Wednesday, April 16, 2014

LBD - What are the Stages/Progressions?

Knowing Mom's condition has  a progression doesn't ease matters much.   But knowing what to expect does help in understanding what's actually taking place.

The only problem is that there is the tendency for the condition to morph - insofar as to become something known as "Mixed Dementia".

Mixed Dementia is quite common among the afflicted.  This is a condition where one might be diagnosed with one form (say, LBD), but also have symptoms and factors related to VCI (Vascular Dementia),  and/or AD (Alzheimers).  There lies a rub, however, for our purposes we will focus on what we know - LBD (or DLB - Lewy Body Dementia).

Earlier I've outlined many of the symptoms.  Today, I'm going to run through the possible/probable stages of the condition (I daren't say 'disease', as that sounds off-base and is a little deceptive).  There are no real stages - just the progression of the affliction.

Lewy Body Dementia and Dementia with Lewy Bodies affects men far more greatly than women.  Women are more affected by Alzheimer's than men.  I found this quite interesting. Don't you?!



Did you know that Lewy Body Dementia and Dementia with Lewy Bodies (LBD and DLB) are two different diagnoses?  I didn't.  In a future blog, I'll go into the differences, but today I would like to show the signs, progressions and symptoms of LBD, with which Mom was diagnosed.

Cognitive Decline - What used to be simple isn't any longer.  There are times when the patient is lost - not always literally, but mentally.  S/he becomes forgetful, or can't recall what they were doing, speaking about, or where they were going.  Many times there are word substitutions, which happens for many of us, from time to time, but more often for the LBD patient.


I remember a time when we were sitting out on the deck at the beach house, enjoying the day, and Mom was talking about a man she knew who, I believe she said, had something to do with 'prophylactics'.  My brother and I looked at each other and repeated her statement.  She agreed, then realized she made a mistake, and we corrected her with 'prosthetics'.  We thought it cute at the time, but then she stated another zinger, and we wondered if it was the wine, or that she was tired - but neither of us thought it had to do with mental decline.   I cannot recall how long ago this was, but I believe it was a sign.



Loneliness and Depression - Mom was speaking of being so lonely quite a bit of the time when I'd call.  I knew her doctor had put her on anti-depressants a few years ago, but she didn't like them, and decided not to take them - until I realized she was still taking them, despite her claim they didn't work.    This could have explained a few things.  But then she began calling over and over about the same things; not remembering our last conversations, asking the same questions, and wanting information that couldn't be had (my deceased father's cell number, his address, my grandmother's phone number, etc.).



I also believe Mom suffers from Sundowner's Dementia, as well, which is another type of condition that affects the patient around 5-6 pm with many of the same symptoms, but more so around end-of-day (that, too, will arise later in another blog).

Physically, Mom has had pain in her shoulders - a stiffness.  This, too, can be related to LBD.  You see, the Lewy Bodies attache themselves to the cerebral cortex related to the cognitive functioning of the brain, and then progress down to the movement components of the structure.  This, too, is non-reversible, but with P/T, and regular exercise, it can be slowed in its progression.



When walking, the posture is stooped, the arms stop swinging from side to side as with a normal walk on the average person.  The feet tend to shuffle, rather than take steps.  The movement is forward, with the head placed forward.  This can lead to an advance of movement that sometimes cannot be stopped (meaning she will gain momentum quickly and cannot pace herself).   The nurse at the facility calls it the "charging bull".  Mom has hurt her hand doing this, and it may explain a great deal of how she has hurt herself in the past while still ensconced in her own home, but hitting things that were in her way, inadvertently.

Memory.

This is something to which I can speak of the differences between LDB and AD (Alzheimers).

In one of the books I'm currently perusing on the condition, the author put it very well -

Think of your memory as being coded data, like a file in the library.  When something occurs, this is put into a file and placed on the shelf, coded, and tagged for later reference.

With Alzheimer's, the codes are blocked, and it is quite difficult if not impossible for the patient to retrieve that information.

Patients with LBD can access those files, but they're under a pile of papers, and the file itself is open so all the pages need to be sorted through in order to locate the proper forms for the recall.  As time progresses, and the affliction continues, the pile of papers grows more and more immense, making the locating of the memories much more difficult to locate accurately.

Now, Mother, having been the one who wrote the books on the family history, dealt with all the genealogical records, and used to be able to recall a  great deal, cannot locate a goodly amount of those memories accurately.  Remember the last blog when I shared her speaking of my brother's pool as being 1,000 feet long?  Because she remembered the pool, but the elements of the memory were jumbled with other information that was piling up on the table in her brain.

Now it all begins to make sense, yet in a nutshell (what a large nut to crack!)

Till next time!





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