What is lewy body dementia?
Lewy body dementia, or dementia with Lewy bodies (DLB) is probably the third cause of dementia, after Alzheimer's disease and vascular dementia.
Lewy body dementia definition
Lewy body dementia may not be an independent disease entity in addition to Parkinson's disease and Alzheimer's disease.
Parkinson's disease and lewy body dementia are part of a spectrum of Lewy pathology, wherein DLB as a cortical (localized in the cerebral cortex) variant can be considered as Parkinson's disease, in which disease the deviations are mainly localized in the brain stem.
The disease process is characterized in that located in the brain cells with the protein alfasynucleine moldings, which are called Lewy bodies. These cells accumulate in Parkinson's disease on in the substantia nigra in the brain stem. In lewy body dementia, these inclusion bodies also found in the cerebral cortex.
In lewy body dementia occurs, not only, as in Parkinson's disease, loss of dopamine-producing nerve cells in the substantia nigra, but also, as with Alzheimer's disease, of acetylcholine-producing cells of the nucleus basalis of Meynert and elsewhere. The cells of the cerebral cortex atrophy (shrink).
The distinction between parkinsonism dementia (Parkinson's disease dementia, PDD) and DLB is a matter of definition. When the dementia symptoms occur within one year after the onset of Parkinson's disease, it is called DLB; when dementia occurs later in the course of Parkinson's disease, one speaks of PDD.
At section is often found a combination of the deviations associated with DLB and the deviations which are characteristic of Alzheimer's disease. Besides Lewy bodies in the cerebral cortex you can also find abnormalities in the hippocampus, called neurofibrillary tangles and senile plaques.
It is assumed that, in the DLB the loss of acetylcholine-producing nerve cells is responsible for the deterioration of the cognitive (thinking) and emotional functioning and that the loss of dopamine-producing cells causes the motor symptoms.
Lewy body dementia symptoms
To diagnose Lewy body dementia criteria were drawn up in 1995
- Progressive cognitive impairment of such gravity that they impede the functioning. In particular, the focus is reduced, the concentration, and the orientation in space. Memory disorders play a role only when the disease has progressed.
- Fluctuating attention and alertness.
- Recurrent visual hallucinations that can usually be clearly defined and detailed.
- Signs of parkinsonism, not caused by medication.
- Features that support the diagnosis: repeated drops; fainting; temporary loss of consciousness; sensitivity to antipsychotics; delusions.
- The diagnosis of lewy body dementiais less likely to: stroke, or if there are diseases that may cause the same phenomena.
Lewy body dementia treatment
- Medicines against Parkinson's symptoms will have to be careful because they may increase the hallucinations and confusion. In practice, they try to come out with the lowest possible dosage of levodopa.
- The confusion, disorientation and hallucinations of lewy body dementia respond well to treatment with cholinesterase inhibitors such as rivastigmine and galantamine
- Antipsychotics for Dementia with Lewy bodies and Parkinson's disease dementia have a disastrous effect, because they strengthen the Parkinson symptoms. If they are still considered necessary, in fact, only clozapine and quetiapine usable, albeit with the necessary care and caution.
Help from peers
Belgium
The Flemish Alzheimer League is pluralistic and not tied to other organizations. She has partnerships with other self-help groups and organizations. In addition to supporting the exchange of knowledge and experience with Alzheimer's disease (by family groups), the League also does sensitization.
Netherlands
- Alzheimer's is the Netherlands organization for people with dementia and their families. This foundation provides information and assistance and provides online and offline fellow patients. In addition, the foundation interests and funds scientific research.
- The Parkinson Association is involved in peer support, information and education, support of scientific research and advocacy.