Lewy Body Dementia Versus Parkinson’s

What Are The Types Of Lewy Body Dementia

There are two types of LBD: dementia with Lewy bodies and Parkinsons disease dementia.

Both types cause the same changes in the brain. And, over time, they can cause similar symptoms. The main difference is in when the cognitive and movement symptoms start.

Dementia with Lewy bodies causes problems with thinking ability that seem similar to Alzheimers disease. Later, it also causes other symptoms, such as movement symptoms, visual hallucinations, and certain sleep disorders. It also causes more trouble with mental activities than with memory.

Parkinsons disease dementia starts as a movement disorder. It first causes the symptoms of Parkinsons disease: slowed movement, muscle stiffness, tremor, and a shuffling walk. Later on, it causes dementia.

Who Gets Dementia With Lewy Bodies

Around 5% of people with a diagnosis of dementia are recorded as having DLB, but there is good evidence that the condition is under-diagnosed. Scientists think DLB may account for up to 20% of all dementia.

Dementia with Lewy bodies affects men and women roughly equally. As with most other types of dementia, DLB becomes increasingly common over the age of 65. It can also affect people younger than this.

There is not much evidence that anything we might be exposed to during our lives increases the risk of DLB. Having a traumatic head injury may increase the risk of developing Parkinsons disease later in life, but its not known whether this also applies to DLB.

Almost all people who develop DLB have a sporadic form, which means that the main cause is unknown. Some genes may increase the risk of developing DLB.

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Difference Between Parkinsons Disease Dementia And Dementia With Lewy Bodies

Technically, the difference between these two conditions lies in how quickly the cognitive difficulties and hallucinations develop in relation to the movement issues. In DLB, the cognitive difficulties and hallucinations develop much sooner in the disease course than in PDD, sometimes even prior to the movement difficulties. Because of the similarities between PD, PDD, and DLB, current thinking in the medical community is that they should be viewed as related diseases which fall along a continuum of Lewy body disorders.

APDAParkinsons Disease SymptomsLewy Bodies, Dementia, and Parkinsons What Does it all Mean?

Here are two common scenarios that may sound familiar:

Scenario 1A patient develops a series of neurologic symptoms, is evaluated by a neurologist and is told that she has Parkinsons disease . She then visits another neurologist for a second opinion and is told she has Lewy Body Dementia .

Scenario 2A patient has his first visit with his neurologist and is told that he has PD, at a subsequent visit the diagnosis is changed to Parkinsons disease dementia , and at a follow up visit the diagnosis is changed yet again to Dementia with Lewy Bodies .

Both of these situations understandably cause great uncertainty and frustration.

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Rapid Eye Movement Sleep Behavior Disorder

REM sleep behavior disorder refers to a syndrome in which the normal paralysis of REM sleep is impaired. As a result, patients bed partners may report that they act out their dreams with behaviors such as kicking, punching, and yelling. The observation that most REM sleep behavior disorder behaviors are violent suggests that the impairment of paralysis may be relative, with a reduction in threshold that is overcome by only the most emotionally salient dreams, perhaps on the basis of catecholamine or amygdala drive.

Mild Cognitive Impairment Preceding Dementia With Lewy Bodies

Patients with the clinical features of DLB but who remain independent for their instrumental and basic activities of daily living meet criteria for Lewy body spectrum MCI.14 The sensitivity and specificity for a diagnosis of Lewy bodyMCI are likely to be lower than for DLB, in part due to milder manifestations of the core criteria. Ancillary testing has yet to be validated in LB-MCI. For example, the prevalence of occipital hypometabolism appears to be reduced in LB-MCI compared with DLB. In addition, the sensitivity of the DAT scan may be reduced when extrapyramidal symptoms are mild. Like preclinical DLB, LB-MCI is a useful construct for therapeutic clinical trials and for biomarker studies.

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Whats The Difference Between Lewy Body Dementia Parkinsons Disease And Alzheimers Disease

Lewy body dementia is an umbrella term for two related clinical diagnoses: dementia with Lewy bodies and Parkinsons disease dementia. These disorders share the same underlying changes in the brain and very similar symptoms, but the symptoms appear in a different order depending on where the Lewy bodies first form.

Dementia with Lewy bodies is a type of dementia that causes problems with memory and thinking abilities that are severe enough to interfere with everyday activities. It specifically affects a persons ability to plan and solve problems, called executive function, and their ability to understand visual information. Dementia always appears first in DLB. The motor symptoms of Parkinsons such as tremor, slowness, stiffness and walking/balance/gait problems usually become more evident as the disease progresses. Visual hallucinations, REM sleep behavior disorder, fluctuating levels of alertness and attention, mood changes and autonomic dysfunction are also characteristic of DLB.

Finally, Alzheimers is characterized by different abnormal clumps called amyloid plaques, and jumbled fiber bundles called tau tangles. These microscopic structural changes in the brain were discovered by Dr. Alois Alzheimer in 1906. These plaques and tangles, together with loss of connections between nerve cells, contribute to loss of coherence and memory, as well as a progressive impairment in conducting normal activities of daily living.

How Is Lewy Body Dementia Diagnosed

Diagnosing Lewy body dementia can be challenging. Early LBD symptoms are often confused with symptoms found in other brain or psychiatric conditions.

There are no medical tests that can diagnose Lewy body dementia with 100% accuracy. A diagnosis may require a group of specialists, including:

• Neuropsychologists.

Together, they can make the diagnosis of probable LBD based on the combined results of tests and symptoms.

Along with a history of progressive cognitive decline that interferes with daily activities, a diagnosis of LBD is considered probable if two of the following four core features are present and is considered possible if only one is present:

• Fluctuations in cognition and behavior.
• Recurrent visual hallucinations.
• Rapid eye movement sleep behavior disorder.

Some people with Parkinsons disease who develop cognitive symptoms less than a year after the onset of movement problems may be diagnosed with Lewy body dementia.

Healthcare providers use the following strategies to help diagnose LBD and to rule out conditions that cause similar symptoms:

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Global Lewy Body Dementia Treatment Industry Report Highlights Significant Dynamics And In

The MarketWatch News Department was not involved in the creation of this content.

Oct 22, 2022 –Global Lewy Body Dementia Treatment Market includes Elaborative company profiling of leading players of the Lewy Body Dementia Treatment market. All of the segments studied in the report are analyzed based on different factors such as market share, revenue, and CAGR. The analysts have also thoroughly analyzed different regions such as North America, Europe, and the Asia Pacific on the basis of production, revenue, and sales in the Lewy Body Dementia Treatment market. The researchers used advanced primary and secondary research methodologies and tools for preparing this report on the Lewy Body Dementia Treatment market.

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About Lewy Body Dementia Treatment Market:

Lewy body dementia is an umbrella term that includes Parkinson’s disease dementia and dementia with Lewy bodies , two dementias characterized by abnormal deposits of the protein alpha-synuclein in the brain.

Due to the COVID-19 pandemic and Russia-Ukraine War Influence, the global market for Lewy Body Dementia Treatment estimated at USD 4422.9 million in the year 2022, is projected to reach a revised size of USD 5383.5 million by 2028, growing at a CAGR of 3.3% during the forecast period 2022-2028.

Report Scope

Here is List of BEST KEY PLAYERS Listed in Lewy Body Dementia Treatment Market Report are:-

Key Stakeholders

Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license , applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Mechanisms For Dementia And Disease

Multiple pathologic processes have been linked to cognitive impairment and psychosis in DLB and PDD, including -synuclein deposition with secondary synapse impairment,7,52,53 amyloid burden,10,54 and dopamine55 and acetycholine9 cell loss .5260 The difference in the timing of cognitive and motor impairments in DLB and PDD likely reflects a difference in the temporal sequence of these pathologies. One possibility is that in DLB, cortical lesions, mostly -amyloid, arise early, driving cognitive impairment. Then, -synuclein pathology ascends from brainstem to cortex. In contrast, in PDD, cortical lesions arise late, and ascending -synuclein pathology drives the clinical syndrome. Amyloid PET imaging in DLB and PDD supports this model, showing high amyloid burden in most cases of DLB, with more modest accumulation in PDD.54 Antibodies targeting -amyloid have entered clinical trials in AD and MCI.61 Although the outcomes are uncertain, the strategy is applicable to DLB and possibly to PDD, where amyloid accumulation appears to contribute to certain clinical features, including the timing and rate of cognitive decline.54 A similar immune targeting approach is under development for -synuclein. If successful, this strategy would be applicable to both DLB and PD, irrespective of cognitive impairment.

Memory And Thinking Problems

You may experience forgetfulness, slowed thinking and difficulty concentrating. You might find it harder to follow conversations, and remember some words and names. This can make communication difficult.

You may also find it increasingly difficult to make decisions, plan activities and solve problems. This can make everyday activities harder.

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Loss Of Cognition And Memory

Cognition is the mental process of acquiring knowledge and understanding through thought, experience, and the senses. With both LBD and Alzheimer’s, cognition is affected but in significantly different ways.

With LBD, the loss of cognition and memory can fluctuate. On one day, a person will LBD will not recognize a grandchild but, on the next, be able to recall the names of each of their grandchildren.

With Alzheimer’s, there may be variations, but the decline is generally steady, and there is not usually a big change from one day to the next. Over time, the gaps in lucidity become smaller and smaller.

Behaviors Seen In Parkinsons Disease Dementia

As dementia progresses, managing disorientation, confusion, agitation, and impulsivity can be a key component of care.

Some patients experience hallucinations or delusions as a complication of Parkinsons disease. These may be frightening and debilitating. Approximately 50 percent of those with the disease may experience them.

The best thing to do when giving care to someone experiencing hallucinations or delusions from Parkinsons disease dementia is to keep them calm and reduce their stress.

Take note of their symptoms and what they were doing before they exhibited signs of hallucinating and then let their doctor know.

This element of the disease can be particularly challenging for caregivers. Patients may become unable to care for themselves or be left alone.

Some ways to make caregiving easier include:

• sticking to a normal routine whenever possible
• being extra comforting after any medical procedures
• limiting distractions
• using curtains, nightlights, and clocks to help stick to a regular sleep schedule
• remembering that the behaviors are a factor of the disease and not the person

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Lewy Body Dementia: A Common Yet Underdiagnosed Dementia

While its not a household word yet, Lewy body dementia is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States. Because LBD symptoms can closely resemble other more commonly known disorders like Alzheimers disease and Parkinsons, it is often underdiagnosed or misdiagnosed. In fact, many doctors or other medical professionals still are not familiar with LBD.

What Is Dementia With Lewy Bodies

Dementia with Lewy bodies inhibits everyday activities by causing memory and thinking problems, specifically targeting problem-solving, planning, and visual learning abilities. In contrast to PDD, dementia usually always appears first or around the same time as parkinsonism) in patients with DLB. The motor symptoms of Parkinsons come as the disease progresses.

The main difference between Parkinsons disease and dementia with Lewy bodies is the timeline of the symptom onset. With Parkinsons, onset of symptoms usually happens gradually over years of having the illness. However, with Lewy body dementia, the onset of symptoms is much more aggressive, rapidly affecting patients within a year of diagnosis.

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Behavioral And Mood Symptoms Of Lewy Body Dementia

Changes in behavior and mood are possible in LBD and may worsen as the persons thinking abilities decline. These changes may include:

• Apathy, or a lack of interest in normal daily activities or events and less social interaction
• Anxiety and related behaviors, such as asking the same questions over and over or being angry or fearful when a loved one is not present
• Agitation, or restlessness, and related behaviors, such as pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability
• Delusions, or strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living.
• Paranoia, or an extreme, irrational distrust of others, such as suspicion that people are taking or hiding things

Causes Of Dementia With Lewy Bodies

Dementia with Lewy bodies is caused by clumps of protein forming inside brain cells. These abnormal deposits are called Lewy bodies.

These deposits are also found in people with Parkinsons disease, and they build up in areas of the brain responsible for functions such as thinking, visual perception and muscle movement.

Its not clear why the deposits develop and how exactly they damage the brain. Its thought that part of the problem is the proteins affecting the brains normal functions by interfering with signals sent between brain cells.

Dementia with Lewy bodies usually occurs in people with no family history of the condition, although there have been very rare cases that seem to run in families.

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What Are The Signs And Symptoms Of Lewy Body Dementia

The most common symptoms of LBD include changes in thinking abilities, movement, sleep, and behavior. The degree of symptoms can vary widely and people with LBD may not have every symptom. Common symptoms include:

• Trouble with attention, planning, multitasking, problem-solving, and reasoning. Memory problems are also common but may not be noticeable early on.
• Problems with visual and spatial abilities, such as judging distance and depth or misidentifying objects.
• Unpredictable changes in concentration, attention, alertness, and wakefulness.
• Visual hallucinations, which occur in up to 80% of people with LBD, often early on.
• Movement changes, such as tremor or muscle stiffness, known as parkinsonism.
• Sleep disorders, including rapid eye movement sleep behavior disorder in which a person seems to act out dreams while asleep, excessive sleep or lack of sleep, and restless leg syndrome.
• Depression, lack of interest, anxiety, ideas not based in reality, and other changes in mental health.
• Sensitivity to heat and cold, dizziness, poor sense of smell, and other changes in automatic functions of the body.

Individuals with mild symptoms can often function close to normally. As the disease progresses and thinking and movement abilities decline, people with LBD will need more help and may depend on caregivers full time.

Who Does Lewy Body Dementia Affect

Lewy body dementia typically affects people over the age of 50. The older you are, the more at risk you are for developing the condition. Men and people assigned male at birth are more likely to have Lewy body dementia than women and people assigned female at birth.

A family history of LBD and Parkinsons disease also increases your risk of developing it.

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Treatment Of Motor Symptoms In Parkinsons Disease

Treatment of motor, psychological/psychiatric, and autonomous symptoms of Parkinsons disease should be symptomatic, depending on the degree of clinical impairment and independently of a diagnosis of dementia with Lewy bodies or Parkinsons disease dementia. Attention needs to be paid to the reduced response of motor symptoms, especially akinesis, to levodopa in 40% of patients with Lewy body dementia. Owing to the development of the dementia and the tendency to develop psychoses in dementia with Lewy bodies, monotherapy with levodopa is usually recommended. Studies of combination treatment with dopamine agonists and levodopa have not been conducted in patients with Lewy body dementia whether combination treatment with dopamine agonists is useful and tolerable depends on the individual case. This requires consideration, especially bearing in mind the patients age . Close monitoring for possible psychotic symptoms is urgently advised. The administration of anticholinergic drugs is contraindicated.