Lewy Body Dementia Association, Inc.

Mental Illness
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Author:  aelisabeth [ Wed Sep 14, 2011 12:31 am ]
Post subject:  Mental Illness

Does anyone know if there is a link to mental illness in earlier life and LBD later in life? My mother is bi-polar and also appears to have some borderline (they actually call it something else like spectrum or something) personality disorder. I have noticed that when her Stalevo or Exelon patch are increased, she tends to get more manic. I was just wondering if there is a link beyond her simply feeling better and thus being able to indulge her mania.

Thanks for your insights.


Author:  JeanneG [ Wed Sep 14, 2011 1:26 am ]
Post subject:  Re: Mental Illness

In the absence of research to the contrary, I would expect people with various mental illnesses develop dementia at about the same rate as the rest of the population. If there is research on this subject, I'm sure our experts in that area will inform us about it.

And I think I know what you mean, but bipolar persons can't simply decide to indulge a manic episode, can they? Do you mean that when other mental issues are under control, that allows the mania to present itself? That is a very interesting concept.

Inability to sleep is a manic symptom, but it is also common among LBDers. Craig has talked about how his mind races, with thoughts coming at him rapidly -- too rapidly to express them. My bipolar brother talks about this happening to him in manic episodes.

I wonder how many of the manic symptoms you are seeing would appear as part of LBD, even if your mother had never been bipolar?

While this is all very interesting as a discussion topic, and I hope others have more concrete information to contribute, I can imagine that it increases the difficulty and the stress for the caregiver when the loved one has mental illness in addition to LBD.

Hugs to you, dear Liz.

Author:  robin [ Wed Sep 14, 2011 12:26 pm ]
Post subject:  Re: Mental Illness

There is research that suggests a strong association between depression and dementia. Those who are depressed are more likely to develop dementia. I'm not aware of any research on bipolar disorder or borderline personality disorder. You could do a PubMed search (pubmed.gov) to see if there's any published research on this.

Have you checked a website such as rxlist.com to see if feeling manic is a possible side effect of Stalevo or Exelon?

Author:  labeckett [ Sat Sep 17, 2011 5:34 pm ]
Post subject:  Re: Mental Illness

Yes, prospective studies have consistently identified depression as a predictor of both decline in cognitive function and the onset of formal diagnosis of dementia. Interestingly, it appears that though depression is associated with clinical decline, it doesn't seem to be tied to the known neuropathology we think of as responsible for AD or other dementias (see Negash et al, Cur Alzheimer Res 2011). So something else may be going on to account for the effects of depression.

There is also some work suggesting that "neuroticism", in particular, higher levels of anxiety and vulnerability to stress, may also be predictive. To quote from one in Am J Geriatr Psychiatry, 2011, "Neuroticism's association with late-life dementia mainly reflects vulnerability to stress and anxiety and their correlation with decline in the ability to process and retain new information."

Both of these papers involved my colleagues from Rush, where I was on faculty before coming to Davis, David Bennett and Bob Wilson. Just to show that you never know what you will find if you poke around on PubMed, they just had a paper in Chem Senses 2011 linking confirmed Lewy body presence post-mortem with olfactory impairment, and concluded: "Lewy body disease impairs late life olfactory function even in otherwise asymptomatic individuals."

The foundation for much of their work is two key studies: the Religious Orders Study (ROS) and the Memory and Aging Project (MAP). In both studies, participants - mostly healthy at the start - had very detailed annual clinical exams and histories, and then agreed to post-mortem. ROS started in 1994 and MAP about 1999 or 2000, can't remember exactly, so many people have since died and postmortem data are available. There are other studies with post-mortem data but these represent, I believe, the largest and most complete and thorough in the US. Given the difficulties of clinical diagnosis of LBD, studies like these with uniform clinical data before death and near-100% autopsy rates are really critical. Even if they sometimes yield more questions than answers!

Author:  robin [ Sun Sep 18, 2011 12:25 pm ]
Post subject:  Re: Mental Illness

My husband's aunt participated in the Religious Order Studies. She was the first person who told me about brain donation. A high percentage of the nuns participate in these studies; they give selflessly even upon death.

Author:  labeckett [ Sat Sep 24, 2011 5:46 pm ]
Post subject:  Re: Mental Illness

Oh, Robin, that's wonderful to hear about your husband's aunt! The nuns are just amazing in their generosity and support. I was at the very first day at the very first convent, the Sisters of St. Joseph outside Chicago, on a bitterly cold winter day. The warmth of the nuns was like a gentle summer sunshine - I was all set to move in and stay with these marvelous women, except I guess being Quaker would probably have ruled me out. Their selflessness has changed our understanding of aging and dementia.

Author:  aelisabeth [ Tue Sep 27, 2011 10:25 am ]
Post subject:  Re: Mental Illness

Thanks everyone for the info. I did know about the link with depression and anxiety. My husband is a research scientist and I was trained as a cultural anthropologist. As a result, we are always looking/noticing/reading on (and into things that we find interesting but may or may not have any real clinical support). It is great to get info from folks whose specialty is more closely linked to LBD. Both my husband and myself have noticed, however, that my mother has always had poor spatial skills and balance, been extremely stereotypically right brained (has never been able to balance a check book well or keep track of numbers in general, is left handed, has poor cordination, etc.), and has had a variety of personality issues that were diagnosed on the borderline spectrum (along with being bi-polar). My husband observed that it was interesting that many of her LBD symptoms seem like exaggerations of what we thought were personality and/or depression/anxiety/bi-polar/borderline personality disorder types of symptoms. We had wondered about possible brain damage when she was a child or environmental toxins. Anyway - interesting to hear about the research and hope that the puzzle of LBD gets figured out. My mother has mentioned several times that she would like to donate her brain to science. Are there research groups that actually want brains? I would be more than happy to get in touch with such folks and try to make the arrangements for her if I knew who they might be.


Author:  JeanneG [ Tue Sep 27, 2011 11:58 am ]
Post subject:  Re: Mental Illness

Liz, it is interesting that Lewy symptoms seem like exaggerations of existing traits. That is not always the case. My husband, a mechanical engineer, when asked to estimate the width of a ribbon, for example, would eye it and say 5/32 of an inch -- and he'd be right! Once Lewy took over he couldn't figure out how to get into bed so that he wasn't scrunched down at the footboard or bumping his head on the headboard. It doesn't seem to matter how good your spatial perceptions were pre-Lewy, you get the symptoms Lewy deals out.

There is a forum for information on donation of brains. That is an excellent contribution to make in the cause of more knowledge. When you get into that forum you will see that Robin very actively helps people make arrangements.

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