What is Dementia with Lewy Bodies?
DLB is a difficult customer to spot, and even harder to diagnose as it bares such a resemblance to Alzheimer’s and Parkinson’s.
Firstly we have to ascertain what Lewy Bodies are, in truth we know what they are but not where they come from, or why they exist.
Lewy Bodies are abnormal protein deposits that are diffused throughout the brain, in the case of Dementia they will be scattered predominantly through the outer parts of the brain. These deposits seemingly act as blockers, like the Plaques in Alzheimer’s, preventing important chemical messages from getting passed up the chain. Levels of Dopamine and Acetylcholine are depleted, this is imported as between them they help send messages about movement, and in the case of dopamine about our enjoyment level, that tells us “I’m enjoying doing this, I want to do more”. This goes somewhere to explaining why DLB patients get bored easily of tasks, losing concentration and of body movement in 2/3rds of cases. The number of deposits throughout the brain will increase as time goes on.
It is thought to affect around 10% of dementia patients in the UK, 1/3rd of Parkinson’s patients will go on to develop DLB as they are inherently similar.
There are some stand out features of DLB however- visual and auditory hallucinations, and a significant drop in concentration and alertness.
The individual dementia journey varies greatly and can last on average 8 years after symptoms have developed.
What are the Symptoms?
Most people with DLB suffer from visionary hallucinations of some sort these can be really convincing and tend to be about actual things like people in their life or animals being in the room. it is a particular symptom of DLB that not many other types of Dementia have. On fewer occasions some may think they have heard things and have auditory hallucinations. Both cases often lead to complete delusions about the world, and often and most upsettingly about the people around them, it can be hard to convince then that these delusions are not real.
Many of the symptoms that come with DLB are similar in nature, if not just exaggerated versions of Parkinson like symptoms. The majority of those with DLB will develop jagged erratic movements, due to the stiffness of their muscles. When walking a stooped position is likely to be adopted along with a shuffle as opposed to strong steps. The shuffling may also have to do with the symptom below, a fear of not being able to interpret your surroundings due to problems with your visuospatial awareness.
Like with Alzheimer’s many with DLB struggle to perceive depth and volume of objects, the world shrinks to a 2D perspective with limited understanding of colour changes, relying predominantly on contrast from like to dart. This inability to interpret the world around you can lead to a higher risk of falls and trips as you brain struggles to respond appropriately the visual cue. So stairs, door dividers and even differential flooring types can become potential hazards. For example a dark floor after a light floor may seem like a big hole to those with DLB.
Another well reported symptom of DLB are terrible sleep disorders. It is not uncommon for nights to be full of fitful dreams and hallucinations that are acted out in bed. They can be quite lucid in nature and are often violent. This is a clear symptom that something distressing is going on and that a doctors consultation should be sought. Sleep is critical to the body as we all know, it allows us to restore and rejuvenate, thereby helping to ward off further brain degeneration in the cases of Dementia. So poor sleeping patterns at night can be really detrimental to those with DLB as well as the person who cares for them.
Many with DLB will also find that they have far shorter concentration spans than before, they struggle to be attentive for sustained periods of time and appear to get bored of tasks quickly. It isn’t them trying to be difficult although sometimes it can feel that way, it is purely that the brain is struggling to sustain the intensity of thought, the communication between brain cells falter and the connection cannot be picked up again, making focusing really challenging. This lack of concentration can come intermittently throughout the day, it can be frequent, every few minutes or it may only happen a couple of times a day, every person varies.
With Thanks to: Lewy Body Society, Alzheimer’s Society, Alzheimer’s Research UK, Parkinson’s UK
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