I never heard of this disease until a couple of years ago. Nearly everyone knows about Alzheimer’s Disease (AD) which is the leading cause of dementia in the elderly. But have you ever heard of Lewy Body Dementia (LBD), which is now believed to be the second most common cause of dementia?
Mom was diagnosed with LBD in October 2005 (see Lewy Body posts on my blog ). LBD is a cruel combination of Alzheimer's, Parkinson's, hallucinations and fluctuations in cognition.
Dementia plus two of the following three symptoms indicates a probable diagnosis of LBD:
Parkinsonian-like signs such as bradykinesia, rigidity and postural instability, but not always a tremor, e.g. a patient may be unable to sit up straight before involuntarily leaning to one side.
Fluctuating cognitive ability. Sometimes there will be daily shifts in lucidity or mood exhibited, even making the patient appear normal
Visual and other sensory hallucinations, e.g. a patient may repeatedly experience a single, identical, odor that can’t be explained.
Mom currently fluctuates between level 6 and 7 on the following dementia scale:
Level 6: Severe Cognitive Decline (Middle Dementia or Moderately Severe AD)
Occasionally forget the name of the spouse upon whom they are entirely dependent for survival.
Largely unaware of all recent events and experiences in their lives.
Retain some knowledge of their past lives but this is very sketchy.
Generally unaware of their surroundings, the year, the season, etc.
Possible difficulty counting from 10, both backward and sometimes forward.
Require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will display ability to familiar locations.
Diurnal rhythm frequently disturbed.
Almost always recall own name.
Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment.
Personality and emotional changes occur. These are quite variable and include:
(1) delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror;
(2) obsessive symptoms, e.g., person may continually repeat simple cleaning activities;
(3) anxiety symptoms, agitation, and even previously nonexistent violent behavior may occur;
(4) cognitive abulla, i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action.
6a - Requires Assistance dressing
6b - Requires Assistance bathing properly
6c - Requires Assistance with mechanics of toileting
6d - Urinary incontinence
6e - Fecal incontinence
Level 7: Very Severe Cognitive Decline (Late Dementia or Severe AD)
All verbal abilities are lost. Frequently there is no speech at all - only grunting.
Incontinent of urine, requires assistance toileting and feeding
Lose basic psychomotor skills, e.g., ability to walk, sitting and head control
The brain appears to no longer be able to tell the body what to do
Generalized and cortical neurologic signs and symptoms are frequently present
7a - Speech ability limited to about a half-dozen intelligible words
7b - Intelligible vocabulary limited to a single word
7c - Ambulatory ability lost
7d - Ability to sit up lost
7e - Ability to smile lost
7f - Ability to hold up head lost
Unfortunately, our Mom is at the point where she needs to be evaluated for hospice in the home. It’s been a sad day after Christmas trying to get the wheels in motion. And I thought living with Parkinson’s was bad. " I ain’t see nothin’ yet.”
Resources:
Shake, Rattle and Roll: Kate Kelsall’s posts on Lewy Body Dementia
http://katekelsall.typepad.com/my_weblog/lewy_body_dementia/index.html
Lewy Body Dementia Association
http://www.lewybodydementia.org
Mary Gordon from Allexperts.com
http://en.allexperts.com/q/Alzheimer-s-Disease-1005/End-Stage-Lewy-Body.htm
Preparing for approaching death
http://en.allexperts.com/q/Parkinson-s-Disease-2096/tell-death-imminent.htm
I never heard of this disease until a couple of years ago. Nearly everyone knows about Alzheimer’s Disease (AD) which is the leading cause of dementia in the elderly. But have you ever heard of Lewy Body Dementia (LBD), which is now believed to be the second most common cause of dementia?
Mom was diagnosed with LBD in October 2005 (see Lewy Body posts on my blog ). LBD is a cruel combination of Alzheimer's, Parkinson's, hallucinations and fluctuations in cognition.
Dementia plus two of the following three symptoms indicates a probable diagnosis of LBD:
Parkinsonian-like signs such as bradykinesia, rigidity and postural instability, but not always a tremor, e.g. a patient may be unable to sit up straight before involuntarily leaning to one side.
Fluctuating cognitive ability. Sometimes there will be daily shifts in lucidity or mood exhibited, even making the patient appear normal
Visual and other sensory hallucinations, e.g. a patient may repeatedly experience a single, identical, odor that can’t be explained.
Mom currently fluctuates between level 6 and 7 on the following dementia scale:
Level 6: Severe Cognitive Decline (Middle Dementia or Moderately Severe AD)
Occasionally forget the name of the spouse upon whom they are entirely dependent for survival.
Largely unaware of all recent events and experiences in their lives.
Retain some knowledge of their past lives but this is very sketchy.
Generally unaware of their surroundings, the year, the season, etc.
Possible difficulty counting from 10, both backward and sometimes forward.
Require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will display ability to familiar locations.
Diurnal rhythm frequently disturbed.
Almost always recall own name.
Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment.
Personality and emotional changes occur. These are quite variable and include:
(1) delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror;
(2) obsessive symptoms, e.g., person may continually repeat simple cleaning activities;
(3) anxiety symptoms, agitation, and even previously nonexistent violent behavior may occur;
(4) cognitive abulla, i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action.
6a - Requires Assistance dressing
6b - Requires Assistance bathing properly
6c - Requires Assistance with mechanics of toileting
6d - Urinary incontinence
6e - Fecal incontinence
Level 7: Very Severe Cognitive Decline (Late Dementia or Severe AD)
All verbal abilities are lost. Frequently there is no speech at all - only grunting.
Incontinent of urine, requires assistance toileting and feeding
Lose basic psychomotor skills, e.g., ability to walk, sitting and head control
The brain appears to no longer be able to tell the body what to do
Generalized and cortical neurologic signs and symptoms are frequently present
7a - Speech ability limited to about a half-dozen intelligible words
7b - Intelligible vocabulary limited to a single word
7c - Ambulatory ability lost
7d - Ability to sit up lost
7e - Ability to smile lost
7f - Ability to hold up head lost
Unfortunately, our Mom is at the point where she needs to be evaluated for hospice in the home. It’s been a sad day after Christmas trying to get the wheels in motion. And I thought living with Parkinson’s was bad. " I ain’t see nothin’ yet.”
Resources:
Shake, Rattle and Roll: Kate Kelsall’s posts on Lewy Body Dementia
http://katekelsall.typepad.com/my_weblog/lewy_body_dementia/index.html
Lewy Body Dementia Association
http://www.lewybodydementia.org
Mary Gordon from Allexperts.com
http://en.allexperts.com/q/Alzheimer-s-Disease-1005/End-Stage-Lewy-Body.htm
Preparing for approaching death
http://en.allexperts.com/q/Parkinson-s-Disease-2096/tell-death-imminent.htm