10.10.16 DeMystifying Alzheimer’s with Mary Yamin-Garone More About Lewy Dementia
Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today I’ll be talking more about Lewy Body Dementia.
While the exact cause of Lewy Body dementia isn’t known, scientists are learning more about its biology and genetics. They know an accumulation of Lewy bodies is related to a loss of certain neurons in the brain that produce important neurotransmitters or chemicals that act as messengers between brain cells. The first, acetylcholine, is vital to memory and learning. The other, dopamine, is vital to behavior, cognition, movement, motivation, sleep and mood.
They’re also learning more about risk factors. Age is the greatest. Most individuals who develop LBD are over 50.
Other known risk factors include:
- Diseases and health conditions: In particular, Parkinson’s disease and REM sleep behavior disorder are linked to a higher risk of LBD.
- Genetics: Having a family member with Lewy Body Dementia may increase an individual’s risk, although LBD isn’t generally considered a genetic disease. Currently, no genetic test can accurately predict if someone will develop LBD.
- Lifestyle: No specific lifestyle factor has been proven to increase the risk for LBD. Some studies do suggest that a healthy lifestyle that includes regular exercise, mental stimulation and a healthy diet might lower the chance of developing age-associated dementias.
Who can diagnose LBD
Many physicians and medical professionals aren’t familiar with Lewy Body dementia. As a result, individuals may have to consult with several doctors before getting a diagnosis. Visit your regular doctor if you or a loved one experience changes in thinking, movement or behavior. You will probably be referred to a neurologist, who typically has the expertise needed to diagnose LBD. Geriatric psychiatrists, neuropsychologists and geriatricians also may be skilled in diagnosing the condition.
How Lewy Body Dementia is diagnosed
It’s important to know which type of LBD an individual has. That way, a treatment plan can be adapted to their particular symptoms and they can understand the disease’s likely progression. Typically, the “1-year rule” is used to diagnose the form of LBD. If cognitive symptoms appear within one year of movement problems, the diagnosis is dementia with Lewy bodies. If cognitive problems develop one year after the onset of movement problems, it’s Parkinson’s disease dementia.
No matter what the initial symptoms, in time all those suffering from LBD will develop the same symptoms because of the presence of Lewy bodies in the brain. There are some differences, however. Dementia with Lewy bodies may progress faster than Parkinson’s disease dementia.
No one test can diagnose LBD. Instead, it’s done by eliminating other conditions that may cause the same signs and symptoms.
Your doctor may check for signs of Parkinson’s, strokes, tumors or other medical conditions that can affect the brain and physical function. A neurological exam may test:
- Muscle tone
- Eye movements
- Sense of touch
Your doctor also will perform a test that assesses your memory and thinking skills. It can be done in less than 10 minutes right in the office. Although not useful in distinguishing Lewy body dementia from Alzheimer’s, it can indicate dementia. More extensive tests can take several hours but they’ll help identify Lewy body dementia.
Blood tests are another part of the diagnosis. The results can eliminate physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland.
Brain scans, such as an MRI, PET of CT scan, will identify a stroke or bleeding and rule out the possibility of a tumor. Although dementias are diagnosed based on the individual’s history and a physical exam, certain features on imaging studies can suggest different types of dementia, like Alzheimer’s or Lewy Body. Your doctor may conduct a sleep evaluation to check for REM sleep behavior disorder or an autonomic function test to see if there are signs of heart rate and/or blood pressure instability.
No brain scans or medical tests can definitively diagnose Lewy Body Dementia. At this time, it only can be diagnosed with certainty by a brain autopsy.
Researchers are studying ways to diagnose LBD more accurately in the living brain. Certain types of neuroimaging, such as positron emission tomography and SPECT, show promise in detecting the differences between dementia with Lewy bodies and Alzheimer’s. These methods may help diagnose certain features of the disorder, like dopamine deficiencies. They’re also investigating the use of lumbar puncture (spinal tap) to measure proteins in cerebrospinal fluid that might distinguish dementia with Lewy bodies from Alzheimer’s and other brain disorders.
It’s important to tell the doctor if you or a loved one are experiencing any symptoms involving thinking, movement, sleep, behavior or mood. Let him know about other health problems and provide a list of all current medications, including prescriptions, over-the-counter drugs, vitamins and supplements. Certain medications can worsen LBD symptoms.
Some things to consider when faced with a diagnosis of Lewy Body Dementia include:
- Find a doctor to manage you or your loved one’s care. Ask about being put on the medications typically prescribed for Alzheimer’s patients. They’ll enhance independence.
- Start building a long-term care plan. Knowing how care will be provided and paid for are critical.
- Have fun and make memories. If there’s a trip you or your loved one want to take or an activity you want to participate in, the early stages are the time to do it.
- Join a support group. The Lewy Body Dementia Association sponsors support groups for families. You also can contact the Family Caregiver Alliance.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me next time for more about Lewy Body Dementia.