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Lewy body dementia is a form of dementia that may account for as many as 20% of all dementia cases. Lewy bodies are tiny spherical deposits of a protein called alpha-synuclein that are found in the brains of patients with this disorder. The presence of Lewy bodies throughout the brain disrupts the brain's normal functioning. Lewy body dementia is now believed to be the second most common specific cause of dementia after Alzheimer's disease.

There is considerable overlap between Lewy body dementia and Alzheimer's and Parkinson's disease. In Lewy body dementia, patients experience a loss of dopamine-producing nerve cells similar to that seen in Parkinson's disease. They also lose acetylcholine-producing nerve cells, similar to what occurs in Alzheimer's disease.

Patients with Lewy body dementia often experience cognitive problems associated with Alzheimer's disease, such as memory loss, spatial impairment and language difficulties. They may also develop parkinsonian symptoms, such as muscle rigidity, a blank facial expression, soft voice, tremor, poor balance and gait disturbances. Some patients initially diagnosed with Parkinson's disease later go on to develop a dementia that closely resembles Lewy body dementia.

Certain symptoms of Lewy body dementia help distinguish it however. For example, early in the illness Lewy body dementia patients often experience detailed and extremely vivid hallucinations, unlike people with Alzheimer's disease. People with Lewy body dementia also tend to show marked fluctuations in their cognitive functioning, often several times a day. In addition, they tend to fall asleep easily during the day and have restless, disturbed sleep with behavioral acting out.

Recognition of these symptoms leads to an accurate diagnosis of Lewy body dementia. A correct diagnosis is particularly important because the medical management of patients with Lewy body dementia presents special challenges. The drugs that are normally used can aggravate other problems and cause potentially serious adverse reactions. In particular, antipsychotic drugs can provoke dangerous side effects, including a return to psychosis, and must be used cautiously, if at all. In addition, levodopa, a drug normally used to treat parkinsonian symptoms, may worsen hallucinations, so its dosage needs to be carefully adjusted in patients with Lewy body dementia.

This disease is named for Frederick Lewy, the physician who first identified them in 1912 while working in the laboratory of Dr. Alois Alzheimer.

Original article from Johns Hopkins

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Though a cure for Alzheimer's disease remains elusive, experts believe earlier and more accurate diagnosis will aid efforts to discover effective therapies. Marilyn Albert, Ph.D., director of the Johns Hopkins Alzheimer’s Disease Research Center, answers the question: "Why is early diagnosis of Alzheimer's disease important if no treatments currently exist to delay progression of the disease?" 

Early and more accurate diagnosis of Alzheimer’s disease is important in helping us develop a better understanding of the biology of the disease. This, in turn, will help researchers design and test new drugs that will intervene earlier in the disease process. 

We use the term Alzheimer's disease to talk about people who are demented, but there are many people with it who aren't yet demented. In fact, one third of all older adults show Alzheimer’s disease pathology in their brains, though they may not yet show symptoms. 

We know that the symptoms of Alzheimer’s disease progress gradually over many years. People with Alzheimer’s disease don’t go from normal to demented overnight. Instead, the disease is a continuum, and earlier diagnostic procedures will help us treat it as such. 

For instance, we understand that high blood pressure is a risk factor for stroke. So, when we go to the doctor and find out that we have high blood pressure, we start to treat it right away, years before a stroke might occur. The same should apply to Alzheimer’s disease. 

We want to identify those who are at risk years before dementia occurs, because we are working hard toward the day when we can diagnose and treat those risk factors for Alzheimer’s disease in the earliest stages -- just as we might treat high blood pressure or cholesterol.

From Johns Hopkins Health Alert

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Recent research by Johns Hopkins and Utah State University has found that a person is more likely to develop dementia if his or her spouse has dementia. Here's what the research suggests.
 
One thousand two hundred twenty-one married couples age 65 and older were selected from the Cache County Study on Memory and Aging, a trial that began in 1995. Couples were followed for up to 12.6 years, with a median follow-up time of 3.3 years. Dementia was diagnosed in 255 of the 2,442 participants.

Individuals whose spouses were diagnosed with dementia had a six-fold greater risk of dementia, even after adjusting for other factors, than individuals whose spouses showed no signs of dementia. Husbands had a significantly higher risk of developing dementia than wives.
 
Bottom line: The physical and mental burden of caregiving, the emotional stress associated with watching a loved one struggle with dementia, shared environmental risks like similar diets, or homogamy (similar individuals are more likely to marry) are among the possible reasons. More research is needed to pinpoint the cause and find the best way of keeping one spouse from sharing the fate of their husband or wife.
 
Reported in the Journal of the American Geriatrics Society (Volume 58, page 895)   

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