Causes Of Lewy Body Disease

HEALTH MATTERS: Forgetfulness, Dementia and Alzheimer's Disease

About a month ago, I attended an educational seminar organized by the Alzheimer’s and Dementia Alliance of Wisconsin and organizations with care facilities in south-central Wisconsin. Besides having a professional interest in the subject, I have a personal connection with dementia. I am a caregiver to my mother who suffers from dementia and has for the past eight years. Early on in the seminar, Lynette Gisel, GNP, MSN, APRN-BC, Clinical Coordinator of the OSF IL Neurosciences Institute-Memory Disorders Clinic, defined several conditions associated with memory loss.

Dementia is a general term for the loss of memory and other intellectual abilities that are serious enough to interfere with daily life. It is not reversible. Often, the patient becomes progressively confused. Usual early signs are memory problems; changes in the way of speaking, such as forgetting words; and personality problems. Poor problem solving, difficulty in learning new skills, and impaired decision-making are other symptoms. There are definite brain abnormalities associated with dementia including the loss of brain cells, neurons, connections, and neurotransmitters, particularly with Alzheimer’s Disease. Alzheimer’s Disease is the most common form of dementia and affects more than a third of people with memory loss. The disease progresses slowly and is designated as mild, moderate, or late. The cause is yet unknown; there is no cure at the present time. There are, however, medications that help manage Alzheimer’s symptoms. Vascular Dementia affects 10 percent of memory-loss patients and appears within three months of a recognized stroke. There are definite changes in the brain that cause an abnormal neurological exam. Gait abnormalities, visual field blockage, and facial droop are also often associated with a stroke and Vascular Dementia. Mixed Dementia is a combination of Vascular and Alzheimer’s. It affects some 15 percent of all memory loss patients. Lewy Body Dementia (LBD) affects some 15 percent of patients with dementia. It is an umbrella term for two related clinical diagnoses: Parkinson’s Disease Dementia (PDD) and Dementia with Lewy bodies (DLB.) People whose dementia occurs within one year of Parkinson’s symptoms are diagnosed with DLB. People with an existing diagnosis of Parkinson’s disease for more than a year and later develop dementia are diagnosed with PDD.

Life and Memory Center » Lewy Body Disease

Lewy Body Disease is the second most common cause of progressive dementia after Alzheimer’s disease affecting over 1 million in the U.S. Dr. Frederich discovered aggregates of proteins in the brain stem that deplete a neurotransmitter known as dopamine. This causes Parkinson’s symptoms and the abnormal proteins are known as Lewy Bodies. In some persons, Lewy bodies diffuse out of the core brain structures to other areas of the brain causing diffuse Lewy body disease.

Lewy Body disease is a progressive brain disorder characterized by decline in short-term memory (not as prominent as in Alzheimer’s disease), visual hallucinations (but other types of hallucinations may occur), movement disorders (e.g., slowness of movement or speaking, shuffling feet, walking stiffly, falls, blank stare), delusions (false ideas about another person such as partner having an affair), sleep disorders (e.g., movement, gesturing, speaking during sleep or confusion at awakening), and fluctuating cognition (episodes of acute confusion leading partners to think they are faking).

Like with Alzheimer’s disease, the cause of Lewy Body disease is unknown. Risk factors include being older than 60, being male, and having a family member with Lewy Body disease. A recent study published in the European Journal of Neurology suggests that having Attention Deficit Disorder may also increase the risk of developing Lewy Body disease. Nearly half of the study participants with Lewy Body disease had prior symptoms of Attention Deficit Disorder, whereas only 15% of either those with Alzheimer’s disease or healthy controls had preceding symptoms of Attention Deficit Disorder. This finding needs further exploration but does not mean that those with Attention Deficit Disorder will become demented but rather that they need to monitor their memory as they age.

The distinction between Alzheimer’s disease and Lewy Body disease is important for two reasons. First, persons with Lewy Body disease may respond better to medications such as Aricept, Exelon, and Razadyne than those with Alzheimer’s disease. Second, many with Lewy Body disease are especially sensitive to antipsychotic drugs used to treat hallucinations and delusions.

Assessment for Lewy Body disease is the same as for Alzheimer’s disease and should include both medical and neuropsychogical evaluation and should focus on early detection of changes especially in those at higher risk. The course of treatment needs to be proactive and use of antipsychotic drugs needs to be undertaken with great care. Lewy Body disease is often underdiagnosed and less familiar to professional and lay persons alike. Support services such as the Alzheimer’s Support Network of the Parkinson’s Association of Southwest Florida can offer help and support.

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