for rest and relaxation, and make time to do the things you enjoy. Complementary therapies such as yoga and Tai Chi, together with exercise such as swimming may help with this.

Many people find it helps to adapt their home and work environments to their needs. For example, you may want to remove clutter to reduce the number of visual distractions and make it easier for you to find your way around. Keeping furniture, visual and hearing aids in the same place and having a regular daily routine may help you too. At night, you may find it useful to keep a low-level night light on to minimise possible disorientation if you wake.

As time passes, carrying out more complex tasks is likely to become harder. Try writing down the various steps you have to go through in order to complete specific tasks, and follow these steps one by one.

Use memory aids such as post-its, a whiteboard for notes, a notebook and alarms. Doing a crossword or Sudoku puzzles will also keep your brain active.

Dementia With Lewy Bodies And Parkinson Disease Dementia

, MD, PhD, Department of Neurology, University of Mississippi Medical Center

Dementia with Lewy bodiesParkinson disease dementia

Dementia is chronic, global, usually irreversible deterioration of cognition.

Dementia with Lewy bodies is the 3rd most common dementia. Age of onset is typically > 60.

Lewy bodies are spherical, eosinophilic, neuronal cytoplasmic inclusions composed of aggregates of alpha-synuclein, a synaptic protein. They occur in the cortex of some patients who have dementia with Lewy bodies. Neurotransmitter levels and neuronal pathways between the striatum and the neocortex are abnormal.

Lewy bodies also occur in the substantia nigra of patients with Parkinson disease, and dementia may develop late in the disease. About 40% of patients with Parkinson disease develop Parkinson disease dementia, usually after age 70 and about 10 to 15 years after Parkinson disease has been diagnosed.

Because Lewy bodies occur in dementia with Lewy bodies and in Parkinson disease dementia, some experts think that the two disorders may be part of a more generalized synucleinopathy affecting the central and peripheral nervous systems. Lewy bodies sometimes occur in patients with Alzheimer disease, and patients with dementia with Lewy bodies may have neuritic plaques and neurofibrillary tangles. Dementia with Lewy bodies, Parkinson disease, and Alzheimer disease overlap considerably. Further research is needed to clarify the relationships among them.

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Educate Others About Lewy Body Dementia

Most people, including many health care professionals, are not familiar with LBD. In particular, emergency room physicians and other hospital workers may not know that people with LBD are extremely sensitive to antipsychotic medications. Caregivers can educate health care professionals and others by:

  • Informing hospital staff of the LBD diagnosis and medication sensitivities, and requesting that the person’s neurologist be consulted before giving any drugs to control behavior problems.
  • Sharing materials with health care professionals who care for the person with LBD. Materials are available from NIH, as well as the Lewy Body Dementia Association and the Lewy Body Dementia Resource Center.
  • Teaching family and friends about LBD so they can better understand your situation.

Make Plans For The End Of Life

Lewy Bodies Disease and Parkinsons Dementia

Advance care planning is an important part of end of life care. Planning ahead can improve the quality of life of the person with LBD and their caregivers and help ensure that the person with LBD has input into health care and legal and financial decisions. Having these conversations early allows the person to actively participate in the decision-making process and express their personal wishes.

For health care providers and caregivers who donât have experience with LBD, it can be challenging to recognize the end of life. LBD is unpredictable. It can be hard to know when the person will die, and the process may be shorter or longer than expected, which may make coping more difficult. Staying in touch with the personâs physician can help you decide when to pursue end of life care and what to expect towards the end of life. Some physicians may be unlikely to initiate end of life conversations. It is important for caregivers to take an active role during appointments and come prepared.

Spending time and doing simple activities together towards the end of life may help ease the process. Listening to music, spending time outdoors, or watching a favorite television show are just a few examples of activities you can do. Some family members find a lot of value in simply holding their loved oneâs hand and talking to them in their last few days.

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Lewy Body Dementia Vs Parkinsons Disease Dementia

Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.

Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.

The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.

This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.

The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.

Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.

Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.

Parkinsons disease itself isnt fatal, but complications can be.

Research has shown a median survival rate of about

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Who Gets Dementia With Lewy Bodies

Around 5% of people with a diagnosis of dementia are recorded as having DLB, but there is good evidence that the condition is under-diagnosed. Scientists think DLB may account for up to 20% of all dementia.

Dementia with Lewy bodies affects men and women roughly equally. As with most other types of dementia, DLB becomes increasingly common over the age of 65. It can also affect people younger than this.

There is not much evidence that anything we might be exposed to during our lives increases the risk of DLB. Having a traumatic head injury may increase the risk of developing Parkinsons disease later in life, but its not known whether this also applies to DLB.

Almost all people who develop DLB have a sporadic form, which means that the main cause is unknown. Some genes may increase the risk of developing DLB.

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Outlook For Dementia With Lewy Bodies

How quickly dementia with Lewy bodies gets worse varies from person to person.

Home-based help will usually be needed, and some people will eventually need care in a nursing home.

The average survival time after diagnosis is similar to that of Alzheimer’s disease around 6 to 12 years. But this is highly variable and some people live much longer than this.

If you or a loved one has been diagnosed with dementia, remember that you’re not alone. The NHS and social services, as well as voluntary organisations, can provide advice and support for you and your family.

Treatment Of Hallucinations Delusions And Agitation

SPARK: Robin Williams and His Battle with Lewy Body Dementia

Visual hallucinations, delusions, and other productive-psychotic symptoms may occur early on in the disease course in dementia with Lewy bodies. In Parkinsons disease, these often develop only during the course of the disease, and in a scenario where new hallucinations or psychoses occur for the first time after a change in medication, the most recent change in medication should be reversed . If this does not yield the desired success or if hallucinations occur without prior change of medication, the medication for Parkinsons disease should be changed according to the treatment algorithm provided in the guidelines .

Algorithm for the treatment of psychosis PDD, Parkinsons disease dementia DLB, dementia with Lewy bodies

If this does not improve the productive-psychotic symptoms to a satisfactory degree, the use of antipsychotics may be considered. This is particularly the case when a reduction in the Parkinson medication is followed by a substantial deterioration in motor functioning, so that a minimum dose of levodopa is a definite requirement.

It is in particular the productive-psychotic symptoms of dementia with Lewy bodies and Parkinsons disease dementia that place a heavy burden on relatives and carers they are also responsible for a multitude of admissions to residential care homes, so that medication treatment is absolutely essential.

In acute situations, patients may be given a short course of clomethiazole and lorazepam .

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How Is Lbd Different From Parkinsons Or Alzheimers

These diseases are similar in a lot of ways. But there are some key differences in the symptoms that affect people with LBD and when those symptoms happen.

LBD may not cause short-term memory loss like Alzheimerâs. People with both conditions have trouble with thinking, alertness, and paying attention. But in LBD, those problems come and go. The disease can also cause hallucinations, often in the first few years someone has LBD. People with Alzheimerâs usually donât have hallucinations until the later stages.

People with LBD also often act out their dreams and make violent movements when theyâre asleep. Itâs called REM sleep behavior disorder. Sometimes, itâs the first sign that someone has LBD.

LBD and Parkinsonâs disease both cause movement problems, like stiff muscles and tremors. But most people with Parkinsonâs donât have problems with their thinking and memory until the very later stages of their disease. Sometimes, they donât have it at all. In the type of LBD known as Parkinsonâs disease with dementia, these problems begin much sooner.

People with LBD also need different drugs for their condition than the ones that treat Parkinsonâs or Alzheimerâs.

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Difference Between Parkinsons Disease Dementia And Dementia With Lewy Bodies

Technically, the difference between these two conditions lies in how quickly the cognitive difficulties and hallucinations develop in relation to the movement issues. In DLB, the cognitive difficulties and hallucinations develop much sooner in the disease course than in PDD, sometimes even prior to the movement difficulties. Because of the similarities between PD, PDD, and DLB, current thinking in the medical community is that they should be viewed as related diseases which fall along a continuum of Lewy body disorders.

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Treatment Of Motor Symptoms In Parkinsons Disease

Treatment of motor, psychological/psychiatric, and autonomous symptoms of Parkinsons disease should be symptomatic, depending on the degree of clinical impairment and independently of a diagnosis of dementia with Lewy bodies or Parkinsons disease dementia. Attention needs to be paid to the reduced response of motor symptoms, especially akinesis, to levodopa in 40% of patients with Lewy body dementia. Owing to the development of the dementia and the tendency to develop psychoses in dementia with Lewy bodies, monotherapy with levodopa is usually recommended. Studies of combination treatment with dopamine agonists and levodopa have not been conducted in patients with Lewy body dementia whether combination treatment with dopamine agonists is useful and tolerable depends on the individual case. This requires consideration, especially bearing in mind the patients age . Close monitoring for possible psychotic symptoms is urgently advised. The administration of anticholinergic drugs is contraindicated.

Caregiver Corner: Lewy What Explaining Lewy Body Dementia

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Dementia with Lewy bodies is a common progressive brain disease that affects thinking, movement, behavior and sleep. Approximately 1.3 million Americans have Lewy body dementia, but may not be correctly diagnosed because many doctors are unfamiliar with it. Most people see multiple doctors before receiving the final diagnosis of Lewy body dementia. Their first response is often, Lewy what?

Symptoms and Diagnosis

Lewy body dementia is a general term and includes both Parkinsons disease dementia and dementia with Lewy bodies . LBD symptoms include dementia, visual hallucinations and frequent variations in cognitive ability, attention or alertness. There are also changes in walking or movement, as well as a sleep disorder called REM sleep behavior disorder, in which people physically act out their dreams. LBD patients may also have a severe sensitivity to medications prescribed for hallucinations.

Treatment

Many LBD symptoms are highly treatable and aggressive symptom detection and treatment can improve quality of life for both the person with LBD and their caregiver. Some Alzheimers and Parkinsons medications can help cognition, behavior and movement symptoms. Family caregivers are an important link in the partnership with healthcare professionals and also require significant support throughout the illness. For more information and to find support visit www.lbda.org.

Elizabeth Patrick is the Marketing and Communications Manager for the Lewy Body Dementia Association.

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Discuss Lewy Body Dementia Diagnosis With Family

Not all family members may understand or accept LBD at the same time. This can create conflict. Some adult children may deny that their parent has a problem, while others may be supportive. It can take a while to learn new roles and responsibilities.

Family members who visit occasionally may not see the symptoms that primary caregivers see daily and may underestimate or minimize your responsibilities or stress. Professional counselors can help provide guidance on how families can work together to manage LBD.

Although LBD and Alzheimer’s disease are different disorders, they share similar family concerns. For more information, read Helping Family and Friends Understand Alzheimer’s Disease and Helping Children Understand Alzheimer’s Disease.

The Difference Between Parkinsons Disease And Lewy Body Dementia

One of the most confusing concepts to explain in the clinic is the difference between Parkinsons Disease, Parkinsons Disease Dementia and Lewy Body Dementia. Ultimately people with Parkinsons can look very similar with motor and non-motor problems. This is particularly tricky when PwP first present but the easiest way to consider Lewy Body Dementia is like having a very aggressive progression of Parkinsons where patients are dementing in the first year of their condition whereas this process is much slower when patients develop Parkinsons Disease Dementia. Indeed, clinically Lewy Body Dementia patients look like they have a cross between Parkinsons and Alzheimers, which is actually close to what is seen down the microscope when researchers study the brain. Understanding the differences between Parkinsons Disease and Lewy Body Dementia is not only difficult for patients and their families but has led some professional groups to try and lump all of these patients together under one umbrella, which probably does little to help individual families appreciate what the future holds.

Hopefully this video will help you to gain a more complete understanding of the differences between Parkinsons Disease, Parkinsons Disease Dementia and Lewy Body Dementia.

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Prognosis For Lewy Body Dementia

Unfortunately, there is currently no cure for Lewy Body Dementia. The average life expectancy for people with LBD after the onset of symptoms is 5 to 8 years. However, individuals with Lewy Body Dementia have lived anywhere between 2 and 20 years depending on their age, the severity of their symptoms, and their other medical conditions.

The course of Lewy Body Dementia can vary across people, but is usually progressive but vacillating. In other words, across time, people decline, but there may be periods of return to a higher functioning level. This decline may be exacerbated by medications and/or infections/diseases.

What You Need To Know

Coding Parkinson’s Disease with Lewy Body Dementia
  • Lewy body dementia is a form of progressive dementia that affects a persons ability to think, reason, and process information.
  • Diagnosing Lewy body dementia can be challenging an estimated 1.4 million Americans are living with the disease.
  • LBD has three features that distinguish it from other forms of dementia:
  • Fluctuating effects on mental functioning, particularly alertness and attention, which may resemble delirium
  • Recurrent visual hallucinations
  • Parkinson-like movement symptoms, such as rigidity and lack of spontaneous movement.
  • Interventions used in other forms of dementia may help people living with Lewy body dementia. Its important to work with a specialist familiar with the many aspects of the disease.
  • Lewy bodies are clumps of abnormal protein particles that, for reasons that are not fully understood, accumulate in the brain. These deposits cause a form of dementia called Lewy body dementia, or LBD which is what the late actor and comedian Robin Williams suffered from.

    LBD is not the same as Parkinsons, but the two are closely related: LBD causes some or all of the motor symptoms of Parkinsons. More than 1 million people in the U.S. are affected by Lewy body dementia, according to the Lewy Body Dementia Association.

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