Lewy Body Dementia (LBD) is a disease that is related to Parkinson Disease, but has significant involvement of memory and thinking as well.
Like Parkinson Disease, people with LBD get slowed movements, stooped unsteady shuffling gait, loss of facial expression, and tendency to fall. Additionally, people with LBD also develop significant changes to memory and thinking. Commonly, they will have major fluctuations in their attention and awareness, which can last for significant periods of the day, or can be momentary. This may manifest as staring spells, spending most of the day sitting or sleeping, or difficulty following events. Oftentimes, the types of thinking changes will look like psychiatric disease like major depression, odd false beliefs (delusions) or seeing things that are not there (visual hallucinations).
Over time, both the movement and cognitive symptoms get worse. These symptoms tend to develop slowly, but somewhat quicker than in dementia of the Alzheimer type. Rarely, the symptoms may develop extremely rapidly.
Late in the course, people may develop problems with injuries from falls, immobility, or swallowing problems.
Diagnosis and Treatment
How it’s diagnosed
LBD is diagnosed based on the signs and symptoms above by a qualified doctor. Oftentimes, an MRI and basic bloodwork is done to make sure that there are no other explanations for the symptoms.
The movement problems in LBD can be treated with Parkinson Disease medication, such as carbidopa-levodopa. Depression and motivation problems may respond to antidepressants. Antipsychotic medications such as quetiapine can help behavior, psychiatric problems such as delusions and hallucinations, and with agitation, but can also worsen movements, so need to be used with caution. Alzheimer’s medications such as donepezil seem to help with the fluctuations in many with LBD.
Supportive treatment for problems with behavior, swallowing, speech and communication, falls and mobility are available. Many people with LBD benefit immensely from occupational therapy, physical therapy, and speech therapy.