Symptoms of Lewy Body Dementia

People with Lewy body dementia (LBD) may not have every LBD symptom, and the severity of symptoms can vary greatly from person to person. Throughout the course of the disease, any sudden or major change in functional ability or behavior should be reported to a doctor.Older man in a wheelchair with his wife

The most common symptoms include changes in cognition, movement, sleep, and behavior.

Cognitive Symptoms

LBD causes changes in thinking abilities. These changes may include:

  • Dementia—Severe loss of thinking abilities that interferes with a person’s capacity to perform daily activities. Dementia is a primary symptom in LBD and usually includes trouble with attention, visual and spatial abilities (judging distance and depth or misidentifying objects), planning, multitasking, problem solving, and reasoning. Unlike in Alzheimer’s dementia, memory problems may not be evident at first but often arise as LBD progresses. Dementia can also include changes in mood and behavior, poor judgment, loss of initiative, confusion about time and place, and difficulty with language and numbers.
  • Cognitive fluctuations—Unpredictable changes in concentration, attention, alertness, and wakefulness from day to day and sometimes throughout the day. A person with LBD may stare into space for periods of time, seem drowsy and lethargic, or sleep for several hours during the day despite getting enough sleep the night before. His or her flow of ideas may be disorganized, unclear, or illogical at times. The person may seem better one day, then worse the next day. These cognitive fluctuations are common in LBD and may help distinguish it from Alzheimer’s disease.
  • Hallucinations—Visual hallucinations—seeing things that are not present—occur in up to 80 percent of people with LBD, often early on. They are typically realistic and detailed, such as images of children or animals. Nonvisual hallucinations, such as hearing or smelling things that are not present, are less common than visual ones but may also occur. Hallucinations that are not disruptive may not require treatment. However, if they are frightening or dangerous (for example, if the person attempts to fight a perceived intruder), then a doctor may prescribe medication.

Main Characteristics of Lewy Body Dementia

Core Clinical Symptoms

  • Dementia
  • Movement problems/parkinsonism
  • Cognitive fluctuations
  • Visual hallucinations
  • REM sleep behavior disorder

Supportive Clinical Symptoms

  • Extreme sensitivity to antipsychotic medications
  • Falls, fainting
  • Severe problems with involuntary functions (maintaining blood pressure, incontinence, constipation, loss of smell)
  • Changes in personality and mood (depression, apathy, anxiety)

Test Results Supporting Diagnosis

  • PET or SPECT brain scan showing reduced dopamine transporter (DaT) uptake in basal ganglia (brain region)
  • Abnormal 123iodine-MIBG myocardial scintigraphy showing reduced communication of cardiac nerves
  • Sleep study confirming REM sleep behavior disorder without loss of muscle tone

For more information visit the Lewy Body Dementia Association’s Comprehensive LBD Symptoms Checklist.

Movement Symptoms

Some people with LBD may not experience significant movement problems for several years. Others may have them early on. At first, movement symptoms, such as a change in handwriting, may be very mild and easily overlooked. Parkinsonism is seen early on in Parkinson’s disease dementia but can also develop later on in dementia with Lewy bodies. Specific signs of parkinsonism may include:

  • Muscle rigidity or stiffness
  • Shuffling walk, slow movement, or frozen stance
  • Tremor or shaking, most commonly at rest
  • Balance problems and repeated falls
  • Stooped posture
  • Loss of coordination
  • Smaller handwriting than was usual for the person
  • Reduced facial expression
  • Difficulty swallowing
  • A weak voice

Sleep Disorders

Sleep disorders are common in people with LBD but are often undiagnosed. A sleep specialist can help diagnose and treat sleep disorders. Sleep-related disorders seen in people with LBD may include:

  • REM sleep behavior disorder (RBD)—A condition in which a person seems to act out dreams. It may include vivid dreaming, talking in one’s sleep, violent movements, or falling out of bed. RBD may be the earliest symptom of LBD in some people, appearing many years before other LBD symptoms.
  • Excessive daytime sleepiness—Sleeping 2 or more hours during the day.
  • Insomnia—Difficulty falling or staying asleep, or waking up too early.
  • Restless leg syndrome—A condition in which a person, while resting, feels the urge to move his or her legs to stop unpleasant or unusual sensations. Walking or moving usually relieves the discomfort.

Behavioral and Mood Symptoms

Changes in behavior and mood are possible in LBD and may worsen as cognition declines. These changes may include:

  • Depression—A persistent feeling of sadness, worthlessness, or inability to enjoy activities, often with trouble with sleeping or eating.
  • Apathy—A lack of interest in normal daily activities or events; less social interaction.
  • Anxiety—Intense apprehension, uncertainty, or fear about a future event or situation. A person may ask the same questions over and over or be angry or fearful when a loved one is not present.
  • Agitation—Restlessness, as seen by pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability.
  • Delusions—Strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living. Capgras syndrome, in which the person believes a relative or friend has been replaced by an imposter, may also appear.
  • Paranoia—An extreme, irrational distrust of others, such as suspicion that people are taking or hiding things.

Other LBD Symptoms

People with LBD can also experience significant changes in the part of the nervous system that regulates automatic functions such as those of the heart, glands, and muscles. The person may have:

For More Information About Symptoms of LBD

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
1-800-438-4380 (toll-free)
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Lewy Body Dementia Association
1-404-975-2322
1-844-311-0587 (toll-free LBD Caregiver Link)
www.lbda.org

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Atrial Fibrillation – Signs, Symptoms, and Complications

You may or may not notice atrial fibrillation. It often occurs with no signs or symptoms. If you do have symptoms, you may notice something that occurs only occasionally. Or, your symptoms may be frequent or serious. If you have heart disease that is worsening, you may notice more symptoms of atrial fibrillation. If your atrial fibrillation is undetected or left untreated, serious and even life-threatening complications can arise. They include stroke and heart failure.

Signs and symptoms

The most common symptom of atrial fibrillation is fatigue. Other signs and symptoms include:

Keep track of when and how often your symptoms occur, what you feel, and whether these things change over time. They are all important clues for your doctor.

Complications

When it is undetected or untreated, atrial fibrillation can lead to serious complications. This is especially significant for African Americans. Even though whites have atrial fibrillation at higher rates, research has found that many of its complications—including stroke, heart disease, and heart failure—are more common among African Americans. Some complications of atrial fibrillation include:

  • Blood clots. With atrial fibrillation, the heart may not be able to pump the blood out properly, causing it to pool and form an abnormal blood clot in the heart. A piece of the clot—a type of embolus—can break off and travel through the blood to different parts of the body, blocking blood flow to the brain, lungs, intestine, spleen, or kidneys. Atrial fibrillation may also increase the risk of venous thromboembolism, which is a blood clot that forms in a vein.
  • Cognitive impairment and dementia. Some studies suggest that impaired cognition, Alzheimer’s disease, and vascular dementia occur more often among people with atrial fibrillation. This may be due to blockages in the blood vessels of the brain or reduced blood flow to the brain.
  • Heart attack. The risk of a heart attack from atrial fibrillation is highest among women and African Americans and especially in the first year after atrial fibrillation is diagnosed.
  • Heart failure. Atrial fibrillation raises your risk of heart failure because the heart is beating fast and unevenly. The heart’s chambers do not fill completely with blood and cannot pump enough blood to the lungs and body. Atrial fibrillation may also make your heart failure symptoms worse.
  • Stroke. If an embolus travels to the brain, it can cause a stroke. For some people, atrial fibrillation has no symptoms, and a stroke is the first sign of the condition. If you have atrial fibrillation, the risk of a stroke is higher if you are a woman.
  • Sudden cardiac arrest. With atrial fibrillation, there is an increased risk that the heart may suddenly and unexpectedly stop beating if you have another serious heart condition.
Atrial fibrillation and stroke. The illustration shows how a stroke can occur during atrial fibrillation. A blood clot can form in the left atrium of the heart. If an embolus, or a piece of the clot, breaks off and travels to an artery in the brain, it can block blood flow through the artery. The lack of blood flow to the portion of the brain fed by the artery causes a stroke.

 

Look for
  • Diagnosis will explain tests and procedures used to detect signs of atrial fibrillation and help rule our other conditions that may mimic atrial fibrillation.
  • Treatment will discuss treatment-related complications or side effects.
Syndicated Content Details:
Source URL: https://www.nhlbi.nih.gov/subscribe/3832
Source Agency: National Heart, Lung, and Blood Institute (NHLBI)
Captured Date: 2018-09-27 13:46:00.0

Symptoms and causes – Mayo Clinic

Overview

Legionnaires’ disease is a severe form of pneumonia — lung inflammation usually caused by infection. Legionnaires’ disease is caused by a bacterium known as legionella.

You can’t catch legionnaires’ disease from person-to-person contact. Instead, most people get legionnaires’ disease from inhaling the bacteria. Older adults, smokers and people with weakened immune systems are particularly susceptible to legionnaires’ disease.

The legionella bacterium also causes Pontiac fever, a milder illness resembling the flu. Separately or together, the two illnesses are sometimes called legionellosis. Pontiac fever usually clears on its own, but untreated legionnaires’ disease can be fatal. Although prompt treatment with antibiotics usually cures legionnaires’ disease, some people continue to experience problems after treatment.

Symptoms

Legionnaires’ disease usually develops two to 10 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

  • Headache
  • Muscle pain
  • Chills
  • Fever that may be 104 F (40 C) or higher

By the second or third day, you’ll develop other signs and symptoms that may include:

  • Cough, which may bring up mucus and sometimes blood
  • Shortness of breath
  • Chest pain
  • Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
  • Confusion or other mental changes

Although legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of legionnaires’ disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headache and muscle aches. Pontiac fever doesn’t infect your lungs, and symptoms usually clear within two to five days.

When to see a doctor

See your doctor if you think you’ve been exposed to legionella bacteria. Diagnosing and treating legionnaires’ disease as soon as possible can help shorten the recovery period and prevent serious complications. For people at high risk, prompt treatment is critical.

Causes

The bacterium Legionella pneumophila is responsible for most cases of legionnaires’ disease. Outdoors, legionella bacteria survive in soil and water, but rarely cause infections. Indoors, though, legionella bacteria can multiply in all kinds of water systems — hot tubs, air conditioners and mist sprayers in grocery store produce departments.

Although it’s possible to contract legionnaires’ disease from home plumbing systems, most outbreaks have occurred in large buildings, perhaps because complex systems allow the bacteria to grow and spread more easily.

How the infection spreads

Most people become infected when they inhale microscopic water droplets containing legionella bacteria. This might be the spray from a shower, faucet or whirlpool, or water dispersed through the ventilation system in a large building. Outbreaks have been linked to a range of sources, including:

  • Hot tubs and whirlpools on cruise ships
  • Grocery store mist machines
  • Cooling towers in air conditioning systems
  • Decorative fountains
  • Swimming pools
  • Physical therapy equipment
  • Water systems in hotels, hospitals and nursing homes

Although legionella bacteria primarily spread through aerosolized water droplets, the infection can be transmitted in other ways, including:

  • Aspiration. This occurs when liquids accidentally enter your lungs, usually because you cough or choke while drinking. If you aspirate water containing legionella bacteria, you may develop legionnaires’ disease.
  • Soil. A few people have contracted legionnaires’ disease after working in the garden or using contaminated potting soil.

Risk factors

Not everyone exposed to legionella bacteria becomes sick. You’re more likely to develop the infection if you:

  • Smoke. Smoking damages the lungs, making you more susceptible to all types of lung infections.
  • Have a weakened immune system as a result of HIV/AIDS or certain medications, especially corticosteroids and drugs taken to prevent organ rejection after a transplant.
  • Have a chronic lung disease such as emphysema or another serious condition such as diabetes, kidney disease or cancer.
  • Are 50 years of age or older.

Legionnaires’ disease is a sporadic and local problem in hospitals and nursing homes, where germs may spread easily and people are vulnerable to infection.

Complications

Legionnaires’ disease can lead to a number of life-threatening complications, including:

  • Respiratory failure. This occurs when the lungs are no longer able to provide the body with enough oxygen or can’t remove enough carbon dioxide from the blood.
  • Septic shock. This occurs when a severe, sudden drop in blood pressure reduces blood flow to vital organs, especially to the kidneys and brain. The heart tries to compensate by increasing the volume of blood pumped, but the extra workload eventually weakens the heart and reduces blood flow even further.
  • Acute kidney failure. This is the sudden loss of your kidneys’ ability to perform their main function — filtering waste material from your blood. When your kidneys fail, dangerous levels of fluid and waste accumulate in your body.

When not treated effectively and promptly, legionnaires’ disease may be fatal, especially if your immune system is weakened by disease or medications.

Prevention

Outbreaks of legionnaires’ disease are preventable, but prevention requires meticulous cleaning and disinfection of water systems, pools and spas.

Avoiding smoking is the single most important thing you can do to lower your risk of infection. Smoking increases the chances that you’ll develop legionnaires’ disease if you’re exposed to legionella bacteria.

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Twelve signs and symptoms of low testosterone

What is Tinnitus?

For most, tinnitus — a ringing in the ears — is an occasional annoyance. But for some people, it can last 6 months or more.

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Fibromuscular Dysplasia- Patient Experience, Struggles, and Living with FMD

Kari Ulrich, a patient with Fibromuscular Dysplasia (FMD), shares her story of struggles before and after being diagnosed with FMD in 2007. Kari reveals details of symptoms, treatments, lifestyle changes, living her life with FMD, and resources available for patients to obtain more information about this often misdiagnosed disease.

More information is available at: http://www.mayoclinic.com/health/fibromuscular-dysplasia/DS01101

Learn more about the Medical side of FMD with Dr. Rooke here: http://www.youtube.com/watch?v=n9QTpvP_sYg

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