Info dementia with lewy bodies

ALZHEIMER’S SOCIETY INFORMATION SHEET · JANUARY 2002 Dementia with Lewy bodies (DLB)
Dementia with Lewy bodies (DLB) is a form of dementia that shares characteristics with both
Alzheimer’s and Parkinson’s diseases. It may account for 10 to 15 per cent of all cases of dementia
in older people. This information sheet outlines the symptoms of DLB, how it is diagnosed and
treated.
What are Lewy bodies?
Symptoms characteristic of DLB
Lewy bodies (named after the doctor who first There are also symptoms that are characteristic of identified them in 1912) are tiny spherical protein deposits found in nerve cells. Their presence in the • Find that their abilities fluctuate daily, even brain disrupts the brain’s normal functioning, interrupting the action of important chemicalmessengers including acetylcholine and dopamine. • Faint, fall, or have ‘funny turns’ Lewy bodies are also found in the brains of • Experience detailed and convincing visual people with Parkinson’s disease (PD), a progressive hallucinations, often of people or animals. neurological disease that affects movement. Somepeople who are initially diagnosed with PD later go • Fall asleep very easily by day and have restless on to develop a dementia that closely resembles disturbed nights with confusion, nightmares and DLB. Researchers have yet to understand fully why Dementia with Lewy bodies (DLB) is sometimes Who gets DLB?
referred to by other names, including Lewy body dementia, Lewy body variant of Alzheimer’s disease, equally. As with all forms of dementia, DLB is diffuse Lewy body disease, cortical Lewy body more prevalent in people over the age of 65.
disease and senile dementia of Lewy body type. All However, in certain rare cases people under 65 may Symptoms
Diagnosing DLB
DLB is a progressive disease. This means that over DLB can be difficult to diagnose. People are often time the symptoms will become worse. In general diagnosed as having Alzheimer’s disease or vascular dementia. The diagnosis is made on the basis of the Alzheimer’s disease, typically over several years.
symptoms, particularly visual hallucinations, People with DLB will typically have some of the fluctuation and the presence of the stiffness and symptoms of Alzheimer’s and Parkinson’s diseases. While it is always important to get an accurate • People who have DLB often experience the diagnosis of dementia, a proper diagnosis is particularly important in cases of suspected DLB communication difficulties associated with since people with DLB have been shown to react badly to certain forms of medication (see below). • They may also develop the symptoms of Parkinson’s disease, including slowness, muscle DLB and neuroleptics
stiffness, trembling of the limbs, a tendency to Neuroleptics are strong tranquillisers usually given shuffle when walking, loss of facial expression to people with severe mental health problems. In and changes in the strength and tone of the voice. the past they have been prescribed to people withdementia. It is always preferable to find ways of dealing with a person’s distress and disturbance that do not For further information call the Alzheimer’s Helpline 0845 300 0336
ALZHEIMER’S SOCIETY INFORMATION SHEET · JANUARY 2002 involve medication. Under no circumstances should neuroleptics be prescribed as a substitute for good Department of Old Age PsychiatryInstitute for the Health of the Elderly particularly dangerous. This class of drugs induceParkinson-like side-effects, including rigidity,immobility, and an inability to perform tasks or tocommunicate. Studies have shown that whenprescribed for people with DLB they may causesudden death. If a person with DLB must be prescribed a neuroleptic it should be done with the utmost care,under constant supervision, and they should bemonitored regularly. The following list includes the names of many of the major neuroleptics available. New drugs areappearing from time to time. The generic name isgiven first, followed by some of the commonproprietary (drug company) names for thatparticular compound.
Chlorpromazine (Largactil)Clopenthixol (Clopixol)Haloperidol (Haldol, Serenace)Olanzapine (Zyprexa)PromazineQuetiapine (Seroquel)Risperidone (Risperdal)Sulpiride (Dolmatil, Sulparex, Sulpitil)Trifluoperazine (Stelazine) Treatment
At the moment there is no cure for DLB. Recent
research suggests that the cholinesterase inhibitor
drugs used to treat Alzheimer’s disease may also be
useful in treating DLB, although they are not yet
licensed for this use.
Symptoms such as hallucinations may resond to being challenged, but it can sometimes be unhelpfulto try to convince the person that there is nothingthere. It is then better to try to provide reassuranceand alternative distractions. People who are experiencing rigidity and stiffness owing to parkinsonism may benefit from anti-Parkinson’s disease drugs although these can makehallucinations and confusion worse. Physiotherapyand mobility aids may also help.
important to be as flexible as possible, bearing inmind that the symptoms of DLB will fluctuate. Alzheimer’s Society, Gordon House, 10 Greencoat Place, London SW1P 1PH. Telephone 020 7306 0606. Fax 020 7306 0808. Email info@alzheimers.org.uk. Website www.alzheimers.org.uk. Registered charity no. 296645. A company limited by guarantee and registered in England no. 2115499

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