Dementia and Parkinson’s are two disorders affecting one’s cognitive, behavioral, and motor functions. With the presence of Lewy bodies affecting both disorders, what is the difference between the two? Here’s all you need to know about Lewy body disease and what makes it different from Parkinson’s.
What Is Lewy Body Disease?
A type of progressive dementia, Lewy body disease or dementia (LBD) happens when an individual’s thinking and reasoning declines. There is also a noticeable deterioration in one’s independent functions.
Also called dementia with Lewy bodies, LBD is caused by Lewy bodies, which are protein deposits. These abnormal deposits cause damage in the brain regions which are involved in movement, memory, and thinking. Lewy bodies are also linked to Parkinson’s disease dementia (PDD).
How Is It Diagnosed?
Like with the different types of dementia, no test can bring about a conclusive diagnosis for LBD. A physician only “clinically” diagnoses an individual as having LBD based on his or her professional judgment for the symptoms manifested. A postmortem autopsy is the only way to identify LBD.
As for further research and study, experts in the field consider LBD and PDD as two completely different terms. While both disorders have the same problem involving the brain’s handling of the protein called alpha-synuclein, experts advise that LBD and PDD be diagnosed separately.
The disorder is diagnosed as LBD when:
- Symptoms of dementia are consistent with the initial development of Lewy body dementia.
- There are symptoms involving movement and symptoms of dementia were present at the time it was diagnosed.
- Symptoms of dementia appeared within a year subsequently to symptoms involving movement.
The disorder is diagnosed as PDD when:
- The individual has already been diagnosed with Parkinson’s solely on symptoms involving movement. Moreover, the symptoms of dementia manifest after a year or more following the diagnosis.
However, it may be tough to differentiate between LBD from Alzheimer’s disease, particularly during the early stage. This is because the presence of Lewy bodies coexists with changes in the brain of an individual with Alzheimer’s.
What Are the Stages of LBD?
The speed of LBD’s progression varies with each individual. Here are the stages covering the symptoms it may manifest per person.
1. Early Stage
This stage primarily involves distortions of one’s reality. Aside from visual hallucinations, other symptoms include restlessness, REM sleep disorder or acting out one’s dream while asleep, difficulties in movement, and delusions. Other people may experience “freezing up” while walking. Also, incontinence and urinary urgency may also be developed. At this stage, one’s memories are still in one piece. However, mild changes in cognition and confusion may manifest.
2. Middle Stage
The symptoms in this stage start to resemble indications of Parkinson’s. These include difficulty with dialogue, increased delusions, impaired capacity to swallow, and impaired motor functions. Cognitive skills also decline. At this stage, an individual experiences problems on staying focused and suffers from major phases of confusion.
3. Later Stage
As extreme muscle rigidity starts to develop, activities of daily life (ADL) become significantly hard to do. Thus, a caregiver is needed for ADL. The skill to communicate is either absent or difficult. Moreover, a person at this stage of LBD becomes vulnerable to infections, which could most likely lead to death.
What Are the Symptoms?
The most common signs and symptoms of LBD include the following:
Deviations in functions of the autonomic nervous system
In LBD, the nervous system is affected. So, normal functions regulated by the nervous system are disrupted. An individual may experience constipation, incontinence, or urgency to urinate. Moreover, the blood pressure and temperature of the body is also affected.
While visual hallucinations (seeing things that aren’t there) are most common, other hallucinations may affect touch, smell, and sound.
Mood or behavior changes
Depression or anxiety is common. Other changes include apathy, agitation, and paranoia.
Problems with cognition
An individual manifests memory loss, loss of focus and attention, and confusion. These symptoms are similar to Alzheimer’s. Furthermore, there is an impairment in thinking which involves the inability to comprehend visual info and process it.
Problems involving movement
These include difficulties in walking or shuffling walk. Other disorders are muscle stiffness, tremors, or slowed movements.
Problems with sleep
Those with LBD may “act out” their dream during sleep.
Individual may be caught staring off into space at extended periods. There may also be episodes of drowsiness. Furthermore, muddled speech is noted.
What Is the Treatment?
Currently, LBD has no treatment and no cure. Physician’s treatment plans are focused on the symptoms of the disease.
Extreme caution is advised when antipsychotic drugs are prescribed. While these medications manage behavioral symptoms, it is likely that it could cause severe side effects in 50 percent of the populace diagnosed with LBD.
Since depression is a common symptom present in LBD as well as in Alzheimer’s and PDD, doctors prescribe antidepressants. Those that are used include selective serotonin reuptake inhibitors or SSRIs.
While these medications are a mainstay in the treatment of cognitive changes for those with Alzheimer’s, it also helps symptoms manifested in LBD.
This drug is used for the treatment of REM sleep disorder.
What Are the Other Approaches for Treating LBD?
Since some of the antipsychotic drugs commonly prescribed by physicians worsen the symptoms of LBD, nondrug approaches are recommended. Some of these include the following.
1. Minimize Confusion
This is done by keeping a daily routine and sticking to it. A structured routine keeps the person focused and less likely to experience confusion. Also, try to keep tasks as simple as possible. Break complex tasks into small steps to make it easy.
2. Modify the Environment
As mentioned, hallucinations (visual, olfactory, auditory, or tactile) are a common symptom. So, to help lessen hallucinations, decrease the amount of clutter and distractions, whether visual or auditory. By making changes in one’s environment, it becomes easier to function.
3. Offer Comforting Responses
During the later stages of the disease, a caregiver’s aid is highly important for a person with LBD to function. At such time, a caregiver must always be mindful of their response. Rather than automatically correcting a person with this disease, offer encouragement and support.
As with the different types of dementia, LBD worsens over the course of time and reduces one’s life expectancy. For now, prescription medications only help with the symptoms of Lewy body disease.