Mental Health Center

Dementia With Lewy Bodies

Exams and Tests for Dementia With Lewy Bodies continued...

Imaging studies for dementia

An imaging study of the brain is useful in determining the underlying cause of dementia. MRI is sometimes preferred to a CT scan, because it affords greater detail of the brain. Although Lewy bodies cannot be detected on these images, other causes of dementia such as stroke can be ruled out. These images also can detect brain atrophy (shrinkage). The degree of atrophy can be useful in making a diagnosis.

Other tests for dementia

• Electroencephalography (EEG) measures brain waves. People with DLB sometimes have abnormal waves that can help in the diagnosis. This test is not used routinely, however.
  
• Lumbar puncture (spinal tap) with testing of spinal fluid may be used to rule out infection and certain other reversible disorders. Again, however, this test is not done routinely.

Treatment for Dementia With Lewy Bodies

There is no cure or treatment that stops or slows DLB, although the drug galantamine (Razadyne or Reminyl), which inhibits an enzyme called acetylcholinesterase, has been shown in studies to improve hallucinations, sleep problems, and cognitive problems associated with DLB . Treatment is aimed at relieving symptoms and delaying loss of mental abilities for as long as possible.

An individual with DLB should always be under medical care. Much of the day-to-day care, however, is handled by family caregivers. Medical care should focus on optimizing the individual’s health, safety, and quality of life while helping family members cope with the many challenges of caring for a loved one with DLB.

Home Care of Dementia With Lewy Bodies

People with DLB usually can remain at home with their families. They require close supervision because they can fall or faint. They should be checked often by their medical team to monitor the effects of treatment and make changes if needed.

Individuals with DLB should remain physically, mentally, and socially active as long as they are able.

• Daily physical exercise helps maximize body and mind functions and maintains a healthy weight.
• The individual should engage in as much mental activity as he or she can handle. Puzzles, games, reading, and safe hobbies and crafts are good choices. These activities should ideally be interactive
  
• Social interaction is stimulating and enjoyable for most people with DLB. Most senior centers or community centers have scheduled activities that are suitable for those with dementia.

A balanced diet that includes plenty of fruits and vegetables will help maintain a healthy weight and prevent malnutrition and constipation. An individual with DLB should not smoke, both for health and safety reasons.

Drugs for Dementia With Lewy Bodies

Drugs can be used to relieve depression, treat agitation and hallucinations, and improve cognition and/or alertness. There is a great deal of controversy about whether or not acetylcholinesterase inhibitors may slow the rate of cognitive decline or slow the need for nursing home placement.