lewy body dementia case study

THE ENIGMA OF LEWY BODY DEMENTIA: A CASE REPORT

Affiliation.

• 1 1Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Catholic University of Croatia, Zagreb, Croatia; 4School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
• PMID: 34285451
• PMCID: PMC8253061
• DOI: 10.20471/acc.2020.59.04.27

Lewy body dementia is a progressive neurodegenerative disease and is considered to be the second most common cause of dementia in the elderly. Because of the complexity of clinical presentation, it is often misdiagnosed and mistaken for other dementias, which may result in administering inappropriate therapy, and thus worsening of the patient condition. We reviewed a case of a 71-year-old patient whose clinical presentation gradually occurred with complex visual hallucinations, atypical extrapyramidal motor symptoms, fluctuating cognitive impairments with delirious episodes, and oscillating syncope. Depressive mood, impaired daily functioning and sensitivity to antipsychotics were also noted. Extensive diagnostic workup was performed with neuropsychological testing and use of single-photon emission computerized tomography. Considering the clinical presentation and diagnostic procedures performed, the diagnosis of Lewy body dementia was set and pharmacotherapy was revised. We discuss the importance of taking overall clinical presentation and diagnostic treatment in consideration and applying appropriate therapy to slow down the progression of the disease and exacerbation of the patient's psychological functions.

Keywords: Cholinesterase inhibitors; Cognitive dysfunction; Dementia; Hallucinations; Lewy body disease; Parkinsonian disorders.

Publication types

• Case Reports
• Lewy Body Disease* / complications
• Lewy Body Disease* / diagnosis
• Neurodegenerative Diseases*

Clinical Trials

Lewy body dementia.

Displaying 24 studies

The objectives of this study are to determine the predictors of death within 6 months in individuals with Dementia with Lewy Bodies (DLB), to identify whether a change in caregiver measures can predict approaching end of life of individuals with DLB, and to identify factors that affect quality end of life experiences for persons with DLB and their caregivers.

Dementia with Lewy bodies (DLB) is part of Lewy body dementia, the 2nd-most-common degenerative dementia in the U.S. It is also one of the Alzheimer’s disease-related dementias (ADRDs). Evidence-based models of end-of-life care for ADRDs are insufficient; families face difficult ...

The purpose of this study is to examine the effects of the medication Armodafinil in patients who have dementia with Lewy bodies which is associated with memory loss and other thinking problems, excessive daytime sleepiness, hallucinations, delusions, apathy, and reduced quality of life.

Longitudinal Imaging Biomarkers of Disease Progression in Prodromal and Overt DLB

This study seeks to evaluate the efficacy and safety of intepirdine (RVT-101) in patients with dementia with Lewy bodies.

The purpose of this study is to assess the safety and tolerability of CT1812 as a treatment for mild-to-moderate Dementia with Lewy Bodies.

The purpose of this study is twofold:

Specific Aim 1

• In biopsies of skin from living subjects with DLB, PD without dementia (PD), and PD with dementia (PDD), assess the relative diagnostic sensitivity and specificity of IHC and seeding assay measures of aSyn, relative to normal control subjects.

Specific Aim 2

• In second biopsies of skin from subjects with DLB, PD and PDD, assess whether IHC and seeding measures of aSyn progress, regress or remain stable over time, indicating whether these may be useful as measures of therapeutic agent target engagement and disease progression.

The purpose of this study is to evaluate the safety and effectiveness of Nelotanserin for the treatment of visual hallucinations in patients with Lewy body dementia.

This 6-month extension study will provide further information regarding the long-term safety and tolerability of intepirdine (RVT-101) in subjects with Dementia with Lewy bodies (DLB) who have participated in the double-blind, placebo-controlled, lead-in study RVT-101-2001.

The purpose of this study is to collect blood samples for DNA analysis from patients clinically diagnosed with Alzheimers disease, Lewy Body disease, and Frontotemporal degeneration.

A randomized placebo-controlled trial in individuals with Parkinson's disease dementia to evaluate the safety and efficacy of three doses of study drug LY3154207 in participants with mild-to-moderate Parkinson's disease dementia treated for 12 weeks.

This study seeks to evaluate the safety and efficacy of Nelotanserin for the treatment of Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD) in subjects with dementia with Lewy bodies (DLB) or Parkinson's disease dementia (PDD).

The purpose of this study is to evaluate the effect of neflamapimod on cognitive function as assessed in a study-specific Cogstate Neuropsychological Test Battery (NTB).

The purpose of this study is to optimize profile questionnaire and matching algorithm developed in Phase I and implement in final website design, and to determine if algorithmically matched participants have statistically significant increase in match satisfaction and self-reported sense of resiliency and quality of life over randomly matched caregivers.

The purpose of this study is to develop and test the effectiveness of an investigational imaging technique called magnetic resonance elastography (MRE) to measure the stiffness (mechanical properties) of tissues.

This study is being done to learn more about normal memory and aging, mild memory and thinking problems, Alzheimer's disease and other forms of dementia.

This study seeks to evaluate the long-term safety and effectiveness of nelotanserin for the treatment of visual hallucinations (VHs) and Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD) in subjects with Lewy body dementia (LBD).

The purpose of this study is to facilitate focus groups to assess/identify important qualities and characteristics that dementia caregivers are looking for in a supportive person, and to design a prototype website for matching current and former caregivers.

The investigators propose using DaTscan in patients with mild cognitive impairment (MCI), Parkinson's disease (PD), dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and other neurodegenerative syndromes and disorders, to test several hypotheses - some confirmatory, and some novel. Such use will provide new data on the potential clinical and research utility of DaTscan in neurodegenerative diseases. The findings on DaTscan will be correlated with clinical diagnoses and other multimodal imaging studies (e.g., MRI, MRS, FDG-PET, and amyloid-PET) to enhance our understanding of neurodegenerative diseases.

The purpose of this study is to understand why patients with multiple system atrophy, Parkinson’s disease, Parkinson’s disease with autonomic failure, and dementia with Lewy bodies have a fall in blood pressure on standing up. It is believed that different patients develop these symptoms for different reasons. The reasons could be:

• damage to nerve supply to the legs

• the autonomic nerves are not working properly

• the brain is not controlling blood pressure or heart rate properly

This study will look at these different reasons.

The purpose of this study is to learn more about Lewy Body disease and a skin condition called Bullous Pemphigoid.

The goal of this study is to gain a better understanding of the status of advanced care planning among caregivers of patients with dementia and examine how this differs by race and disease stage.

The purpose of this study is to develop a diagnostic test using tissue biomarkers to provide an accurate diagnosis of alpha-synucleinopathies in patients with Parkinson's disease, Multiple System Atrophy, Dementia with Lewy bodies and Pure Autonomic Failure. Using a simple diagnostic test will improve clinical accuracy in diagnosing, earlier diagnosis, and distinguishing between neurodegenerative diseases.

Most individuals with rapid eye movement (REM) sleep behavior disorder (RBD) develop additional neurological symptoms and are subsequently diagnosed with overt synucleinopathies, including dementia with Lewy bodies (DLB), Parkinson disease (PD), and multiple system atrophy (MSA), indicating that RBD represents a prodromal stage of synucleinopathy. RBD therefore offers a window of opportunity to intervene with neuroprotective treatments at the earliest stages of disease when treatment is most likely to be effective. Recognizing the importance of early intervention, key federal agencies focused on neurodegenerative disease have proposed high priority recommendations for prodromal aspects of synucleinopathies, including specifically RBD, to prepare for ...

The purpose of this study is to study the structure and biochemistry of the brain and/or bodily fluid and tissue after death.  Comparison of specimens from normal and diseased individuals provide essential clues that lead to a greater understanding of the diseased state which, in turn, will lead to new ideas for therapy.

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Case study – Heather’s story

Home > Case study – Heather’s story

Thank you to Heather Ritchie for sharing her story as part of the Carers Week report. Read the report and recommendations here .

Carers Week charities are calling for an urgent 12-month plan of targeted support for unpaid carers, as many struggle with the ongoing impact, as well as the legacy, of the pandemic, together with the strain of the social care and cost of living crises.

For the first time, the impact of caring on their own physical and mental health has topped carer’s concerns, closely followed by money worries.

The research, released for Carers Week 2022 (6-12 June), reveals that 84% of the general public think that the UK governments should provide additional support to unpaid carers including increased financial support and investment in care and support services so that unpaid carers can have a break. Only 3% disagreed.

The report also shows that the number of unpaid carers remains higher than before the pandemic with one in five of the UK’s adults (approximately 10.58 million people) now supporting a relative, close friend or neighbour because of chronic illness, including mental ill-health, dementia, disability, or older age.

Heather’s Story

My partner Chris was diagnosed with early onset Lewy body dementia at the age of 60.

Chris is a very active campaigner, gives lots of talks and is an ambassador for several charities, including The Lewy Body Society. I want to support her to do these things and live her life as she wants to, but the support she requires has significantly increased during the Covid-19 pandemic.

Chris has gone from being a person being able to travel to meetings on her own and giving talks, to now needing much more support to do this. She needs someone to accompany her and needs reassurance.

Chris was classed as clinically vulnerable and wasn’t allowed to leave the house for significant periods of time, not even to have a walk. Due to this her mood and symptoms have declined, and she has lost confidence. This directly impacts on the time I have to look after my own well-being.

Her medication used to be put into dosette boxes by the pharmacy which ensured the right tablets were in order and labelled for morning, evening and night-time. Due to Covid this was withdrawn and has never been reinstated. This meant I had to purchase our own boxes and still have to take on the extra responsibility for sorting out all the medication into correct time zones. She is on about 30 different tablets per day and I have to prompt her to take the tablets.

I get less of a break as I am far more worried about leaving Chris for longer periods now. Not only does she forget to take medication, but she struggles to prepare food and eat meals without reminders.

I have little to no confidence in getting the support we will need in the future from official sources and expect to be heavily reliant on support from charities supporting those living with dementia and carers groups. We will probably have to use all our savings to pay for care, and I fear we will live out our last years in poverty. I don’t understand why dementia is classed as a social care problem. As a terminal, life-limiting brain illness it should come fully under health care. We urgently need the Government to do something about this.

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Updates in Fluid, Tissue, and Imaging Biomarkers for Dementia with Lewy Bodies and Implications for Biologically Based Disease Definitions

• Published: 04 May 2024

Cite this article

• Samantha K. Holden MD, MS 1  

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Purpose of Review

Dementia with Lewy bodies (DLB) remains underrecognized and underdiagnosed due to its clinical and pathological heterogeneity. Diagnosis currently relies on recognition of clinical features and imaging and neurophysiologic biomarkers. However, clinical features are less obvious in mixed neurodegenerative pathologies, advanced imaging techniques are often inaccessible, and current DLB indicative biomarkers do not directly identify Lewy pathology.

Recent Findings

Seed amplification assay techniques have allowed for in vivo detection of pathological alpha-synuclein protein in the cerebrospinal fluid, blood, and dermal biosamples. Incorporation of co-pathology markers and refinement of the application and interpretation of existing tests for DLB, including brain and cardiac imaging, are also ongoing. Strategic combinations of Lewy biomarkers with other markers of neurodegeneration and neuroinflammation could create individualized patient profiles for diagnosis, prognosis, treatment selection, and response monitoring.

Continued validation and technical harmonization efforts will be needed prior to widespread clinical application of new Lewy body biomarkers. Combining existing and novel DLB and co-pathology biomarkers, along with thorough clinical evaluation, will lead to increased reliability and accuracy of etiological dementia diagnosis. Use of biomarker profiles and biologically based disease definitions will improve care and accelerate treatment discovery for people living with DLB.

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Biomarkers in biological fluids for dementia with Lewy bodies

Clinical biomarkers for Lewy body diseases

Fluid Biomarkers in Alzheimer’s Disease and Frontotemporal Dementia

Data availability.

No datasets were generated or analyzed during the current study.

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Holden, S.K. Updates in Fluid, Tissue, and Imaging Biomarkers for Dementia with Lewy Bodies and Implications for Biologically Based Disease Definitions. Curr Treat Options Neurol (2024). https://doi.org/10.1007/s11940-024-00791-w

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Published : 04 May 2024

DOI : https://doi.org/10.1007/s11940-024-00791-w

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Lewy body dementia is the second most common type of dementia after Alzheimer's disease. Protein deposits called Lewy bodies develop in nerve cells in the brain. The protein deposits affect brain regions involved in thinking, memory and movement. This condition is also known as dementia with Lewy bodies.

Lewy body dementia causes a decline in mental abilities that gradually gets worse over time. People with Lewy body dementia might see things that aren't there. This is known as visual hallucinations. They also may have changes in alertness and attention.

People with Lewy body dementia might experience Parkinson's disease symptoms. These symptoms may include rigid muscles, slow movement, trouble walking and tremors.

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Lewy body dementia symptoms can include:

• Visual hallucinations. Seeing things that aren't there, known as hallucinations, might be one of the first symptoms of Lewy body dementia. This symptom often occurs regularly. People with Lewy body dementia might see shapes, animals or people that aren't there. Hallucinations involving sounds, smells or touch are possible.
• Movement disorders. Signs of Parkinson's disease, known as parkinsonian signs, may occur. These symptoms include slowed movement, rigid muscles, tremor or a shuffling walk. This can cause the person to fall.
• Poor regulation of body functions. The part of the nervous system that controls automatic functions is called the autonomic nervous system. Lewy body dementia can affect how well the autonomic nervous system controls blood pressure, heart rate, sweating and digestion. This can result in sudden drops in blood pressure upon standing, dizziness, falls, loss of bladder control and bowel issues such as constipation.
• Cognitive problems. People with Lewy body dementia might have thinking problems similar to those of Alzheimer's disease. They may include confusion, poor attention, visual-spatial problems and memory loss.
• Trouble with sleep. People with Lewy body dementia can have rapid eye movement (REM) sleep behavior disorder. This disorder causes people to physically act out their dreams while asleep. People with REM sleep behavior disorder may punch, kick, yell or scream while sleeping.
• Varying attention. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible.
• Depression. People with Lewy body dementia might develop depression.
• Apathy. Loss of motivation may occur.

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Lewy body dementia is characterized by the buildup of proteins into masses known as Lewy bodies. This protein also is associated with Parkinson's disease. People who have Lewy bodies in their brains also have the plaques and tangles associated with Alzheimer's disease.

Risk factors

A few factors seem to increase the risk of developing Lewy body dementia, including:

• Age. People older than 60 are at greater risk.
• Sex. Lewy body dementia affects more men than women.
• Family history. Those who have a family member with Lewy body dementia or Parkinson's disease are at greater risk.

Complications

Lewy body dementia is progressive. This means it gradually gets worse over time. As symptoms get worse, Lewy body dementia can lead to:

• Severe dementia.
• Aggressive behavior.
• Depression.
• Increased risk of falling and injury.
• Worsening of parkinsonian symptoms, such as tremors.
• Death, on average about 7 to 8 years after symptoms start.

Lewy body dementia care at Mayo Clinic

• Lewy body dementia. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Dementia-Lewy-Bodies-Information-Page. Accessed April 26, 2023.
• Farlow MR. Clinical features and diagnosis of dementia with Lewy bodies. https://www.uptodate.com/contents/search. Accessed Feb. 15, 2021.
• Budson AE, et al. Dementia with Lewy bodies. In: Memory Loss, Alzheimer's Disease, and Dementia. 3rd ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 26, 2023.
• Prasad S, et al. Recent advances in Lewy body dementia: A comprehensive review. Disease-a-Month. 2023; doi:10.1016/j.disamonth.2022.101441.
• Clinical management. Lewy Body Dementia Association. https://www.lbda.org/healthcare-professionals/. Accessed April 26, 2023.
• Understanding behavioral changes in dementia. Lewy Body Dementia Association. https://www.lbda.org/understanding-behavioral-changes-in-dementia/. Accessed Feb. 16, 2021.
• Taylor J-P, et al. New evidence on the management of Lewy body dementia. Lancet Neurology. 2020; doi:10.1016/S1474-4422(19)30153-X.
• Ferri FF. Dementia with Lewy bodies. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed April 26, 2023.
• Press D, et al. Management of neuropsychiatric symptoms of dementia. https://www.uptodate.com/search/contents. Accessed Feb. 15, 2021.
• Donaghy PC, et al. Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis. Alzheimer's & Dementia. 2023; doi:10.1002/alz.13105.
• Graff-Radford J (expert opinion). Mayo Clinic. Feb. 25, 2021.
• Luo G, et al. Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia — A network meta-analysis of randomized controlled trials. Frontiers in Aging: Neuroscience. 2023; doi:10.3389/fnagi.2023.1131744.
• Liang C-S, et al. Mortality rates in Alzheimer's disease and non-Alzheimer's dementias: A systematic review and meta-analysis. The Lancet Healthy Longevity. 2021; doi:10.1016/S2666-7568(21)00140-9.
• Oxybutynin oral. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed April 28, 2023.
• Diphenhydramine oral. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed April 28, 2023.
• Cholinesterase inhibitors. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed April 28, 2023.
• Huang Y, et al. Comparative risk of cardiac arrhythmias associated with acetylcholinesterase inhibitors used in treatment of dementias — A narrative review. Pharmacology Research & Perspectives. 2020; doi:10.1002/prp2.622.
• Choudhary G, et al. Myocardial sympathetic innervation imaging with MIBG in dementia with Lewy bodies. Journal of Nuclear Cardiology. 2021; doi:10.1007/s12350-020-02042-2.
• Ami TR. Allscripts EPSi. Mayo Clinic. May 17, 2023.
• Lewy Body Dementia: Autopsy
• Lewy Body Dementia: Background
• Lewy Body Dementia: Pathology Treatment
• Lewy Body Dementia: Research
• Lewy Body Dementia: Support
• Living with Lewy Body Dementia

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Understanding Lewy body dementia

Key takeaways:

• Lewy body dementia is associated with abnormal protein clumps in the brain. It's usually diagnosed after someone dies.
• Symptoms include hallucinations, movement issues, changes in concentration and alertness and loss of thinking abilities.
• Treatment includes medication and changing daily habits to make the person comfortable.

“I just want to reboot my brain.” Those were among the ways comedian Robin Williams expressed his mental anguish before his death in 2014.

An autopsy found Williams suffered from Lewy body dementia (LBD). While Williams may not be in the headlines as much anymore, LBD is still relevant for around 1.4 million Americans, says Courtney McFarlin , PA, an OSF HealthCare provider who specializes in geriatrics. In fact, it’s the second most common type of dementia behind Alzheimer’s disease.

What is Lewy body dementia?

McFarlin says LBD is associated with Parkinson's disease in that they both have Lewy bodies as a medical finding. This is usually in an autopsy. Or if the person is living, McFarlin says an LBD diagnosis is one of exclusion after providers have ruled other things out.

A Lewy body is an abnormal protein clump that forms in the brain’s neurons. It’s named for Frederic Lewy, the neurologist who discovered them.

“Those proteins block certain neurotransmitters from appropriately working in the brain. Specifically, dopamine and acetylcholine,” McFarlin says. Dopamine is associated with motivation and pleasure, while acetylcholine helps with memory, learning, attention and muscle movement.

“What often separates [Lewy body dementia] from Parkinson's disease dementia is that with Lewy body dementia, the dementia symptoms start in conjunction with Parkinson's-type features,” McFarlin adds. “Whereas somebody who has Parkinson's disease dementia has an already established Parkinson's disease based on rigidity, tremors and a shuffling gait. That’s already been diagnosed and determined, and the dementia happens after.”

The National Institute on Aging says LBD symptoms include:

• Visual hallucinations
• Changes in concentration and alertness
• Loss of thinking abilities
• Movement issues such as impaired balance, a stooped posture, reduced facial expressions, difficulty swallowing and a weak voice
• Sleep issues like excessive daytime sleepiness, insomnia and restless leg syndrome
• Behavioral changes like depression, anxiety, apathy and agitation
• Changes in body temperature and blood pressure
• Sensitivity to heat and cold
• Urinary incontinence and constipation
• A poor sense of smell

McFarlin says treatment for LBD could include medication like Namenda, Aricept and Exelon. And since it’s related to Parkinson's disease, those type of medications may help, too: Sinemet and carbidopa-levodopa.

Patients and their caregivers must also commit to changing daily habits to make the person comfortable. For example, remove trip hazards in a home. Make the home bright during the day and dark at night to promote a regular wake-sleep schedule. Let the person rest near a bathroom in case they need to use it quickly. Consider having a family member or health care provider in the home often to help, or consider a move to an assisted living facility. Physical, occupational and speech therapy are also common treatments.

Caregivers should also know that support groups, whether online or in person, are available to help with the tall task of treating a loved one with dementia. Your primary care provider can also link you with resources.

“I reiterate to those caregivers to eat healthy, get sleep themselves and make sure they’re keeping up on their medical well-being,” McFarlin says, recalling conversations with helpers. “Having those open conversations is very important.”

Read more about how to care for older adults on the OSF HealthCare website .

Interview clips

• View Courtney McFarlin on Lewy bodies Courtney McFarlin on Lewy bodies
• View Courtney McFarlin on Lewy body dementia and Parkinsons Courtney McFarlin on Lewy body dementia and Parkinsons
• View Courtney McFarlin on caregiver support Courtney McFarlin on caregiver support

Related stories When the sun goes down Caring for someone with dementia Nose picking and dementia? Too soon to link How old is too old to drive? Wendy Williams diagnosed with FTD, aphasia Understanding aphasia Dementia vs. Alzheimer's: What's the difference between them? When should you worry about frequent forgetfulness? Four things you can do to keep your brain healthy

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Dementia Symptoms

Dementia is characterized by the gradual loss of mental functions including memory, thinking, and reasoning. Dementia is known as an umbrella term that covers a variety of neurodegenerative disorders that cause a decline in mental function. The most common disorder under the dementia umbrella is Alzheimer's disease . These disorders cause brain cells to stop functioning properly, affect brain cell connections, and can eventually lead to brain cell death. There are currently no cures for the disorders that cause dementia.

Dementia mostly affects people over 65 years old, but symptoms can start as early as 45. Symptoms start out gradually, usually beginning with small lapses in memory. As the symptoms worsen over time, memory lapses get more severe and the ability to communicate, reason, and perform everyday tasks becomes significantly impaired. The development of symptoms varies widely from person to person. Some types of dementia cause additional non-mental symptoms including movement problems, sleep disorders, hallucinations, and many others.  

Dementia is a serious medical condition that affects millions of people worldwide. While it is normal for people to become more forgetful as they age, it is important to note that dementia and its symptoms are not part of the normal aging process. There are many people over 65 that do not develop dementia. 

Signs and Symptoms

Dementia as a whole causes a wide range of symptoms that affect a person’s everyday life. While dementia can be caused by several different neurodegenerative disorders, there are common symptoms that occur in every type of dementia. The most common signs and symptoms of dementia are:

• Memory loss (this includes forgetting names of friends and family, old memories, common everyday words, and recent events or conversations) 
• Poor judgment and confusion
• Difficulty speaking and expressing or understanding thoughts
• Being confused or disoriented in familiar places, such as getting lost in a familiar neighborhood
• Repeating questions
• Taking longer to perform everyday tasks or having trouble concentrating/focusing on common tasks

How these symptoms present themselves depends on the type of dementia a person has. Neurodegenerative diseases that cause dementia affect different parts of the brain and these differences cause slightly distinct versions of dementia. The most common types of dementia are Alzheimer's disease, Frontotemporal dementia, Lewy body dementia, and vascular dementia.

Alzheimer's Disease

Alzheimer's disease is the most common cause of dementia, causing 60-80% of cases. 

The exact cause of Alzheimer’s disease is unknown, but researchers currently believe that it is caused by the abnormal buildup of tau and amyloid proteins in neurons, which are the cells of the brain. When functioning normally, these proteins are responsible for the development of brain cell structure. The accumulation of abnormal forms of tau and amyloid proteins causes clumps in and around brain cells, which result in loss of brain cell communication and, ultimately, brain cell death.

Symptoms of Alzheimer’s disease vary on a case-by-case basis. They range from mild, such as getting lost and repeating questions, to severe, which include full loss of communication and complete dependence on family members for their care.

Frontotemporal Dementia

Frontotemporal dementia is caused by the accumulation of abnormal proteins in the frontal and/or temporal lobe of the brain. The frontal lobe is responsible for movement, general decision-making, and personality while the temporal lobe is responsible for speech processing and emotional processing. Approximately 25% of dementia cases are caused by frontotemporal dementia.

Symptoms of frontotemporal dementia will vary on where in the brain the accumulation of abnormal proteins is happening. 

Accumulation of abnormal proteins in the frontal lobe lead to behavioral and personality symptoms like impulsiveness, inappropriate or offensive comments, and changes in personality. There can also be some movement symptoms like shaky hands or problems with balance and walking.

Accumulation of abnormal proteins in the temporal lobe can cause severe difficulty with speaking and understanding speech, and emotional symptoms like emotional flatness, not caring about others' emotions, and demonstrating extreme emotions.  

Related: How Is Frontotemporal Dementia Diagnosed? Bruce Willis' Condition, Explained

Lewy Body Dementia

Lewy body dementia is caused by the abnormal accumulation of a protein called alpha-synuclein. The abnormal build-up of this protein affects the brain's signaling molecules. 

Lewy body dementia is known for causing visual hallucinations and affecting sleep patterns, causing insomnia and excessive daytime sleepiness. Lewy body dementia also causes movement problems including muscle rigidity and reduced facial expressions. 

Lewy body dementia can occur alongside Parkinson's disease , which is known as Parkinson's disease dementia. Parkinson's is a neurodegenerative disorder characterized by issues with motor skills, such as tremors, slow or interrupted movements, rigidity, and muscle stiffness. When it cooccurs with dementia, cognitive symptoms usually begin around a year after motor symptoms.

Vascular Dementia

Vascular dementia is caused by sudden changes in the brain’s blood and/or oxygen supply. This is often caused by a stroke , high blood pressure , and blood clots in the brain. About 15% of dementia cases are caused by vascular dementia.

Vascular dementia can cause hallucinations or delusions. The severity of vascular dementia symptoms depends on the amount of damage to the brain.

Other Types of Dementia

There are many other conditions that can cause dementia. Some of these conditions include:

• Huntington’s disease: A rare, inherited condition that causes the nerve cells in the brain to break down over time
• Creutzfeldt-Jakob disease (CJD): A progressive neurodegenerative disorder believed to be caused by a prion, an abnormal protein in the brain
• Chronic traumatic encephalopathy (CTE): A brain disorder that is more likely caused by repeated head injuries, which is especially common in athletes who play contact sports
• HIV-associated dementia: Occurs when human immunodeficiency virus (HIV) spreads to the brain
• Heavy alcohol use over prolonged periods of time: Long-term consumption of large quantities of alcohol can affect the neurons in your brain, even reducing their size
• Concussion : A type of traumatic brain injury (TBI) causes by a blow or jolt to the head

Symptoms In Men/Women

Many studies have tried to determine the differences in the prevalence of dementia by sex and gender.  

Some studies have shown that women over 45 have a 1 in 5 risk of developing Alzheimer’s disease dementia, while men have a 1 in 10 risk. On average, 62% of people with Alzheimer’s are women.

However, other studies suggest that the higher incidence of dementia in women might be a result of women living longer than men. For example, a 2018 study showed that the rates of dementia in men and women are similar up to the age of 80. The study then showed an increased incidence of Alzheimer’s disease in women 85 years and older. More research is needed to determine all the contributing factors, but higher life expectancy among women likely plays a role.

Additionally, there have been reported sex-related differences in the type of dementia diagnosed. A 2021 study states that while more cases of Alzheimer’s dementia are seen in women, cases of vascular dementia are more prevalent in men. 

More studies are needed to address potential gender- and sex-related differences in dementia.

Health recognizes that not everyone who is female was born with female reproductive organs and that not everyone who is male was born with male reproductive organs. Health also recognizes that people may not identify as any one sex or gender. The information in this article is based on how researchers present their results, and the gender- and sex-based language used most accurately reflects their research design and outcomes.

When to See a Healthcare Provider

There are certain early symptoms that can warrant scheduling an appointment with your healthcare provider to discuss a dementia diagnosis. If you are in your early 60’s, reach out to your healthcare provider if you are experiencing any of the following:

• Difficulty remembering dates, events, and recently learned information
• Asking the same questions over and over
• Forgetting to keep track of monthly bills
• Difficulty in concentrating on activities that you are used to performing (driving, buying groceries)
• General confusion with time and places
• Having trouble following conversations and having trouble remembering words
• Not being able to retrace your steps

Related: Exercise, Doing Chores, and Socializing Can All Help Lower Dementia Risk, Study Shows

A Quick Review

Dementia is an umbrella term that is used to define the gradual loss of memory, thinking, and reasoning capability that most commonly occurs in people over the age of 65. Common symptoms are memory loss, confusion, and difficulty understanding and expressing one's thoughts.

Symptoms of dementia start gradually and worsen significantly over time. These symptoms are caused by neurodegenerative disorders like Alzheimer’s, Lewy body dementia, and frontotemporal dementia, which cause damage to brain cells. 

Seek a medical assessment if you or a loved one are currently experiencing symptoms of dementia.

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Read the original article on Health .