Lewy Body Dementia


Lewy body dementia (LBD) is the second most common form of dementia after Alzheimer’s disease dementia (Lewy body dementia – Symptoms and causes ). LBG specifically results from a deposit of protein alpha-synuclein in the brain in abnormal quantities.These deposits are known as lewy bodies. Alpha-synuclein plays important roles in the functioning of a healthy brain, especially within neurons and synapses. However, as a result of alpha-synuclein clumping in the neurons of areas of the brain that control memory and movement, neuronal death can eventually occur. Additionally, lewy bodies affects multiple brain regions such as the cerebral cortex, limbic cortex, hippocampus, midbrain and basal ganglia, as well as the brain stem. As a result, LBD can result in problems that involve thinking, movement, behavior, and mood (LBD ). 

The exact cause of LBD is unknown, however there has been research focused on its biology and genetics to learn more about the precise causes. Lewy body accumulation results in neuronal death of certain neurons that are often involved in the production of two neurotransmitters. One of these neurotransmitters is acetylcholine, which is important for memory and learning. Other information researchers have gathered regarding the possible risk factors for LBD include age, Parkinson’s disorder, REM sleep behavior disorder, and even genetics. Individuals over the age of 50 tend to be at a higher risk for onset of LBD. Although LBD is not a genetic disease, variants in the genes APOE, SNCA, and GBA have been linked to having an increased risk for LBD (LBD ).  Additionally, it has been shown that males are more likely to be affected by LBD than females (Lewy body dementia – Symptoms and causes ). 

There are two diagnoses of LBD, including dementia with lewy bodies (9DLB) and Parkinson’s disease dementia (PDD) (LBD). Both DLB and PDD have similar symptoms, and have the same biological changes in the brain, however they differ in the early signs of onset. LBD results in cognitive impairments in attention and executive and visuo-perceptual abilities. Patients with LBD present with a variety of neuropsychiatric symptoms, such as visual hallucinations, systematised delusions, apathy, aggression, anxiety and depression. Other symptoms that many DLB patients experience include motor difficulties (Taylor, McKeith and Burn, 2019)

Due to the variation in the types of symptoms LBD patients may experience, LBD treatment and care can involve a variety of care takers, especially because LBD cannot be prevented or cured. For instance, physical therapists can assist with motor difficulties, speech therapists can assist with swallowing difficulties or voice projection, occupational therapists can assist in carrying out everyday activities such as eating and bathing, music or art therapists can assist by providing therapeutic activities that can help patients overcome anxiety and depression, and mental health counselors can help patients with neuropsychiatric symptoms as well (LBD ). Other than relying on support provided by healthcare workers and care takers, certain symptoms can be treated utilizing prescribed medication. Studies have shown that the cholinesterase inhibitors (ChEI) donepezil and rivastigmine medications were similarly effective in both DLB and PDD for improving cognition (Taylor, McKeith and Burn, 2019). From medications to having a support team, there are many hopes in assisting patients with LBD so that they can better manage their symptoms.

 

References

Mayo Clinic. n.d. Lewy body dementia – Symptoms and causes.

National Institute on Aging. n.d. What Is Lewy Body Dementia?.

Taylor, J., McKeith, I. and Burn, D., 2019. New evidence on the management of Lewy body dementia. Lancet Neurology, [online] pp.1-9.

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