Re: "Different Forms of Dementia" including LBD - 11/21 webi
Though I think Teepa Snow is typically an incredible presenter, the one-hour webinar format didn't suit her. She raced through the material, and didn't cover many slides. I thought her discussion of Alzheimer's and mixed dementia were very good. For Lewy Body Dementia, I think she would've done better by looking at the diagnostic criteria. I thought she was very unclear on FTD (frontotemporal dementia). And I think she under-rates the challenge of diagnosing dementia.
She said two things about Lewy Body Dementia that were new to me:
* "This is not AD plus PD. "
* "About 50% of those with LBD can't get into REM sleep."
You can find an online recording of the 11/21 webinar here:http://www.screencast.com/t/kwaagMKHNhy
Put your mouse over the "11-21-11" area. Click on the file folder that appears below the word "Understanding."
And, I've copied my notes from the short general section and the short LBD section of the webinar below.
Understanding the Different Forms of Dementia
Speaker - Teepa Snow, a dementia education specialist, her website is teepasnow.com
Three sponsors = Alzheimer's Foundation of America (alzfdn.org), Senior Helpers (seniorhelpers.com), and American Society on Aging (asaging.org)
Dementia is caused by changes in the brain:
* Structural changes: permanent; cells are shrinking and dying
* Chemical changes: variable; cells are producing and sending less chemicals; people can "shine" when least expected ("chemical rush")
"Dementia" - umbrella term that covers 70-80 different disorders, such as Alzheimer's Disease (50-60%), vascular dementias, Lewy body dementia, fronto-temporal lobe dementias, other dementias. The "other dementias" category includes genetic syndromes, drugs/toxin exposure, white matter diseases, and Parkinson's. Most of AD co-occurs with other dementias. These are terminal disorders. These are life-altering disorders.
LEWY BODY DEMENTIA
Important to know about. This is not AD plus PD. This is a different phenomenon.
Most mis-diagnosed and missed as a diagnosis.
Can be misidentified as PD. It does involve movement problems (especially frequent falls) early in the disease. Often falls are in bathrooms and bedrooms.
Can have visual hallucinations. Almost always involve animals, children, or people. Usually in the late afternoon and evening. Some people have insight into their hallucinations.
Can have fine motor problems -- hands and swallowing.
Don't often have rest tremor. The person is often awkward due to an intention tremor. (This is a distinguishing characteristic.)
Episodes of rigidity. The person might get stuck. They are NOT getting stuck on purpose!
Episodes of syncope.
Can have nightmares. Think dreams are real. Can have a dark edge of the dreams.
Can have insomnia. About 50% of those with LBD can't get into REM sleep.
Fixed delusional thinking.
Fluctuations in abilities.
Drug responses can be extreme and strange. This is probably the most important thing. Often, MDs, if they are thinking PD, will prescribe Sinemet. Sinemet can make the hallucinations worse. Often the drugs used to treat hallucinations are antipsychotics. 50% of those with LBD have a seriously strong reaction (extrapyramidal side effects) to antipsychotics. This is one of the reasons for a black-box warning on antipsychotics.
Often drugs used to treat agitation can make the problem worse.
Average: live 7-9 years with symptoms.