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Dementia with Lewy Body
Lewy Body dementia is characterized by accumulation of abnormal protein deposits called Lewy bodies, which we typically associate with Parkinson’s disease. Most cases of Lewy body dementia occur in adults older than 60 and it appears to be more common in men. Common symptoms include visual hallucinations, fluctuating levels of attention (clear days and confused days), cognitive and motor dysfunction, sleep behavior disorder and severe sensitivity to anti-psychotic drugs.
The symptoms can closely resemble and overlap with Alzheimer’s and Parkinson’s making Dementia with Lewy bodies widely under-diagnosed. In fact, some patients start out with a movement disorder leading to a diagnosis of Parkinson’s, then develop dementia and other symptoms of Lewy body dementia. Others present with cognitive dysfunction that may look like Alzheimer’s initially, but with time, hallucinations, motor impairments and fluctuating attention appear. A third smaller group of patients present first with neuropsychiatric symptoms such as hallucinations, behavioral problems or difficulty with complex mental activities and later develop other symptoms. Drugs that are effective for Lewy body dementia include cholinesterase inhibitors which increase the levels of chemical messengers that are important for memory, thought and judgment and may help with hallucinations. Parkinson’s disease medications which help with motor problems can also cause increased confusion and hallucinations. Antipsychotic medications may improve hallucinations, but at least a third of Lewy body dementia patients can exhibit dangerous sensitivity to neuroleptics.