Robin Williams: Dementia with Lewy Bodies VS Alzheimer's

 "You are only given a little spark of madness. You must not lose it"~ R. Williams  

 

D is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States, but many doctors or other medical professionals still are not familiar with LBD. - See more at: http://www.lbda.org/learn_about_lbd#sthash.KJTg8Hv4.dpuf

D is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States, but many doctors or other medical professionals still are not familiar with LBD. - See more at: http://www.lbda.org/learn_about_lbd#sthash.KJTg8Hv4.dpuf

Many people did not know what Robin Williams, beloved actor and inspiration to all, was suffering quietly alone. He suffered from depression, paranoia,  Parkinson's Disease, as well as dementia. These symptoms describe dementia with Lewy Bodies (DLB). The symptoms fluctuate in their intensities in very unpredictable ways. DLB is the second most common cause of dementia in older individuals, where Alzheimer's is the first. (A)

 According to the LBDA (Lewy Body Dementia Association) there are 3 common symptoms: some will begin with movement disorder leading to Parkinson's Disease then later to dementia. (diagnosis: Parkinson's Disease Dementia), another group of individuals will have cognitive/memory disorder that could easily be mistaken for Alzheimer's Disease, but time will show more distinctive characteristics that leads to LBD. Next, is the smalls group of this disease who at first show neuropsychiatric symptoms (e.x: Hallucinations, behavioral problems, and have a hard time with more complex mental activities) (B)

• Some individuals will start out with a movement disorder leading to the diagnosis of Parkinson's disease and later develop dementia. This is diagnosed as Parkinson’s disease dementia.
• Another group of individuals will start out with a cognitive/memory disorder that may be mistaken for AD, but over time two or more distinctive features become apparent leading to the diagnosis of ‘dementia with Lewy bodies’ (DLB).
• Lastly, a small group will first present with neuropsychiatric symptoms, which can include hallucinations, behavioral problems, and difficulty with complex mental activities, also leading to an initial diagnosis of DLB.

Regardless of the initial symptom, over time all three presentations of LBD will develop very similar cognitive, physical, sleep and behavioral features. - See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

 

LBD can have three common presentations:

• Some individuals will start out with a movement disorder leading to the diagnosis of Parkinson's disease and later develop dementia. This is diagnosed as Parkinson’s disease dementia.
• Another group of individuals will start out with a cognitive/memory disorder that may be mistaken for AD, but over time two or more distinctive features become apparent leading to the diagnosis of ‘dementia with Lewy bodies’ (DLB).
• Lastly, a small group will first present with neuropsychiatric symptoms, which can include hallucinations, behavioral problems, and difficulty with complex mental activities, also leading to an initial diagnosis of DLB.

Regardless of the initial symptom, over time all three presentations of LBD will develop very similar cognitive, physical, sleep and behavioral features. - See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

"To live...To live would be an awfully great adventure." ~Williams as Peter Pan in Hook  

Individuals who suffer from Parkinson's disease have symptoms of shaking tremors, slow movements of their limbs, and shuffling style of walk. Lewy bodies were found in people with Parkinsons. Lewy bodies are microscopic clumps of protein (aka: alpha-synucein) where under specific conditions- still unknown to scientists and physicians- accumulate in the nerve cells of the brain. This accumulation involving the brainstem, midbrain structures, and substantia nigra accounts for the loss of Dopamine (a neurotransmitter) in the brain leading to Parkinson's Disease. Recent studies show that Lewy bodies do in fact affect other parts of the brain that can occur in autonomic and PNS producing symptoms of low blood pressure, constipation, and sweating. These symptoms are very commonly known as vegetative symptoms. (A)

The most common symptoms of LBD include impaired thinking, fluctuations in cognition(attention or awareness), visual hallucinations,sleep disorders, behavioral and mood symptoms i.e. depression, anxiety, agitation, delusions, paranoia), and changes in autonomic body functions (i.e blood pressure control, temp regulation, bladder and bowel function) (B)

Impaired thinking, such as loss of executive function (planning, processing information), memory, or the ability to understand visual information.

Fluctuations in cognition, attention or alertness;

Problems with movement including tremors, stiffness, slowness and difficulty walking

Visual hallucinations (seeing things that are not present)

Sleep disorders, such as acting out one’s dreams while asleep

Behavioral and mood symptoms, including depression, apathy, anxiety, agitation, delusions or paranoia

Changes in autonomic body functions, such as blood pressure control, temperature regulation, and bladder and bowel function.

- See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

DLB diagnosed patients have lewy bodies within the cerebral cortex. The symptoms begin with mild, fluctuating disturbances in attention and wakefulness. The individual will appear vague, drowsy or confused as their interests decrease and inabilities to reason and carry out daily tasks. (Similar to Apathy but is mistaken for depression). R. Williams' visuo-perceptual function was also affected as he would get bruising from bumping into objects. He would also have very life like hallucinations which is common in 80% of cases. (A)

"No matter what people tell you... words and ideas CAN change the world"~ Williams in Dead Poets Society

 As the lewy body disease progresses, general cognitive impairment and dementia get worse although it occurs in a fluctuating pattern of intervals. The hallucinations that these individuals suffer from can be life threatening, confusing as well as frustrating as to why they are unable to recognize familiar faces or strangers. Some have hallucinations as a form of nightmares which develops in part as a specific sleep disorder. The initial diagnosis of Parkison's disease is dementia followed by symptoms of short term memory failure, alzheimer's diseass pathology in the brain, and the walking nightmares people like Williams suffered with on a daily basis. (A)

 

 "Please, don't worry so much, because in the end, none of us have very long on this earth"~ Williams in Jumanji

If DLB is so common, why did it take so long for physicians to recognize it in Williams? Unfortantely, lewy bodies are extremely difficult to see in the brain using conventional methods such as staining. 

"You will always have bad times, but they will wake you up to things you weren't paying attention to"~Williams 

Trials for DLB have been rare because there is a lack of compounds to test. A preoccupation with targeting Alzheimer's and a reluctance of regulatory bodies to recognize DLB are just some of the obstacles researchers face. Because of Robin William's, pharmacological trials for DLB, will increase public awareness. Families will now search for organizations that provide information, advice, advocacy, and support for research activity. DLB is the key to unlock the key to BOTH parkinson's and Alzheimer's disease. (A)

"Never say goodbye because goodbye means going away and going away means forgetting"~Peter Pan, Neverland

Links:
(A)http://www.iflscience.com/health-and-medicine/robin-williams-had-dementia-lewy-bodies-so-what-it-and-why-has-it-been-eclipsed
(B) http://www.lbda.org/learn_about_lbd

*These images are not mine they were found on various tumblr sites! If any are yours please let me know so that I can give you credit~ Thanks so much!