Dementia with Lewy Bodies (DLB) is a progressive degenerative disease or syndrome of the brain. It shares symptoms - and sometimes overlaps - with several diseases, especially with two common diseases of older adults, Alzheimer’s and Parkinson’s.
DLB is named after smooth round protein lumps, called Lewy bodies, that are found in the nerve cells of affected brains. Lewy bodies are often present in the nuclei (nerve cells) of brains afflicted with a variety of disorders. In DLB, the Lewy bodies are found throughout the outer layer of the brain (the cerebral cortex) and deep inside the midbrain or brainstem. These “abnormal protein structures” were first described in 1912 by Frederich Heinrich Lewy, M. D., a contemporary of Alois Alzheimer who first identified the more common form of dementia that bears his name.
What are the symptoms?
The dementia associated with Lewy body disease affects:
memory
language
the ability to judge distances
the ability to carry out simple actions
the ability to reason.
People with this form of dementia suffer hallucinations for example seeing a person or pet on a bed or a chair when nothing is there.
They may suffer from falls for no apparent reason, because their ability to judge distances and make movements and actions accurately is disrupted.
They may develop some Parkinson type symptoms such as slowness of movement, stiffness and tremor. In a few cases heart rate and blood pressure are affected.
The abilities of the affected person often fluctuate from hour to hour, and over weeks and months. This sometimes causes carers to think that the person is 'putting on' their confusion.
If the physician tries to treat patients with Lewy Body dementia with anti-psychotic medications to get rid of the hallucinations, the Lewy Body patient often will have severe side effects from the medication, even on very low dosages. If Lewy Body patients are given anti-psychotic medication, they are at three to four times greater risk of severe side effects or even death than other patients.
It is believed that DLB, as a defined disease process, accounts for as many as 20% of the seven million cases of dementia in the United States and for as much as one-third of dementing illness in elderly Americans. This makes DLB the second most common form of dementia after Alzheimer’s.
The cause of DLB is unknown and no specific risk factors are identified. Cases have appeared among families but there does not seem to be a strong tendency for inheriting the disease. Genetic research may reveal more information.
I have taken care of several people with DLB. You can tell what the diagnosis is by their stooped, shuffling gait. The hallucinations are severe in some cases, and as mentioned above, the medications that will help with the hallucinations may also harm. The hallucinations can make the person violent and agitated.
About 2 years ago I was called at 2 a.m. because a staff member had been taken to the floor by a resident suffering from DLB. He saw her as his ex- wife who had stolen all his money. The staff member was terrified, rightly so, and by the time I had made it to the facility the resident had quietly went to his room and was sleeping. This man had been a gentleman all his life. He would be devastated to know the terror he had caused. He couldn't help it. He has since passed.
There are so many diseases that cause dementia. They seem unreal, and in this age, I wonder why we can't find a cure. The people suffering from these illnesses are heros, through them we are learning, and someday, I believe we will see an end to all of the suffering.
