Lewy body dementia

Lewy body dementia

Lewy body dementia (LBD, sometimes referred to as Lewy body disorder) is an umbrella term that includes Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), two dementias characterized by abnormal deposits of the protein alpha-synuclein in the brain.

As of 2013, Lewy body dementias affect about 1.3 million people in the United States, though this number is said to be an underestimate given the difficulty of diagnosing the disorder. LBD usually develops after the age of 50. While a study published on JAMA Neurology in 2013 pointed out a notable difference between DLB and PDD in age and sex, more research is needed to confirm any discrepancies.

While both dementia with Lewy bodies and Parkinson's disease dementia have similar neuropathologic features, they are highly variable and should not be distinguished on pathologic features alone. Generally, DLB is distinguished from PDD by the time frame in which dementia symptoms appear relative to parkinsonian symptoms. DLB is diagnosed when cognitive symptoms begin before or at the same time as parkinsonism, while PDD is the diagnosis when Parkinson's disease is well established before the dementia occurs.

Current disease management focuses on treating each symptom. For cognitive symptoms, the standard treatment is Cholinesterase Inhibitors (CHEIs). This drug class is effective in reducing apathy, visual hallucinations, and delusions symptoms. For movement symptoms, Levodopa is considered the standard treatment. Some research efforts in exploring alternative LBD therapeutics have been called questionable due to a variety of factors including choice of study design, exclusion criteria, limitation of outcomes, strength of evidence, and complications between PDD and DLB classifications. Beside pharmacological management, there are other available non-medical treatments like physical therapy, speech therapy, occupational therapy, individual and family psychotherapy, and support groups that might be recommended by physicians to improve and address the needs of each patient.