What is Lewy Body Dementia?

The following is extracted from the Lewy Body Dementia Association website:

Lewy body dementia (LBD) is a progressive brain disease and the second leading cause of degenerative dementia in the elderly. The clinical name, “dementia with Lewy bodies” (DLB), accounts for up to 20% of all dementia cases, or 800,000 patients in the US. Over 50% of Parkinson’s disease patients develop “Parkinson’s disease dementia” (PDD), which accounts for at least 750,000 patients. (PDD is also a Lewy body dementia.)

Other names for the Lewy body dementias are:

  • Lewy body disease (LBD)
  • Diffuse lewy body disease (DLBD)
  • Cortical Lewy body disease (CLBD)
  • Lewy body Variant of Alzheimer’s (LBV)(LBVA)
  • Parkinson’s disease with dementia (PDD)

In the early 1900’s, while researching Parkinson’s disease, the scientist Friederich H. Lewy discovered abnormal protein deposits that disrupt the brain’s normal functioning. These Lewy body proteins are found in an area of the brain stem where they deplete the neurotransmitter dopamine, causing Parkinsonian symptoms. In Lewy body dementia, these abnormal proteins are diffuse throughout other areas of the brain, including the cerebral cortex. The brain chemical acetylcholine is depleted, causing disruption of perception, thinking, and behavior. Lewy body dementia exists either in pure form, or in conjunction with other brain changes, including those typically seen in Alzheimer’s disease and Parkinson’s disease. 

Horn of Plenty

–Mark L. Madden

When a music student brought his French horn to my shop for repair, he complained that the instrument “felt stuffy” and he couldn’t blow air through it. It’s not unusual to find partial blockages in brass instruments if small items get lodged in the tubing, but when I tested the instrument, the horn was completely blocked. After much probing and prodding, a small tangerine dropped out of the bell. “Oh,” said the musician when I handed him the fruit. Seeing the bewildered look on my face, he explained, “My mom used the horn for a cornucopia in a Thanksgiving centerpiece.”

 

David

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Winter Blues? Feeling Sad? Dementia and Seasonal Affective Disorder (SAD)

 

 

“This little light of mine…”

 

sad6

 

Do you or your loved ones suffer from:

 

 

 

∞  Feeling sad, grumpy, moody, or anxious

∞  Avoiding social situations and feeling a loss of interest

     in the activities you used to enjoy

∞  Eating more and craving carbohydrates, such as bread

     and pasta

∞  Weight gain

∞  Sleeping more and feeling drowsy during the daytime

∞  A drop in energy level and fatigue

∞  A tendency to oversleep

∞  Difficulty concentrating

∞  Increased sensitivity to social rejection

∞  Feeling that your physical problems worse (even if they aren’t)

 

Then you may be suffering from the winter blues or seasonal affective disorder (SAD). It is a type of depression that affects a person during the same season each year. If you get depressed in the winter but feel much better in spring and summer, you may have SAD. Anyone can get SAD, but it is more common in:

  1. People who live in areas where winter days are very short or there are big changes in the amount of daylight in different seasons.
  2. Women.
  3. People between the ages of 15 and 55. The risk of getting SAD for the first time goes down as you age.
  4. People who have a close relative with SAD.

It is possible for an individual to experience many or all of the above symptoms but yet do not feel depressed. I used to see this more frequently with patients who have more difficulty being in touch with their feelings.

For someone suffering from aging or dementia along with SAD, whether mild or severe, their behaviors and moods may be markedly worsened and more difficult to understand. He/she may feel more confused earlier in the day (sundowners) than usual. Their aches and pains might be worse or they might become more withdrawn. Their dementia may not be getting worse. This is because we turn the clocks back one hour and the days are ‘shorter’ which result in less sunlight.

As many as half a million people in the United States may have winter-onset depression. Another 10% to 20% may experience mild SAD. SAD is more common in women than in men. Although some children and teenagers get SAD, it usually doesn’t start in people younger than 20 years of age. For adults, the risk of SAD decreases as they get older. Winter-onset SAD is more common in northern regions, where the winter season is typically longer and more harsh.

When I practiced psychiatry in Pennsylvania, the phone calls always increased during October and particularly after Daylight Saving Time ended. Ironically, I saw very little SAD in patients where I lived in California where it could even be sunny in the winter.

SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. Just as sunlight affects the seasonal activities of animals, SAD may be an effect of this seasonal light variation in humans. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule. For those who care, research locates the clock in the suprachiasmatic nucleii of the hypothalamus. It’s common to all mammals and that is rather interesting since the hypothalamus is our primitive brain. That primitive part of our brain is very concerned with basic survival and knowing instinctively when darkness is coming, how long the days are, or when it may be time to seek shelter from predators; just the kinds of things that concerned primitive man.

Symptoms come and go at about the same time each year. For most people with SAD, symptoms start in September or October and end in April or May.

Symptoms of SAD keep coming back year after year. They also tend to come and go at about the same time every year. The changes in mood are not necessarily related to obvious things that would make a certain season stressful (like regularly being unemployed during the winter).

 

sadlady

A modest improvement in symptoms of dementia has been associated with the use of bright light in daytime, in an effort to improve their circadian rhythms, according to a study released on June 10, 2008 in the Journal of the American Medical Association (JAMA). Additionally, the use of melatonin resulted in improved sleep.

 

Not to worry! Tomorrow, I will discuss some of the treatments for SAD. I am still impressed with some of the results my patients and I would see when they received the appropriate treatment! They ended up feeling as happy as this smiling lady in the picture.

 

 

 

And a new vocabulary word today.   adumbrate  [a-duhm-breyt, ad-uhm-breyt]

  1. to produce a faint image or resemblance of; to outline or sketch
  2. to foreshadow; prefigure
  3. to darken or conceal partially; overshadow

 

Do you know the 80/20 rule?

— This is one of the best ways to make better use of your time. The 80/20 rule – also known as The Pareto Principle – basically says that 80 percent of the value you will receive will come from 20 percent of your activities.

 

— So a lot of what you do is probably not as useful or even necessary to do as you may think.

 

— You can just drop – or vastly decrease the time you spend on – a whole bunch of things.

 

— And if you do that you will have more time and energy to spend on those things that really brings your value, happiness, fulfilment and so on.

 

I utilize the 80/20 rule when it comes to managing my desk. 80% of the time I only use 20% of ‘stuff’ on my desk. The other 80% of my ‘stuff’ gets used only 20% of the time.

 

 

David

 

 

 

 

Friday October 24, 2008

Bizarre. Yes, dreams can be. Last night I dreamed that I was ‘somewhere’ with a bunch of people. During the gathering, I had a moment of severe confusion and disorientation. It lasted for a long long time in the dream. Now that’s a new type of dream I’ve never experienced before. Go figure.

I’m getting weary of all the political ads. Can’t wait until Election Day is over. Seems like it’s been a long drawn out affair. I’m sure most people have already decided so let’s get it over with. Have been watching MSNBC, CNN, etc. The anchor folks so to have run out of things to say. They’re now down to what kind of clothes people are wearing and how much they cost! Aren’t there more important things in life?

We’re having friends (Margo and Stein) visit us from Pittsburgh tomorrow. They are dear and closer to us than some family members. Funny how ya can choose your friends but not your family! It’ll be a very nice day in spite of the rainy forecast for the weekend. Stein is so witty I don’t know if I’ll be able to keep up with him. Margo’s brother-in-law is suffering from Alzheimer’s disease. I think he’s also on Namenda and Aricept.

Speaking of that. I’m really noticing a positive difference since adding the Namenda to the Aricept. My sleeping pattern had been terrible for the past 3-4 years. I noticed an improvement after taking the Namenda for about 4-5 weeks. Am sleeping better than ever right now. And the Vivimind. That’ll take awhile. Am taking 10-mg daily for 1 month and then I’ll increase it to 2 tabs/day. My understanding of it is that it’ll take much longer to notice any results. Fortunately, I haven’t had any side-effects from any of the 3 of them.

I spoke with Angela Taylor this week. She’s the Chair of the Science Committee and on the Board of Directors of the Lewy Body Dementia Association (LBDA).  What a lovely, caring and smart lady! How lucky we all are with her running the ship. Thank you, Angela, for your interest. You perked me up and encouraged me and you didn’t even know it.

Am looking forward to reading Dr. Tom Grayboys’ book – Life in the Balance. I put in a request to the birthday fairy. She’s coming soon.

I just discovered a new game called KenKen. Never heard of it before. Haven’t tried it yet but it sounds like it’ll be another way of working the brain.

OK, David. Give the computer a rest and do something else today. It’ll stimulate your brain.

David

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