"Lewy Body Dementia" sounds like more fun than it is -- that word "dementia" is probably a good tip-off

Lewy Bodies may sound like things you'd enjoy playing with, but apparently not so much.

by Ken

Didn't I say way back, well, awhile ago, that one thing I really, really didn't want was to find myself on the dementia beat? Well, here am I bearing cheery news about yet another form we can add to the smorgasbord of dementia delights we can hold ourselves ready for -- unless, as Michael Kinsley might put it, a big, big truck comes along to carry us off first.

"Lewy Body Dementia"?

We all know all about Alzheimer's, right? And maybe a little about Parkinson's -- especially if we've read Michael Kinsley (see link above)? And probably it's occurred to many of us that there are other forms of dementia, maybe many other forms of dementia, lying in wait for us out there.

Typically, to make life even more charming, we can expect these other forms as well to be "difficult to diagnose," as the report below puts it, though the difficulty is mitigated somewhat by the limited options for treatment anyway. Just recently, faced with the possibility of, finally, an actual test for Alzheimer's, we pondered the question of whether you'd want to know that you have it.

Very likely you too are on the mailing list for Johns Hopkins Health Alerts, a bustling enterprise whose white papers and other publications actually do draw on the substantial medical resources of the Johns Hopkins community. (Please note that the link is there purely for informational, not for promotional, purposes. It just would have seemed wrong to bring them up without offering a link.) Usually the e-mails tease you with questions to which you might like to know some of the answers, for which you need to buy the publication on offer. (Yes, I've bought a couple, and have to admit that one I found quite useful. They always come with a money-back guarantee, so you can't get really hosed. One would like to think that Johns Hopkins wouldn't be eager to risk its reputation for the sake of some extra bucks. Again, I offer this strictly for informational and not promotional purposes.)

Sometimes, however, we get a freebie, as in this case. Maybe there just isn't an eager market for Lewy's Bodies info -- yet.

Understanding the Signs
of Lewy Body Dementia

Most people associate dementia with Alzheimer's disease. But 1.3 million Americans have another form of dementia called Lewy body dementia or dementia with Lewy bodies. This progressive neurological disorder is named for the Lewy bodies -- tiny deposits of a protein called alpha-synuclein -- found in certain areas of the brain. Over time, these proteins accumulate and cause the death of brain cells. This results in impairments in certain cognitive functions, such as memory, language processing, emotions and behavior, as well as control of movement.

Some experts identify two types of Lewy body dementia: dementia with Lewy bodies, in which cognitive symptoms appear within a year of neurological problems such as slowness of movement and impaired balance, and Parkinson's disease dementia, in which cognitive symptoms appear more than a year after the onset of movement problems.

Difficult to diagnose. No specific brain scans or lab tests can pinpoint the presence of Lewy body dementia, although a type of scan, DAT, or dopamine transporter SPECT scan, can support the diagnosis. Diagnosis of Lewy body dementia is based on identifying the symptoms -- which can vary widely in severity from person to person -- and then ruling out other possible causes such as certain drugs.

The progressive decline of mental function is the primary symptom of Lewy body dementia, but what sets it apart from Alzheimer's disease is the presence of subtle symptoms referred to as parkinsonism because they're not fully suggestive of Parkinson's disease and because hallucinations are common at the beginning of Lewy body dementia. Some symptoms common to early Lewy body dementia and other forms of dementia include:

• Memory loss, difficulty with reasoning, problem solving, visual and spatial judgment and multitasking
• Behavior and mood changes, including depression, anxiety and delusions
• Confusion
• Sleep problems

Certain symptoms are more pronounced in Lewy body dementia than in other forms of dementia:

• Movement difficulties, such as muscle rigidity, a shuffling gait, tremors and loss of coordination, are similar to Parkinson's symptoms but appear more spontaneously.
• Unlike with Alzheimer's, acute episodes of drowsiness and worsened cognition are common, accompanied by worsening attention, focus and alertness. The fluctuation in mental alertness occurs intermittently and can vary from day to day and even hour to hour.
• Vivid hallucinations appear in the early stages of the disease, whereas they tend to occur in later stages of Alzheimer's.
• Sleep problems, particularly REM (rapid eye movement) sleep behavior disorder -- in which the patient acts out dreams, may move in ways that appear violent and may fall out of bed -- may start years before memory symptoms and cause excessive daytime sleepiness.
• Falls, delusions, brief episodes of unconsciousness and fainting are common.
• The part of the nervous system that regulates automatic actions may be affected, resulting in fluctuations in blood pressure, heart rate and body temperature; sexual dysfunction; constipation; or dry eyes or mouth.

Now don't you feel better?

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