Lewy Body Dementia

Fluctuating cognition with pronounced variation in attention and alertness is essential for a probable diagnosis of LBD

Fluctuating cognition with pronounced variation in attention and alertness is essential for a probable diagnosis of LBD

Spontaneous motor features of parkinsonism are essential for a diagnosis of probable LBD

Features supportive of the diagnosis are:

Repeated falls

Syncope

Transient loss of consciousness

Neuroleptic sensitivity

Systematized delusion

Hallucinations in other modalities

Key points

LBD is characterized by distinct cognitive impairment with fluctuating confusion, disturbance of consciousness, visual hallucinations, delusion, falls and significant parkinsonism

The hallmark feature is the presence of widespread Lewy bodies throughout the neo and archi cortex with the presence of Lewy body and cell loss in the subcortical nuclei

In studies comparing both Diffuse Lewy Body disease and Dementia of Alzheimer’s Type they exhibit impaired performance across the range of tasks designed to assess semantic memory. Whereas patients with DAT showed equivalent comprehension of written words and picture stimuli, patients with DLB demonstrated more severe semantic deficits for pictures than words. As in previous studies, patients with DLB but not those with DAT were found to have impaired visuoperceptual functioning. Letter and category fluency were equally reduced for the patients with DLB whereas performance on letter fluency was significantly better in the DAT group. Recognition memory for faces and words was impaired in both groups.
Semantic impairment is not limited to patients with DAT. Patients with DLB exhibit particular problems when required to access meaning from pictures that is most likely to arise from a combination of semantic and visuoperceptual impairments.

The dementia associated with Lewy body disease affects:

• memory
• language
• the ability to judge distances
• the ability to carry out simple actions
• the ability to reason.

People with this form of dementia suffer hallucinations for example seeing a person or pet on a bed or a chair when nothing is there.

They may suffer from falls for no apparent reason, because their ability to judge distances and make movements and actions accurately is disrupted.

They may develop some Parkinson type symptoms such as slowness of movement, stiffness and tremor. In a few cases heart rate and blood pressure are affected. The abilities of the affected person often fluctuate from hour to hour, and over weeks and months. This sometimes causes carers to think that the person is putting on their confusion.

ORTHOREXIA NERVOSA

Orthorexia Nervosa

People want to eat healthy, but people also have a strong tendency to become obsessive about the things they do. As a consequence, some people who seek healthy diets also become obsessive about those diets - and that means that they take something that should be healthy so far and to such extremes that it becomes very, very unhealthy.

Mary Spicuzza writes in the Seattle Times about the pseudoscientific thinking that goes on in some quarters, and the harm it has caused:

Dr. Steven Bratman, a Colorado-based medical doctor and author, says the way some people practice health-food diets is so extreme that they've developed eating disorders. Bratman coined the term "orthorexia nervosa," which he defines as a "pathological fixation on eating proper food" in one book, and he is now writing another book about some of the pitfalls of holistic medicine.

Dr. Diane Mickley, a spokeswoman for the Seattle-based National Eating Disorders Association, says that like any other eating disorder, orthorexia is not exclusively about food. "It's less about the specifics of different diets than the extremes to which more vulnerable people can take them," Mickley said. "They are psychiatric disorders."

"Anyone who becomes obsessed about food, it's a problem," said Tiffany Reiss, Ph.D., an assistant professor in nutrition and exercise science at Kenmore's Bastyr University. Reiss says orthorexia can lead to isolation, rigidity, and alienation. "It can lead to the feeling of virtuousness," Reiss said. "It's like, 'I'm eating this way, everyone should be eating this way, too.' "

The idea that the only healthy diet is one that is based entirely around fruits or around raw food is simply nonsense - but those who follow such diets are the "pure" and the "enlightened" among us. It has become their religion, something they have dedicated their lives to and you can't tell them otherwise.
(source)