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Lewy Body Dementia: Introduction
People with Lewy body dementia have a progressive decline in their memory and ability to think; in this way, Lewy body dementia resembles Alzheimer's disease. However, the cognitive ability or alertness of a person with Lewy body dementia is more likely to fluctuate from one moment to the next, which is not like Alzheimer's disease. They also often have visual hallucinations (seeing things that aren't there) and delusions (believing something that is not true). On the surface, people with Lewy body dementia often appear to have Parkinson's disease since they often also have problems with movement. This is because the same structures of the brain are affected in Lewy body dementia and Parkinson's disease.
How Common Is Lewy Body Dementia?
Dementia with Lewy bodies is the third most common type of dementia after Alzheimer's disease and vascular dementia. Lewy body dementia is progressive, like Alzheimer's disease. This means that with current treatments, individuals who have it will only get worse with time in terms of function and ability.
Other Names
There are several subtypes and different names for Lewy body dementia such as:
- Diffuse Lewy body disease
- Cortical Lewy body disease
- Senile dementia of Lewy type
- Lewy body variant of Alzheimer's
- Parkinson's disease with dementia
The last two types on the list are forms of Lewy body dementia that occur within patients who also have Alzheimer's disease or Parkinson's disease, respectively.
More About Causes, Symptoms, and Diagnosis
Causes, risk factors, and symptoms of Lewy body dementia are somewhat different than other forms of dementia. Follow the links below to learn more.
More About Treatment
There is no cure available for Lewy body dementia at this time. Currently, there are also no medications approved by the FDA that specifically target this form of dementia. However, many individuals with the disease seem to benefit from the use of cholinesterase inhibitors, such as Aricept, Razadyne, or Exelon.
Cholinesterase Inhibitors
Cholinesterase inhibitors are a group of drugs commonly prescribed to individuals with Alzheimer's disease and other forms of dementia in order to slow the disease. For individuals with dementia, brain function decreases in part because their brain cells are no longer able to communicate with one another as well as they used to. Cholinesterase inhibitors act to increase levels of the neurotransmitter acetylcholine, a chemical that helps brain cells (neurons) communicate and work better. In practical terms, you may find that your loved one may be better able to remember names and details or perform activities with fewer problems when taking these medications.
There are currently four cholinesterase inhibitors on the market:
- Aricept® (generic name: donepezil)
- Razadyne®, formerly known as Reminyl (generic name: galantamine)
- Exelon® (generic name: rivastigmine)
- Cognex® (generic name: tacrine) - less commonly prescribed
These medications are typically prescribed to individuals in the early to middle stages of dementia. Aricept® was recently approved to treat severe dementia as well. It is important to remember that they only slow the progression of dementia and Alzheimer's disease; they do not stop or reverse their course. Additionally, as an individual's dementia advances, these medications are not able to balance out the damage that has already occurred. These medications typically help for only months to a few years.
In general, individuals who use cholinesterase inhibitors experience few side effects. The most commonly-experienced side effects are gastrointestinal problems, such as nausea, diarrhea, vomiting, and loss of appetite.
Antipsychotic drugs should not be taken by persons with Lewy body dementia unless otherwise directed by a physician. Even though these medications can help manage hallucinations, in Lewy body patients, these drugs can make movement problems worse.
Apart from the differences already noted, approaches to diagnosis and treatment of Lewy body dementia are similar to those of other forms of dementia. Follow the links below to learn more.
Suggestions for Caregivers
The most important thing to realize when caring for someone with Lewy body dementia is that you need to be flexible. Your loved one's symptoms may change from day to day, becoming better or worse, and this can be difficult for you and others to explain and handle. Remind others that your loved one is not simply "acting up."
As Lewy body dementia develops, your loved one will also have an increasingly difficult time maintaining balance and moving safely. Some caregivers find that suggesting the use of a cane or a walker can be helpful. Additionally, there are several things you can do around the house to make sure that your loved one is able to move about safely and easily in order to prevent future accidents.
As with Alzheimer's disease, Lewy body dementia will continue to progress and reduce your loved one's abilities to make appropriate decisions. Be sure to review our pages on legal and financial issues to learn what can be done before your loved one reaches the later stages of the disease.
View References Kalapatapu R, Swanberg M. eMedicine. Parkinson Disease Dementia. Available at http://emedicine.medscape.com/article/289595-overview. Retrieved March 31, 2009.- Printer-friendly version
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