LEWY BODY DEMENTIA AND PHYSICAL THERAPY

By: Kelly Keenan Veit, DPT

The word dementia in itself is not a diagnosis. It is a word that refers to a group of symptoms that relate to problems with memory, language, problem solving and other thinking skills (Alzheimer’s Association, n.d.). Dementia can be caused by a variety of pathologies and Alzheimer’s disease is the most common and most familiar. The second most common cause of dementia is Lewy Body. This occurs when Lewy body proteins are deposited in neurons in the brain typically in the areas that control thinking, memory, and movement (Mayo Clinic, n.d.). Individuals with Lewy Body Dementia (LBD) also have plaques and tangles in their brain which is associated with Alzheimer’s. According to the National Institute on Aging (2012), over one million people have LBD in the United States. Lewy body dementia is progressive and can have a fluctuating pathway over time. Symptoms can include hallucinations, movement disorders such as those seen with Parkinson’s Disease, cognitive decline, poor body systems regulations, sleep disturbances, depression, and apathy (Mayo Clinic, n.d.). As time progresses an individual will not be able to reside on their own and will need around the clock care to remain safe.

Evaluation & Treatment

Treatment available for a person with LBD is similar to that of Alzheimer’s or Parkinson’s. Medication is used to help improve or slow decline of brain function and to improve movement challenges. Other medication may be needed for additional symptoms, such as sleep problems (Mayo Clinic, n.d.). Because LBD does have a movement component, physical therapy can be beneficial. An evaluation specific to function can help give insight to areas that need improvement, but also education regarding assistance that may be needed in the future. When we think of an independent functional person, you picture someone who can walk easily, balance, avoid falls, perform all those activities in their home and community that require strength and coordination. As a person develops cognitive and functional decline a vicious cycle can begin. Their world shrinks and their movements and cognitive activities become smaller. This leads to more weakness, greater risk of injury and increased dependence on others. This is where physical therapy and exercise can step in.

Exercise & Lewy Body Dementia

A quick online search about dementia and exercise will show you the great extent to which Alzheimer’s disease has been researched. Mayo clinic mentions the findings that exercise can slow cognitive decline. One particular study, the PRIDE study (Inskip et al., 2022) looked specifically at individuals with LBD. While this study was small, it had significant results in the use of tailored progressive high intensity exercise on functional independence in those older adults with LBD (Inskip et al., 2022). Two things they found in their study that are important. For those subjects who had to go through a waiting period prior to starting the 8 week exercise routine, there was a decline in muscle mass and strength and an exacerbation of frailty which all increased their dementia symptoms. For those that then completed the 8-week exercise program there was an improvement in their functional status and a stabilization of their clinical status. Inskip et al. (2022) found that functional independence is associated with balance, walking endurance, cognition, quality of life, and decreased dementia severity. Interestingly they did not find it to be directly associated with strength, but cognition was. While a small study, the meaningful connection between lack of exercise and decline and regular exercise and improvement is poignant. The 8-week program consisted of progressive high intensity resistive exercises, static balance, dynamic balance, and functional practice. These are all things that we do with our clients at Tandem Strength and Balance each session.

Tandem Strength & Balance

If you or a loved one has been recently diagnosed with LBD, an exercise program tailored to your needs may help reduce symptoms or slow progression. Please call to set up an evaluation to learn how we can help you today.

RESEARCH PROVES

Everyone starts to lose strength within 3-5 days after strength training has stopped. So many older adults can not afford to lose any strength because they are just getting by.

DID YOU KNOW?

As physical therapists, we continue to challenge all of our clients in a way that caregivers and families can’t. We address the root cause of their mobility issues and help older adults build strength so they can enjoy their independence and keep living costs lower.

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