Dementia with Lewy bodies

• What is dementia with Lewy bodies?

  Progressive dementia

  Caused by deposits of alpha-synuclein -> cytoplasmic inclusions (Lewy bodies) within brain cells -> disruption of normal cell functioning & eventually neuronal death
• Pathophys - Lewy body dementia

  Abnormal accumulation of alpha-synuclein & forms insoluble fibrils within neuronal cell bodies -> Lewy bodies -> cell death, impaired proteostasis & synaptic dysfunction -> cognitive impairment, Parkinsonism, visual hallucinations & autonomic dysfunction
• What are the signs & symptoms of Lewy body dementia?

  Fluctuating cognition (early impairments in attention & executive function)

  Parkinsonism (rigidity, bradykinesia, postural instability)

  Visual hallucinations

  High sensitivity to neuroleptics
• What are the DDx of Lewy body dementia?

  Alzheimer's disease

  Parkinson's disease dementia

  Vascular dementia
• What are the Inx of Lewy body dementia?

  Full Hx

  Formal cognitive assessment (MMSE)

  Full neuro examination

  Bloods (cognitive screen)

  DaT scan

  EEG
• What is the management of Lewy body dementia?

  Patient & family education

  Supportive therapy (OT, SALT, physio)

  Cognitive stimulation

  Future planning

  Meds

  • cholinesterase inhibitors (donepezil)
  • caution with antipsychotics -> due to increased sensitivity