DEAR DR. GOTT:
My family physician husband and I enjoy reading your column. However, concerning the 80-year-old woman who had been unsuccessfully treated for Alzheimer’s and depression and also had significant rigidity in her extremities, we believe that she may have Lewy body dementia. Her fearfulness may stem from hallucinations which are part of this disorder.
My father suffered from some of these symptoms, particularly increasing rigidity. He was later diagnosed at autopsy with Lewy body dementia. He, too, was on Aricept for several years with little or no difference in the condition.
DEAR READER:
Lewy body dementia is a relatively common form of dementia. It is characterized by the loss of the ability to think, reason and remember. This is due to the development of abnormal round structures (Lewy bodies) in the areas of the brain that control thinking and movement. It is unknown why these anomalies develop in the first place.
Symptoms are similar to both Parkinson’s disease and Alzheimer’s disease. A distinctive symptom is hallucinations that can appear very realistic. These can include sounds, shadows, colors, shapes, animals, people and more. Hallucinations are often the first sign of Lewy body dementia. Like Parkinson’s, it can also cause a shuffling gait, slowed movement, tremors and rigid muscles. Like Alzheimer’s, symptoms can include depression, memory loss, confusion, decreased cognition, and delusions.
Unlike other forms of dementia, sufferers of Lewy body dementia can experience large fluctuations in symptoms. They may awaken in the morning and be completely lucid and by late morning be inattentive or unable to stay awake. Symptoms can also worsen based on medication. If initial symptoms present as Parkinson’s disease and medicines designed to treat that condition are given, confusion, delusions, and hallucinations may worsen.
Lewy body dementia primarily affects individuals between the ages of 50 and 85 with a predominance toward men. You are at higher risk of developing this condition if you have a family member who had it. (Diagnosis can only be confirmed at autopsy.)
Unfortunately, there is no cure; however, treatments are available. Alzheimer’s medications seem to have the best results, but for some, like your father, do little good. Using memory aids and providing well structured environments often improve symptoms. Physical therapy, massage and even aromatherapy may also help. Reducing stress and situations that cause agitation, anger and fear are important and it is equally important to provide stimulating activities such as playing games that encourage memory, walking or another physical activity. Anyone with impaired memory needs to be closely monitored during outside activities to ensure they do not wander off and get lost or injured.
Most sufferers of dementia, regardless of the cause, have less drastic changes in mood, behavior and symptoms if given proper care. In the same way you care for a child, such as with bedtime rituals, proper communication, and more, so you should with the sufferer. In essence, rather than growing up, dementia causes people to “grow down”, reverting to childhood, toddler-hood and eventually infancy. It is a devastating process, but until more research is done and causes are found, we can only do our best to provide care, safety and most importantly, love.
Thank you for writing to remind me and my readers of this disorder.
Anyone who is interested in learning more about this form of dementia can go online to www.MayoClinic.com/health/lewy-body-dementia/DS00795. The Alzheimer’s Association also has information on several forms of dementia and can be found at www.Alz.org.
To give you related information, I am sending you a copy of my Health Report “Alzheimer’s Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott