Lewy body dementia (LBD) is a degenerative disease characterized by Parkinsonian symptoms combined with dementia. Initiated by the presence of proteins that form in the brainstem and elsewhere throughout the structure called Lewy bodies, LBD occurs most often in men over the age of 60. Although it is the second most common degenerative disease, Lewy body dementia is highly underdiagnosed, making it important to recognize the symptoms, as early treatment can extend quality of life.
Cognitive Abnormalities
One of the first symptoms to appear with Lewy body dementia is hallucinations. These may be visual hallucinations, and the patient may see shapes, animals, or even people that are not there. These hallucinations are often recurring and can be very detailed in appearance. Other senses may be affected as well, as auditory, olfactory, and tactile hallucinations may also present -- affecting hearing, smell, and touch, respectively.
As is common among degenerative diseases, much cognitive dysfunction occurs as a result of LBD. Patients often experience significant daytime fatigue, and frequent naps of multiple hours appear to be of great significance. Furthermore, the patient may have difficulty staying focused or paying attention to things; episodes of staring into space for long periods of time are not uncommon. Memory loss is another key symptom of Lewy body dementia; other cognitive symptoms include confusion and problems with visual-spatial abnormalities. Speech may become disorganized and confusing. LBD interferes with the production of certain transmitters, specifically dopamine and acetylcholine. Depression and apathy (a lack of motivation and desire) may present periodically while dealing with the disease.
Unconscious Processes
Lewy bodies form in parts of the brain responsible for the autonomic nervous system, which controls unconscious systems of the body, cardiovascular and digestive functions among them. As Lewy body dementia develops, these systems become less efficient at maintaining themselves. According to the Mayo Clinic, blood pressure, pulse, sweating, and digestive processes are often affected by LBD. This interference with the cardiovascular system can lead to frequent spells of dizziness and even falling down. The gastrointestinal system may not function at top capacity, leading to issues like constipation.
Lewy body dementia also tends to incite REM (rapid eye movement) sleep behavior disorder (RBD). While most individuals enter a state of paralysis during REM sleep, RBD is characterized by acting out the dreams that occur during this stage. Although this may seem a relatively harmless attribute of the disease, patients with RBD may not only flail about and talk in their sleep, they may leap out of bed and can injure themselves or a sleeping partner. This excess of movement can be particularly dangerous for someone with LBD.
Parkinsonian-like Symptoms
The change in movement associated with Lewy body dementia is much like the movement disorders of Parkinson’s disease. As the production of certain neurotransmitters is interfered with, movement becomes more difficult and more erratic. LBD (and Parkinson’s) patients often exhibit a tremor, often visible in the hands as a strong, uncontrollable shaking. Furthermore, a normal walk may become more like a shuffling gait. The muscles become rigid and difficult to move, and movement overall may begin to slow down considerably. If you or someone you love have been exhibiting symptoms of LBD, seek medical advice immediately.
