Dementia with Lewy body is a neurodegenerative disease that gets worse over time and can't be cured, but treatments can help ease the symptoms.
Diagnosis
Lewy body dementia is characterized by a gradual deterioration in cognitive abilities and the presence of at least two of the following symptoms;
- Variations in mental performance, including fluctuating alertness
- Visual hallucinations that keep on repeating themselves
- Parkinsonian symptoms
- Those who suffer from REM sleep behavior disorder frequently enact their dreams while sleeping
Autonomic dysfunction, such as an irregular heart rate and blood pressure, poor control of body temperature, excessive sweating, and other symptoms, makes it more likely that someone has Lewy body dementia. Drug sensitivity, especially to older antipsychotics like haloperidol, also has a role (Haldol). People with Lewy body dementia aren't given medications like Haldol because of the risk of a fatal reaction.
A single test cannot determine Lewy body dementia. The diagnosis is made after all other possible reasons for your symptoms have been ruled out. A few examples of possible tests are:
- Neurological and physical examination
- Assessment of mental abilities
- Brain scans
- Blood tests
- Sleep evaluation
- Emerging biomarkers
- Heart test
Treatment
There is no known cure for Lewy body dementia; however, targeted treatments may alleviate many symptoms.
Medications
- Anti-cholinesterase drugs. Medications for Alzheimer's disease, such as rivastigmine (Exelon), donepezil (Aricept), and galantamine (Razadyne), are effective because they raise concentrations of neurotransmitters that are thought to be crucial to cognitive processes like memory, reasoning, and decision-making. This can assist increase a person's level of alertness and intellect, and it may even lessen their hallucinations and other behavioral issues.
- Possible side effects include stomach pain, muscle cramps, and the need to go to the bathroom more often. Additionally, it may cause or worsen cardiac arrhythmias.
- Memantine (Namenda), an N-methyl-d-aspartate (NMDA) receptor antagonist, might be a cholinesterase inhibitor for some persons with moderate to severe dementia.
- Treatments for Parkinson's disease. Some Parkinson's symptoms, like stiff muscles and slow movement, can be helped by medicines like carbidopa-levodopa (Sinemet, Rytary, Duopa). But these drugs can also make mental symptoms worse, such as feeling confused or paranoid.
- Medicines for alleviating various ailments. Lewy body dementia has several symptoms, some of which can be helped with medication.
Some drugs can make memory worse. Avoid over-the-counter sleep aids with diphenhydramine (Advil PM, Aleve PM) and medications used to relieve the need to go to the bathroom right away that contain oxybutynin (Ditropan XL).
You should also discuss with your doctor whether or not any of the medications you take could contribute to your memory loss, and try to cut back on sedatives and sleeping pills.
To varying degrees, antipsychotic medications may result in drowsiness, coma, and even death. Some second-generation antipsychotics, like quetiapine (Seroquel) or clozapine (Clozaril, Versacloz), may be taken for a limited duration at a low dose, but only if the benefits justify the hazards.
Therapies
Since antipsychotic drugs can make the symptoms of Lewy body dementia worse, it might be best to try non-drug treatments first.
- Tolerating the behavior: Some people suffering from Lewy body dementia aren't bothered by their hallucinations. The medication's adverse effects may be more distressing than the hallucinations themselves.
- Modifying the environment: Eliminating unnecessary distractions can be helpful for those with dementia. The reactions of caregivers can sometimes make the situation worse. Do not try to teach or test someone who has dementia. Reassure them and acknowledge their worries.
- Regular practices and routine simplification: Divide complex work into manageable chunks and look for opportunities, not excuses. You can alleviate confusion with a daily schedule and routine.
Lifestyle Changes and Home Remedies
Lewy body dementia has a wide range of symptoms and a different course from person to person. The following rules are general, and caregivers and care partners may need to change them for specific situations.
- Use simple and clear language: make direct eye contact, speak clearly and gently, and avoid sounding hasty. Disclose only a single concept or directive at a time. Pointing out specifics is an excellent example of a gesture that can help you communicate.
- Encourage physical activity: Physical and mental health both benefit from regular exercise. Exercise might help people with dementia keep their minds from getting worse as quickly.
- Give your mind something to do: People with dementia may benefit from games, crossword puzzles, and word searches that keep their minds active. Promote expressions of individuality through the arts.
- Make plans to do things together: Discuss the matter with pals. Attend certain religious events.
- Establish a bedtime routine: Nighttime is challenging for people with behavioral problems. With the TV turned off, the dishes put away, and everyone in bed, you may create soothing pre-sleep routines. Avoid getting lost by keeping some light on at night.
You could avoid being restless at night by drinking less coffee, skipping naps, and exercising more daily.
Many people with Lewy body dementia experience a range of feelings, from confusion and irritation to rage and melancholy. Help the person feel better by listening, telling them there is still joy in life, keeping a good attitude, and doing everything you can to help them keep their sense of self-worth.
Caretakers of those with Lewy body dementia must keep a close eye on their loved ones to prevent accidents like falls, loss of consciousness, and adverse drug reactions. When the person is having mental distress, such as feeling lost or hallucinating, try to reassure them.