Lewy body dementia

Overview  

Lewy body dementia, also known as dementia with Lewy bodies (LBD), stands as the second most common form of dementia after Alzheimer’s disease. This condition is characterized by the formation of protein clusters called Lewy bodies within nerve cells of the brain, particularly impacting regions associated with cognition, memory, and movement. Over time, LBD leads to a progressive decline in mental abilities. It may manifest with visual hallucinations, changes in alertness, and even Parkinson’s–like symptoms such as muscle rigidity, slow movements, walking difficulties, and tremors. 

While LBD primarily affects individuals over 65, its symptoms can resemble those of other neurological disorders like Alzheimer’s and Parkinson’s disease. Unfortunately, there is no cure for LBD, but there are management options available. Medications can help alleviate some symptoms, and nonmedical therapies like physical and speech therapy can also provide valuable support for individuals and their loved ones dealing with this challenging condition.

Symptoms   

Lewy body dementia can lead to a range of symptoms, including: 

• Visual hallucinations: People with Lewy body dementia often experience regular visual hallucinations, where they see things that aren’t actually there. These hallucinations can involve shapes, animals, or people. Sometimes, they might also hear, smell, or feel things that aren’t real. 
• Movement issues: This condition can cause movement problems similar to Parkinson’s disease. These may include slow movements, stiff muscles, trembling, or difficulty walking, which can increase the risk of falls. 
• Problems with automatic functions: Lewy body dementia can affect the autonomic nervous system, which controls automatic bodily functions like blood pressure, heart rate, sweating, and digestion. This can lead to issues such as sudden drops in blood pressure upon standing, dizziness, falls, loss of bladder control, and constipation.  
• Sleep troubles: Many individuals with Lewy body dementia experience a sleep disorder called REM sleep behavior disorder. This condition makes people physically act out their dreams while asleep, leading to actions like punching, kicking, yelling, or screaming during sleep. 
• Varying attention: Individuals with this condition may have periods of drowsiness, extended periods of staring into space, frequent daytime naps, or difficulties with organized speech. 
• Mood changes: Depression can develop in people with Lewy body dementia, leading to feelings of sadness and hopelessness. 
• Cognitive problems: Cognitive problems are common in Lewy body dementia, resembling those seen in Alzheimer’s disease. These issues may involve confusion, difficulty concentrating, problems with spatial awareness, and memory loss. 
• Apathy: A loss of motivation and interest in activities may also occur. 

In summary, Lewy body dementia can manifest through various symptoms, including visual hallucinations, movement problems, issues with automatic bodily functions, cognitive challenges, sleep disturbances, fluctuating attention, mood changes, and apathy. Understanding these symptoms can help in early diagnosis and appropriate care. 

Causes  

Lewy body dementia (LBD) and Parkinson’s disease dementia both result from the buildup of Lewy bodies, protein clumps in the brain. The exact causes of LBD are unclear but may involve a mix of genetics, environment, and aging. Recent research found genetic risk factors in APOE and GBA genes, which can increase the risk of LBD, but such genetic causes are rare. Most cases of LBD are not inherited.  

Risk factors 

Several factors may increase one’s risk of developing Lewy body dementia, such as:  

• Age: This condition commonly affects people over the age of 60.  
• Sex: Men are at a higher risk of Lewy body dementia than women.  
• Family history: The likelihood of having LBD is increased by a family history or having a family member with the condition and Parkinson’s disease.