Pathology:
Lewy body Dementia (LBD) is a very
complicated disease both in terms of pathology and treatment. This is the one
type of disease that has both characteristics of Alzheimer’s disease and
Parkinson’s disease. What distinguishes between the types of diseases is the
timing of the appearance of symptoms. If symptoms of dementia happen before
that of Parkinson’s, the situation is diagnosed as dementia with Lewy bodies or
Lewy body dementia. On the contrary, Parkinson’s disease dementia is diagnosed
when cognitive impairment happens after Parkinson’s disease.
In essence, it is the formation of
Lewy bodies and over time the abnormal accumulation of these bodies that leads
to the clinical symptoms. These protein deposits often take place in pre-synaptic
terminals that are responsible for neurotransmitter release and cycling.
Symptoms of LBD can be divided to three levels of cognitive, behavioral, and
physical. Cognitive symptoms can begin with presentation of non-amnestic
cognitive impairments such as language presentation (deficits in word finding),
visuospatial presentation (problems in spatial cognition, face recognition,
etc), and executive dysfunction (impaired reasoning and judgment). Behavioural
symptoms include delirium, depression, and visual hallucinations. Finally,
parkinsonism, hyposmia (decreased sense of smell), and constipation can be
named as physical symptoms.
As there are overlaps of the
clinical symptoms of LBD with Alzhiemer’s and Parkinson’s such as: deficits in
attention, recurrent hallucinations, and so on, there are imposed challenges in
terms of diagnosis and LBD is often misdiagnosed as Alzheimer’s disease.
Therefore, ensure proper diagnosis of LBD before looking into exercise programs
to deal with this disease.
Research:
The research involving exercise and
its effects on those with Lewy Body Dementia is far from extensive. The reality
of the matter is that several systematic reviews have found that a majority of
the literature related to exercise and dementia excludes those with Lewy Body
Dementia (Inskip et al. 2016). As well as finding that there is little
high-quality research when it comes to the benefits of exercise with Lewy Body
Dementia (Inskip et al. 2016). Therefore, the effect of exercise on this
disease can not be concluded as firmly as the previous issues that we have
discussed. However, it is possible to make ‘educated estimations’ about this
field of study through other forms of research. In a case study with an
87-year-old man with Lewy body Dementia who underwent intense anabolic
exercise, the study recorded a trend to precipitate a return to previous levels
of functional decline (Inskip et al. 2020). Again though this is a trend, not a
significant conclusion. Furthermore, although there is no firm conclusion about
the benefits of exercise with Lewy Body Dementia, such interventions have been
recorded as being helpful with other types of dementia (Conners et al. 2018).
On the other hand, physical exercise strategies may be useful for people with
Parkinson’s disease (Velayudhan et al. 2017). Therefore, due to the close
relation of Parkinson’s disease to Lewy Body Dementia, this may suggest there
could potentially be a benefit of physical exercise in those with Lewy Body
Dementia.
Therefore, not enough high-quality
research has been conducted to firmly conclude the benefits of exercise in
those with Lewy Body Dementia, but there still may be potential benefits from
physical activity.
Exercise:
Given the fact that there is no
concrete conclusion on the effects of exercise on those with Lewy Body Dementia
in the literature, it is difficult to provide a proper exercise recommendation.
It is possible that simple physical exercise programs or recommendations from
our previous posts about Alzheimer’s and Vascular Dementia may still have
benefits on this illness, but due to the state of the literature we cannot know
for sure. Therefore, this is a perfect example of understanding the benefits of
seeing a registered healthcare professional and a specialist in this field in
regards to coming up with an exercise program that is right for you or a person
you know.
**Don’t forget to check out this
week's “Interesting Reading of the Week '' located in the sidebar.
**Please
note that the exercise related programs from the studies are not the only
effective training modality that produce benefits. If you believe that exercise
will help you or someone you know, please contact a registered healthcare
professional for more information.
**For more detail on this topic or to recommend future content, please email us.
Articles Referenced:
Connors, M. H., Quinto, L., McKeith, I., Brodaty, H., Allan, L., Bamford, C., ... & O'Brien, J. T. (2018).
Non-pharmacological interventions for Lewy body dementia: a systematic review.
Psychological medicine, 48(11), 1749-1758.
Inskip, M., Mavros, Y., Sachdev, P. S., & Singh, M. A. F. (2020).
Interrupting the trajectory of frailty in dementia with Lewy bodies with anabolic exercise,
dietary intervention and deprescribing of hazardous medications. BMJ Case Reports CP, 13(4), e231336.
Inskip, M., Mavros, Y., Sachdev, P. S., & Fiatarone Singh, M. A. (2016).
Exercise for individuals with Lewy body dementia: a systematic review. PLoS One, 11(6), e0156520.
Velayudhan, L., Ffytche, D., Ballard, C., & Aarsland, D. (2017).
New therapeutic strategies for Lewy body dementias. Current neurology and neuroscience reports,
17(9), 1-9.)
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