Dementia with Lewy body disease (DLB) is a condition that affects cognitive functions, behavior, and movement. This guide provides educational information to help patients and caregivers better understand the disease and its impact.
What is Dementia?
Dementia is a general term used to describe brain disorders that impair a person's ability to perform daily tasks without assistance. Symptoms vary widely and may include memory loss, mood changes, difficulty walking, or trouble speaking. Dementia has many causes, and one of them is Lewy body disease.
What is Dementia with Lewy Body Disease?
DLB is characterized by progressive changes in thinking, behavior, and movement. Symptoms often begin with cognitive and behavioral changes, followed by motor difficulties similar to those seen in Parkinson's disease.
What Causes DLB?
The exact cause of DLB remains unknown. However, it is associated with a buildup of a protein called alpha-synuclein in the brain. Clusters of this protein, known as Lewy bodies, interfere with normal brain cell function, leading to cell death and brain shrinkage. These Lewy bodies are also found in Parkinson's disease.
How is Age Related to DLB?
Symptoms of DLB typically appear between the ages of 50 and 85, although earlier onset is possible in some cases.
What Happens in DLB?
Individuals with DLB may experience trouble focusing, memory difficulties, sleep disturbances, and hallucinations. Over time, movement issues may also develop, such as difficulty walking or using hands due to muscle stiffness. The severity of symptoms can vary from day to day. DLB progresses gradually, with many individuals living an average of 5 to 7 years after diagnosis, although this varies.
Are There Medicines to Treat DLB?
While there is no cure for DLB, certain medications can help manage symptoms. Cholinesterase inhibitors like donepezil, rivastigmine, and galantamine may assist with memory problems. Movement issues may be treated with Parkinson's medications such as levodopa. Sleep issues can be addressed with medications like melatonin. Due to heightened sensitivity to medications in individuals with DLB, it is important to review any treatment plans with a healthcare provider to avoid adverse effects.
How Can We Manage Hallucinations?
Not all hallucinations in DLB require treatment, especially if they are not disruptive. If a hallucination is distressing, shifting the focus of the conversation may help alleviate frustration. Should medical intervention be necessary, the healthcare provider can suggest appropriate treatments. However, medications for hallucinations may worsen movement symptoms.
How Can We Support the Sleep/Wake Cycle?
To improve the sleep/wake cycle, establishing a consistent nighttime routine-such as turning off lights and closing curtains at the same time each night-can signal it's time for sleep. During the day, exposure to daylight, avoiding naps, and engaging in stimulating activities can reinforce the distinction between day and night. Calendars and clocks may also help reduce confusion about the time of day.
What Else Can Help?
Various therapies can assist people with DLB. Speech therapy may enhance communication, and physical therapy can help strengthen muscles and prevent falls. Regular exercise, a balanced diet, adequate sleep, and limited alcohol consumption can promote overall brain health. Managing other health conditions like diabetes, high blood pressure, and high cholesterol is also important for maintaining brain function.
Resources
- Lewy Body Dementia Association: lbda.org
- Family Caregiver Alliance: caregiver.org
- National Institutes of Health: nih.gov
- Research: clinicaltrials.gov
