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Dementia with Lewy bodies (DLB) is a form of progressive dementia caused by degeneration of the tissues in the brain.
More than a million people in the U.S. are affected by DLB, according to the Lewy Body Dementia Association.
People with DLB have a buildup of abnormal protein particles called Lewy bodies in their brain tissue. Lewy bodies are also found in the brain tissue of people with Parkinson disease (PD) and Alzheimer disease (AD). However, in these conditions, the Lewy bodies are generally found in different parts of the brain.
The presence of Lewy bodies in DLB, PD, and AD suggests a connection among these conditions. But scientists haven’t yet figured out what the connection is.
DLB affects a person’s ability to think, reason, and process information. It can also affect personality and memory. DLB becomes more prevalent with age, and typically first presents when a person is in his or her 60s and 70s. DLB is progressive, which means it continues to develop over time. There are several types of dementia with different causes.
Dementia with Lewy bodies (DLB) is caused by degeneration or deterioration of brain tissue. DLB may be genetic, but it is not always clear why someone develops DLB. Lewy bodies in the brain affect substances called neurotransmitters. A neurotransmitter is a chemical that helps to transmit signals from one nerve cell to another.
One type of neurotransmitter is dopamine, which helps transmit signals that cause muscle movement. Lewy bodies interfere with the production of dopamine. A lack of dopamine causes movement problems, such as those seen in Parkinson disease.
Acetylcholine is another type of neurotransmitter found in the parts of the brain responsible for memory, thinking, and processing information. When Lewy bodies build up in these areas, they use up the acetylcholine, causing symptoms of dementia.
According to the National Institute of Neurological Disorders and Stroke, dementia with Lewy bodies (DLB) has 3 features that distinguish it from other forms of dementia:
In DLB, memory problems often occur later in the progression of the disease.
DLB can be confused with other forms of dementia, but it also has unique features, such as hallucinations and delirium.
The primary sign of DLB is a progressive decline in cognitive functions, such as memory, thinking, and problem-solving. The decline in cognitive function is enough to affect the ability to work and perform normal daily activities. Although memory may be affected, it isn’t usually as impaired as in someone with Alzheimer disease.
DLB is generally diagnosed when at least 2 of the following features are also present with dementia:
Additional signs and symptoms seen in DLB include:
The symptoms of DLB may resemble other conditions. Always see a health care provider for a diagnosis.
The only definite way to diagnose dementia with Lewy bodies (DLB) is by doing an autopsy – there are tests that show the presence of Lewy bodies. So, DLB is diagnosed based on medical history, a physical exam, and symptoms.
In addition to a complete medical history and physical exam, the health care provider may order some of the following:
Dementia with Lewy bodies (DLB) has no cure. Treatment for DLB involves addressing the symptoms.
Medications used to treat Alzheimer disease (AD) and Parkinson disease (PD) are often used to treat DLB. Other treatments, such as supportive care, physical therapy, psychotherapy, and behavioral interventions, may be used, too.
It’s important that the health care provider treating DLB is familiar with all aspects of the disease, because other specialists are often involved. Because DLB shares features with AD and PD, those features will need to be treated. Many people with DLB, however, can’t tolerate some of the medications for AD or PD. Caution must be used when prescribing certain medications for DLB.
Interventions used in other forms of dementia may also help people living with dementia with Lewy bodies (DLB). These include using glasses or hearing aids as needed, educating the patient and family, providing a structured environment, and teaching behavioral interventions. The interventions depend on the specific needs of each patient and his or her caregivers. Needed interventions will change over time as the disease progresses.
Hallucinations may be managed by simply ignoring them and educating the caregiver(s) about them. Improving lighting and keeping the patient around other people also helps.
It’s important to work with a health care provider familiar with DLB and the many aspects of the disease. Other specialists are often involved, too.
If you are diagnosed with FTD, you and your caregivers should talk with your health care providers about when to call them. Your health care providers will likely advise calling if your symptoms become worse, or if you have obvious and/or sudden changes in behavior, personality, or speech. This includes mood changes, such as increasing depression or feeling suicidal.
Tips to help you get the most from a visit to your health care provider:
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