Emeritus Senior Living runs independent and assisted living retirement communities in the US. (There are several in the Bay Area.) See emeritus.com. (They offer a free "ask the expert" service that connects "you to two eldercare experts to help answer all your senior care questions.")
They've developed "Elder Health Guides" on a variety of topics: dementia, diabetes, incontinence, memory and memory loss, Alzheimer's, Creutzfeldt-Jakob, Huntington's, Parkinson's, Pick's, and Lewy Body Disease.
In the guide, they refer to Lewy Body Dementia as "Lewy Body Disease." I find this confusing because Parkinson's Disease is also a Lewy Body Disease.
Here's a link to their Lewy Body Disease guide and the full text of the guide.
Lewy Body Disease: An Overview
1. Introduction to Lewy Body Disease
2. Definition of Lewy Body Disease
3. Signs and Symptoms
4. Stages of Lewy Body Disease
5. Diagnosing Lewy Body Disease
6. Treating Lewy Body Disease
7. Lewy Body Disease References
Introduction to Lewy Body Disease
Lewy body disease can be difficult condition for you and your family to manage. People who have this condition may see things that aren't there and have difficulty moving and taking care of themselves. They may insist that things are happening that clearly aren't. They may appear confused and disoriented. If you are dealing with issues like this, it is important to discuss them with the doctor. You may be able to find support groups in your area too. Other people are probably having similar experiences and may be able to offer suggestions on how to handle them. This article will give you information on the disease, what to expect over time, treatment options and provide sources for help.
Definition of Lewy Body Disease
Lewy body disease is the most common type of dementia seen in the elderly. It is sometimes referred to as dementia with Lewy bodies. It affects over 800,000 people in the United States and causes up to 20% of all dementia cases. It usually strikes people between the ages of 50 and 85 and affects men more often than women.
This condition causes a protein to be deposited in the brain. These protein deposits are called Lewy bodies. They occur in parts of the brain that control memory and movement. Lewy bodies were first described by Frederich Heinrich Lewy, a physician.
This disease is similar to Alzheimer's and Parkinson's disease but has some unique aspects. Someone with Lewy body disease may have visual hallucinations, that is, see things that aren't there such as unusual colors, shapes, animals and people. This is often the first symptom of the disease. People with the condition also have problems with alertness, memory loss, posture, moving, confusion and muscle stiffness. Someone with the disease may live anywhere from 6 to 12 years after they first develop symptoms.
Signs and Symptoms of Lewy Body Disease
Lewy body disease is a disease in which mental function declines over time. This can cause symptoms that limit someone's ability to perform functions of daily living. Symptoms include:
* Changing alertness
* Lack of energy
* Problems with speaking
* Inability to sleep
* Visual hallucinations (seeing things that aren't there)
* Inability to control body temperature and blood pressure
* Stiff muscles
* Loss of movement
* Memory loss
* REM sleep behavior disorder
REM sleep behavior disorder involves violent movement and speech such as swearing and screaming during sleep. The movement seems to be acting out what is occurring in dreams. Movement can be violent enough to injure bed partners.
In early stages of the disease, mental ability can vary a lot from day to day. Changing levels of awareness can distinguish this condition from Alzheimer's disease. Someone might be able to take part in conversation easily one day and then not talk at all the next day.
Because the ability to move is impaired, someone who has Lewy body disease may be at risk of falling. If he or she is still living at home, consider modifying the house to prevent falls. This can include such things as installing grab bars in the bathroom and getting rid of loose rugs.
Stages of Lewy Body Disease
In Lewy body disease, mental function gets worse over time. Increasing levels of supervision may be required as someone's condition grows worse. With increasing forgetfulness, it will be important to be present to provide assistance and reassurance. Initially, simple reminders to take medicine or warnings to prevent injury may be all that is necessary. Eventually, it may be necessary to lock doors to prevent wandering or limit access to appliances if injury is likely. Let your neighbors know if a family member is likely to wander. You may also want to notify the local police.
Diagnosing Lewy Body Disease
Because Lewy body disease is similar to Alzheimer's and Parkinson's disease, diagnosis can be difficult. It is important to diagnose it correctly because it develops differently from Alzheimer's and Parkinson's disease. Because it is hard to diagnose, many tests may be required. It will be important to rule out other conditions. Your doctor will ask questions about symptoms and medical history. With more information, the doctor will be better able to assist you. The doctor may want to conduct the following tests:
* Brain function tests Â The doctor will test memory, speech and thinking. You or your loved one will be asked questions to assess these abilities. Results will be compared with results from other people of similar age and education. The doctor may want to talk with other people about these functions. They may be asked about use of alcohol and head injuries that occurred in the past. The doctor will want to know if there have been any personality changes.
* Psychiatric tests Â Tests will be performed to see if depression or other mental problems are present.
* Blood tests Â Blood will be collected to look for infection, vitamin deficiencies, medicine levels and disorders of certain organs such as the liver, thyroid and kidneys. Collecting blood will take only a few minutes and will involve inserting a small needle into a vein in your arm. There may be slight bruising later.
* Brain imaging Â The doctor may want to take pictures of the brain to look for problems such as stroke or tumors. Pictures may be taken with an x-ray machine (CT scan), radio waves (MRI) or small amounts of radioactive material (PET). The PET scan can show images of blood flow in the brain.
* Other tests Â Your doctor may order other tests in order to make sure of the correct diagnosis.
Typically, three symptoms are used to distinguish Lewy body dementia from Alzheimer's and Parkinson's disease. Lewy body dementia has changing levels of alertness, visual hallucinations (seeing things that aren't there) and movement problems.
Treating Lewy Body Disease
Unfortunately, there is no cure for Lewy body disease. There is no way to slow down the disease either. Some medicines can help with the symptoms of the disease, however. These medicines include:
* Donepezil and rivastigmine. These help with thinking ability but can make movement problems worse.
* Levodopa. This medicine helps with stiff muscles and improves movement.
* Memantine. This may help with behavioral issues.
* Antidepressants. These improve mood.
* Anticonvulsants. These improve muscle control.
* Clonazepam. Used for REM sleep behavior disorder.
People with Lewy body disease can be especially sensitive to some antipsychotics, which should be used with care if at all. If you or a loved one notices a problem, contact the doctor right away.
Other treatments that may be helpful for people with Lewy body disease include:
* Physical therapy
Other Actions to Take
As Lewy body disease gets worse with time, it will be important to modify the home and day-to-day activities. This will help the person with Lewy body disease feel safe and comfortable. Here are some simple things to improve his or her quality of life:
* Simplify communication. Make sure you can be seen. To focus attention, touch him or her on the arm or shoulder. Speak slowly and limit the number of topics. Point at objects if it is helpful. Don't challenge someone's claims. Be reassuring.
* Encourage exercise. Regular exercise can improve strength and circulation. It can also lessen sadness and reduce the risk of falling.
* Follow a nighttime ritual. Following the same process each night can be comforting and aid sleep.
* Check for safety and security. Limit clutter in the house. This can help prevent falls. Also, limit distractions like TV and the radio. If wandering is a problem, lock doors and place the locks out of reach. Use child-safe handles on cabinets where toxic materials are stored.
Coping with Lewy Body Disease
If you are providing care for someone with Lewy body disease, you may find that some days are difficult. It can be helpful to talk with others who are having similar problems. Check to see if there is a local support group in your area. You may also want to take advantage of in-home caregiving groups. Sources for support can be found at:
* Lewy Body Dementia Association, Inc.
http://www.lbda.org/category/4185/local ... groups.htm
Lewy Body Disease References
1. National Institute of Neurological Disorders and Stroke. (May 27, 2009). Lewy Body Disease. Retrieved July 22, 2009, from http://www.nlm.nih.gov/medlineplus/lewybodydisease.html
2. Family Caregiver Alliance (2001). Dementia with Lewy Bodies. Retrieved July 22, 2009, from http://www.caregiver.org/caregiver/jsp/ ... nodeid=570
3. Hillm C. & Reiss, N. (May 21, 2008). Lewy Body Dementia. Retrieved July 28, 2009, from http://www.mentalhelp.net/poc/view_index.php?idx=about
4. National Institute of Neurological Disorders & Stroke. (June 29, 2009). NINDS Dementia With Lewy Bodies Information Page. Retrieved July 22, 2009, from http://www.ninds.nih.gov/disorders/deme ... bodies.htm
5. Mayoclinic.org. (2009) Lewy Body Dementia. Retrieved July 22, 2009, from http://www.mayoclinic.org/lewy-body-dementia/
6. Honig LS. (n.d.). Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemperal Dementia. Retrieved July 22, 2009, from http://ci.columbia.edu/c1182/web/sect_5/c1182_s5.3.html
7. Merck.com. (n.d.). Lewy Body Dementia. Retrieved July 27, 2009, from http://www.merck.com/pubs/mmanual_ha/se ... ch27d.html
8. McCoy, K. (April 2008). Lewy Body Disease. Retrieved July 22, 2009, from http://www.doctorsofusc.com/condition/document/230658
9. Massironi, G., Galluzzi, S. & Frisoni GB. (2003). Drug treatment of REM sleep behavior disorders in dementia with Lewy bodies. International Psychogeriatrics. 2003;15(4):377-383.
10. Boeve, B.F., Silber, M.H. & Ferman, T.J. (2004). REM sleep behavior disorder in Parkinson's disease and dementia with Lewy bodies. J Geriatr Psychiatry Neurol. 2004;17(3):146-157.
11. Neff, D. & Walling, A. (April 1, 2006). Dementia with Lewy Bodies: An Emerging Disease. Retrieved July 22, 2009, from http://www.aafp.org/afp/20060401/1223.html
12. UCSF Memory and Aging Center. (2009). Dementia With Lewy Bodies (DLB). Retrieved July 27, 2009, from http://memory.ucsf.edu/Caregivers/dlb.html
13. McCoy, K. (2009). Lewy Body Disease. Retrieved July 22, 2009, from http://psych.med.nyu.edu/conditions-we- ... dy-disease
14. Mayo Foundation for Medical Education and Research (MFMER). (September 17, 2008). Lewy body dementia. Retrieved July 29, 2009, from http://www.ohiohealth.com/bodymayo.cfm? ... l&ref=3052