Practice Paper 1: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Lewy body dementia is the second most common dementia after Alzheimer’s disease. Characteristic features of Lewy body dementia include day-to-day fluctuating levels of cognitive functioning, visual hallucinations, sleep disturbance, transient loss of consciousness, recurrent falls and parkinsonian features (tremor, hypokinesia, rigidity and postural instability). Although people with Lewy body dementia are prone to hallucination, antipsychotics should be avoided, as they precipitate severe parkinsonism in 60% of cases. Lewy bodies are abnormalities of the cytoplasm found within neurons, containing various proteins and granular material. They are found in the cerebral cortex in patients with Lewy body dementia, and are also found in patients with Parkinson’s disease.
Psychosocial Aspects of Diabetes
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
However, the leading cause of dementia is AD, which results from death of cerebral cortex cells. Abnormal proteins, believed to be beta amyloids, form lesions in the cerebral cortex that eventually disrupt and destroy surrounding cells. Vascular dementia is caused by atherosclerosis in the brain, in which inadequate blood flow supplies insufficient oxygen. Areas of dead tissue then form, and vascular dementia develops. This is usually linked to previous cardiovascular conditions such as diabetes, heart disease, hypertension, and high cholesterol. Parkinson’s disease results in buildup of Lewy bodies in the brain, which eventually affect memory and cognition, causing dementia. Lewy body dementia usually affects people with no family history, and its causes are unclear. Huntington’s disease also results in dementia, and is caused by a genetic mutation resulting in death of nerve cells in the basal ganglia.
ENTRIES A–Z
Philip Winn in Dictionary of Biological Psychology, 2003
This is a form of senile DEMENTIA (it is also known as SENILE DEMENTIA of the Lewy body type) in which there are extensive deposits of LEWY BODIES. Features of this disorder include motor deficits reminiscent of those seen in PARKINSON'S DISEASE; a rather variable cognitive impairment (which resembles that seen in ALZHEIMER'S DEMENTIA) and features such as HALLUCINATION more commonly associated with conditions such as SCHIZOPHRENIA. Patients are very sensitive to ANTIPSYCHOTIC medication, so some care is need in diagnosis of Lewy body dementia. The disorder has only been classified relatively recently, but evidence is accumulating that loss of ACETYLCHOLINE from the CEREBRAL CORTEX and HIPPOCAMPUS is a significant feature (as it is in Alzheimer's disease).
Epidemiology and economic burden of Lewy body dementia in the United States
Published in Current Medical Research and Opinion, 2022
Urvi Desai, Julie Chandler, Noam Kirson, Mihaela Georgieva, Hoi Ching Cheung, Ben Westermeyer, Henry Lane, Kevin Biglan
Lewy body dementia (LBD) is a generalized term used to describe neurodegenerative disorders characterized by the pathological accumulation of the protein alpha-synuclein (i.e. Lewy bodies) throughout the brain1. Two prominent subtypes of LBD include dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD)2. Although DLB and PDD have overlapping clinical pathologies (i.e. impairment in cognition and movement, sleep disorders), they are differentiated by the chronology of specific symptoms2. Specifically, people who experience parkinsonism prior to cognitive impairment are classified as having PDD while those experiencing cognitive impairment prior to or within one year of parkinsonism are classified as having DLB3,4.
Unmet needs in the diagnosis and treatment of Parkinson’s disease psychosis and dementia-related psychosis
Published in International Journal of Psychiatry in Clinical Practice, 2023
Marwan Sabbagh, Gary W. Small, Stuart H. Isaacson, Yasar Torres-Yaghi, Fernando Pagan, Rajesh Pahwa
The development of PDP is associated with risk factors, such as advanced age, disease severity, disease duration, sleep disturbances, and most significantly, dementia (Goldman & Holden, 2014; Martinez-Ramirez et al., 2016). The presence or absence of dementia may be associated with differences in symptoms, which may need to be considered for therapy selection. For example, it was found that 70% of Parkinson's disease patients with dementia report visual hallucinations, compared to only 10% of patients without dementia (Goldman & Holden, 2014). Visual hallucinations with well-formed images and preserved insight are more commonly reported in PDP; however, hallucinations may worsen and insight can be lost with increased cognitive impairment (Goldman & Holden, 2014; Samudra et al., 2016). Visual hallucinations and non-visual hallucinations (such as auditory, sensory, tactile, olfactory, and gustatory) before motor symptoms or early in the disease course may suggest Lewy body dementia (Martinez-Ramirez et al., 2016).
Pharmacological management of dementia with Lewy bodies with a focus on zonisamide for treating parkinsonism
Published in Expert Opinion on Pharmacotherapy, 2021
Francesco Panza, Madia Lozupone, Mark Watling, Bruno P. Imbimbo
Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), jointly known as Lewy body dementias (LBD) [1], are the second most common cause of neurodegenerative dementia in people older than 65 years, although they have different epidemiological, neuropathological and clinical features [2–4]. In particular, the point-prevalence of dementia is roughly 25% in patients with Parkinson’s disease (PD) [5]. Most PD patients who survive for more than 10 years will develop dementia [6]. In a recent systematic review, DLB accounted for 0.3–24.4% of all cases of dementia in prevalence studies [4]. In an earlier systematic review, the mean prevalence of probable DLB was 4.2% in community-based studies and 7.5% in clinical-based studies [2]. DLB and PDD are typically differentiated by the arbitrary ‘1-year rule’ [3]. This declares that DLB is diagnosed if dementia occurs before or concurrently with parkinsonism or within 1 year of the onset of extrapyramidal motor symptoms. Alternatively, the diagnosis is PDD if dementia starts 1 year or more after well-established PD [7].
Related Knowledge Centers
- Dementia
- Dementia With Lewy Bodies
- Parkinson's Disease Dementia
- Parkinson's Disease
- Neuron
- Lewy Body
- Central Nervous System
- Dysautonomia
- Diagnostic & Statistical Manual of Mental Disorders
- Cerebral Cortex