Dementia with Lewy bodies (DLB) is a form of progressive dementia caused by degeneration of the tissues in the brain.
People with DLB have a buildup of abnormal protein particles in their brain tissue, called Lewy bodies. Lewy bodies are also found in the brain tissue of people with Parkinson disease (PD) and Alzheimer disease (AD). However, in these conditions, the Lewy bodies are generally found in different parts of the brain.
The presence of Lewy bodies in DLB, PD, and AD suggests a connection among these conditions. But scientists haven’t yet figured out what the connection is.
DLB affects a person’s ability to think, reason, and process information. It can also affect movement, personality and memory. DLB becomes more prevalent with age. It often starts when a person is in his or her 60s and 70s. DLB is progressive, which means it continues to develop over time. There are several types of dementia with different causes.
Degeneration or deterioration of brain tissue causes dementia with Lewy bodies. DLB may be genetic, but it is not always clear why someone develops DLB. Lewy bodies in the brain affect substances called neurotransmitters. A neurotransmitter is a chemical that helps send signals from one nerve cell to another.
One type of neurotransmitter is dopamine. It helps transmit signals that cause muscle movement. Lewy bodies interfere with the production of dopamine. A lack of dopamine causes movement problems, such as those seen in Parkinson disease.
Acetylcholine is another type of neurotransmitter found in the parts of the brain responsible for memory, thinking, and processing information. When Lewy bodies build up in these areas, they use up the acetylcholine, causing symptoms of dementia.
DLB is generally diagnosed when at least 2 of the following features are also present with dementia:
Other signs and symptoms seen in DLB include:
DLB can be confused with other forms of dementia, but it also has unique features, such as hallucinations and delirium.
The symptoms of DLB may look like other conditions. Always see a healthcare provider for a diagnosis.
Your healthcare provider may diagnose DLB based on medical history, a physical exam, and symptoms. He or she may do a complete medical history and physical exam, along with these tests:
Dementia with Lewy bodies (DLB) has no cure. Treatment involves managing symptoms.
Medicines used to treat Alzheimer disease (AD) and Parkinson disease (PD) may also be used to treat DLB. Other treatments, such as supportive care, physical therapy, psychotherapy, and behavioral interventions, may also be used.
It’s important that the healthcare provider treating a person with DLB be familiar with all aspects of the disease. Other specialists are often involved in care. Because DLB shares features with AD and PD, those features will need to be treated. Many people with DLB, however, can’t tolerate some of the medicines for AD or PD. Caution must be used when prescribing certain medicines for DLB.
Interventions used in other forms of dementia may also help people living with dementia with Lewy bodies (DLB). These include using glasses or hearing aids as needed, educating the patient and family, providing a structured environment, and teaching behavioral interventions. These will change over time as the disease progresses.
Hallucinations may be managed by ignoring them and educating the caregiver(s) about them. Improving lighting and keeping the patient around other people also helps.
It’s important to work with a healthcare provider familiar with DLB and the many aspects of the disease. Other specialists are often involved, too.
Talk with your healthcare providers about when it's important to call them. Your healthcare providers will likely advise calling if your symptoms become worse, or if you have obvious or sudden changes in behavior, personality, or speech. This includes mood changes, such as increasing depression or feeling suicidal.
Tips to help you get the most from a visit to your healthcare provider:
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