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How Lewy Body Dementia Affects the Brain and Recognizing Symptoms

Understanding Dementia and the Brain

In Lewy body dementia, cells die in the brain's cortex (outer layer) and in a part of the mid-brain called the substantia nigra. Many of the remaining nerve cells in the substantia nigra contain abnormal structures called Lewy bodies that are the hallmark of this type of dementia. Lewy bodies may also appear in the brain's cortex (outer layer).
Lewy bodies contain a protein called alpha-synuclein that has been linked to Parkinson's disease and several other disorders. Dementia research scientists, who sometimes refer to these disorders collectively as "synucleinopathies," do not know why this protein accumulates inside nerve cells people with Lewy body dementia.

Symptoms of Lewy Body Dementia

The symptoms of Lewy body dementia can vary among individuals. They also can vary during the different stages of the disease, or even from hour to hour or day to day. Some people with Lewy body dementia will have traditional parkinsonian effects, such as:
  • Loss of spontaneous movement
  • Rigidity (muscles feel stiff and resist movement)
  • Tremor
  • Shuffling gait.
These symptoms are usually mild or even absent during the early stages of Lewy body dementia; as the disease progresses, these symptoms become more common. Rigidity will usually be severe.
Other people with Lewy body dementia may have symptoms similar to those seen with Alzheimer's disease. These symptoms could include:
  • Acute confusion
  • Loss of memory
  • Loss of (or fluctuating) cognition.
Visual hallucinations may be one of the first Lewy body dementia symptoms people experience, and they may suffer from other psychiatric disturbances such as delusions and depression.
Other symptoms of Lewy body disease can include:
  • Difficulty swallowing
  • Repeated falls
  • Lightheadedness, dizziness, or fainting (syncope)
  • Low blood pressure, especially when going from sitting to standing 
  • Erectile dysfunction (also known as ED or impotence)
  • Constipation
  • Dry eyes or mouth
  • Unexplained loss of consciousness.
  • Autonomic dysfunction.
Although Lewy body dementia usually occurs in older adults, younger people can be affected as well.
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