Alzheimer’s disease is the most common form of dementia, accounting for between 50 and 70 per cent of cases. But there are other types of dementia. One of the most important types for us to be aware of is Lewy Body Dementia (LBD), which accounts for a significant percentage of non-Alzheimer’s dementias. Until recent years, many people with LBD were diagnosed with Alzheimer’s disease. While it is more likely now for persons with LBD to be correctly diagnosed, there are still challenges with the diagnostic process for these individuals.
Many people note that different types of dementia tend to have similar symptoms and ask, “What difference does it make what type it is?” With Lewy Body Dementia, the answer is that we know people with LBD can be very sensitive to certain drugs. Furthermore, limited doses of a drug a person is sensitive to can be detrimental, sometimes even causing irreversible damage.
So, what is Lewy Body Dementia (LBD)? LBD is related to Parkinson’s disease. It is degenerative and has no cure, but it can be slowed. LBD is caused by microscopic Lewy bodies in the cognitive and motor areas of the brain. It is more common in men than women.
Symptoms of LBD include fluctuations in cognitive functioning, vivid visual hallucinations, and motor dysfunctions (parkinsonism). REM sleep behavior disorders are common, as are repeated falls and fainting.
The most dangerous drugs for a person with LBD are traditional antipsychotics (such as Haldol) and benzodiazepines (such as Valium, Xanax, and Ativan) . A traditional antipsychotic may be prescribed for persons with dementia, usually for symptoms of agitation and/or aggression, or for hallucinations. Benzodiazepines may be prescribed for such problems as anxiety and sleep problems.
Other drugs that can cause adverse side effects for someone with LBD include atypical antipsychotics, decongestants and antihistamines, some antidepressants, antispasmodics used to relax muscles and treat incontinence, strong pain medications, and inhaled surgical anesthetics.
Each person with LBD is an individual. What causes problems for one person may not cause problems for another. The important thing is to be alert and aware of possible issues.
Caregivers interested in reading more about LBD may find the following book a very helpful resource:
A Caregiver’s Guide to Lewy Body Dementia by Helen Buell Whitworth and James Whitworth