Lewy body dementia, the condition Sir Patrick Stewart lived with, is one of the most common types of dementia, accounting for 10 to 15% of cases alongside Alzheimer's and vascular dementia. The Star Trek and X-Men actor died aged 86 after a 'brief and poignant' battle with Alzheimer's disease and Lewy body dementia, his family confirmed in a statement following his death.
What is Lewy body dementia?
Also known as dementia with Lewy bodies (DLB), the condition refers to a build-up of Lewy bodies in the areas of the brain that control alertness, visual perception and thinking. Lewy bodies are abnormal clumps of protein that develop in nerve cells responsible for thought, movement, visual perception, sleep and awareness.
'It's rare in people under 65,' Thorrun Govind, former Chair of the Royal College of Pharmacy and health commentator, told Metro. 'But, it's also not an inevitable part of getting older.' The reason for the build-up is not fully understood.
According to Dementia UK, this interrupts the connections between brain cells and stops them from working, while also reducing the chemicals needed for the brain to function properly. 'This tends to develop slowly and can get gradually worse over several years,' Govind added.
Symptoms and diagnosis
Early signs are typically cognitive, including changes in thinking, struggles with spatial awareness or sight, difficulty managing menial tasks and problems staying alert. Memory loss is also an indicator, although it is rarely the first symptom, according to Dementia UK. These symptoms tend to manifest a year before, or at the same time as, problems with movement, which can include slowed movement, shuffling or appearing rigid, or tremors in the hands. Some may have issues with balance and begin falling a lot.
Less common symptoms include swallowing problems, inability to smell, drooling, excessive sweating, constipation and bladder sensitivity. Apathy, anxiety and depression may also manifest, as well as delusions. Some people might experience Capgras syndrome, where they believe someone close to them has been replaced by an imposter.
'DLB has a lot in common with Parkinson's disease, so that can make a diagnosis challenging,' Govind explained. Due to an overlap in symptoms, it can be misdiagnosed, so it is important to keep track of what symptoms manifested and when, because with Parkinson's dementia, the physical symptoms happen first. Lewy body dementia can also be mistaken for Alzheimer's disease because of similar issues with thinking and perception.
'It appears to affect men slightly more than women,' the pharmacist said. 'There may be a genetic component, too, with people who have a family history of DLB or Parkinson's having a higher risk.'
Treatment options
If symptoms are suspected, Govind recommends seeing a GP, who will refer to a dementia service if DLB is suspected. A family and medical history will be taken, along with establishing symptoms and assessing physical health. Patients may also need a SPECT scan or DaTSCAN, which measures dopamine levels; someone with the disease will have low levels of the chemical.
While there is no cure, those with DLB may be offered medication that could improve quality of life as the disease progresses. This could include certain types of antipsychotics to help reduce distressing hallucinations and aid concentration, although Dementia UK warns those with Lewy body dementia can be particularly sensitive to these medications, so they should be used with 'extreme caution'.
Other treatments include physiotherapy to help with movement, or music and art therapy to improve mood and memory. Cognitive training, such as puzzles and memory games, can help slow mental decline. Trying new activities like joining a community group, such as a choir or book club, or learning a skill like a craft, can help with maintaining independence, quality of life, self-esteem and social connections. For further information, visit Dementia UK.
