[32][200] DLB was thought to be rare until it became easier to diagnose in the 1980s after the discovery of alpha-synuclein immunostaining that highlighted Lewy bodies in post mortem brains. [36] People with RBD may fall out of bed or injure themselves or their bed partners,[24][36][42] which may cause bruises, fractures, or subdural hematomae. A diagnosis of Lewy body dementia requires a progressive decline in your ability to think, as well as two of the following: 1. [1], The essential feature is dementia; for a DLB diagnosis, it must be significant enough to interfere with social or occupational functioning. Hu, a 42-year-old neurologist at the Emory Clinic who has researched dementia for the past decade, said Turner's interpretation is not uncommon. Alzheimer’s is the most common cause of dementia in the elderly. See additional information. [48], Motor symptoms may include shuffling gait, problems with balance, falls, blank expression, reduced range of facial expression, and low speech volume or a weak voice. [212], At the time of his suicide on August 11, 2014, Robin Williams, the American actor and comedian, had been diagnosed with Parkinson's disease. [72] Sexual dysfunction usually appears early in synucleinopathies, and may include erectile dysfunction and difficulty achieving orgasm or ejaculating. [112], Diagnostic tests can be used to establish some features of the condition and distinguish them from symptoms of other conditions. Dopar and Laradopa (levodopa) may improve movement problems or rigid limbs. [134] The incidence and prevalence of DLB are not known accurately, but estimates are increasing with better recognition of the condition since 2017. [178][176], The prognosis for DLB has not been well studied; early studies had methodological limitations, such as small sample size and selection bias. [215] As of 2019, clinical trials for several drugs are underway. Increased risk of falling and injury 5. [68] To lessen the risk of fractures in individuals at risk for falls, bone mineral density screening and testing of vitamin D levels are used,[164] and caregivers are educated on the importance of preventing falls. [76] AD pathology frequently co-occurs in DLB, so the cerebrospinal fluid (CSF) testing for Aβ and tau protein that is often used to detect AD is not useful in differentiating AD and DLB. [20] The three early syndromes may overlap. "[213] Ian G. McKeith, professor and researcher of Lewy body dementias, commented that Williams' symptoms and autopsy findings were explained by DLB. [24] Diagnosing DLB can be challenging because of the wide range of symptoms with differing levels of severity in each individual. [50], Up to 80% of people with DLB have visual hallucinations, typically early in the course of the disease. REM sleep behavior disorder (RBD)—in which people lose the muscle paralysis that normally occurs during REM sleep and act out their dreams—is a core feature. Forget your keys? Like Alzheimer disease, LBD causes intellectual and physical deterioration due to progressive damage of brain cells. [22] Modafinil may be used for hypersomnia, but no trials support its use in DLB. [65], From chewing to defecation, alpha-synuclein deposits affect every level of gastrointestinal function. Dementia with Lewy bodies is sometimes classified in other ways. [24][25], While specific symptoms may vary, the core features of DLB are fluctuating cognition, alertness or attention; REM sleep behavior disorder; one or more of the cardinal features of parkinsonism, not due to medication or stroke; and repeated visual hallucinations. DLB is diagnosed when cognitive symptoms begin before or at the same time as parkinsonian motor signs. [9] Most medications to treat anxiety and depression have not been adequately investigated for DLB. However, this is highly variable, and some people may live much longer … [62], Among the other supportive features, psychiatric symptoms are often present when the individual first comes to clinical attention and are more likely, compared to AD, to cause more impairment. [22][10][74] Mirtazapine and SSRIs can be used to treat depression, depending on how well they are tolerated, and guided by general advice for the use of antidepressants in dementia. [30] Problems with executive function surface in activities requiring planning and organizing. [24][44][c] In individuals with dementia and a history of RBD, a probable DLB diagnosis can be justified (even with no other core feature or biomarker) based on a sleep study showing REM sleep without atonia because it is so highly predictive. Most people with DLB do not have affected family members, although occasionally DLB runs in a family. 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