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Katie Dunbar

Informative Speech Outline


Dr. Pisarik
March 6, 2016

Speech Title: Lewy Body Dementia—an Alternative Form of Progressive Brain Dysfunction
Specific Purpose: To inform the audience about Lewy Body Dementia
Thesis Statement: As the number of elderly individuals in the population increases, the
subsequent health consequences also increase, and Lewy Body Dementia is one such memory
disease that is highly present in the population—second only to Alzheimer’s disease.

Introduction
How many of you have heard of Alzheimer’s disease? What about Lewy Body
dementia? Though the exact prevalence of Lewy Body dementia is unknown due to high
potential for misdiagnosis, it is expected that Lewy Body dementia makes up an upwards of
twenty-three percent of dementia cases (Vann Jones, 2014). Interestingly enough, the brain
abnormalities accompanying Lewy Body dementia are similar to those involved in Parkinson’s
disease, as a lack of a chemical called dopamine disrupts normative mental processing efforts.
Current medical research and possible intervention techniques include pharmacological synthetic
dopamine treatments and non-pharmacological occupational therapy techniques (Hovendon,
2015). As the number of elderly individuals in the population increases, health consequences
also increase, so it is important to understand the details behind a disease that affects so many.
In order to develop a fundamental understanding of Lewy Body dementia, it is helpful to
understand the signs and symptoms that present themselves at various stages of disease
progression, the underlying brain abnormalities accompanying the disease, and possible
treatment options. As stated by Bridget Hovendon of the McGill Science Undergraduate
Research Journal, “Dementia impacts patients’ social and occupational functioning, reasoning,
memory, capacity for new learning, self-perception, and interpersonal interactions.” Lewy Body
dementia is no exception.

I. Physical and emotional difficulties accompany the progression of Lewy Body


dementia.
A. Initial memory decline is followed by visual hallucinations.
a. Visuospatial capabilities are compromised.
b. Lewy Body dementia patients are likely to “see” people and animals.
c. Hallucinatory diseases vary in the types of images “seen” by the affected.
d. Hallucinations may be related to impairments in the retinas of the eyes.
B. Sleep and arousal are also impacted by Lewy Body dementia.
a. Sundowning, or memory decline as the day progresses, is common in
Lewy Body dementia patients.
b. Night wandering is also common.
c. As memory impairment progressively worsens, sleep disturbances rise as
well.
d. Patients with Lewy Body dementia have subcortical damage that alters the
ability to control consciousness during the day.
e. J.B. Grace, a lecturer at the Newcastle General Hospital states of REM
sleep that “It is hypothesized that some sleep disturbance at night,
especially the periodic limb movements, bad dreams, and confusion on
waking, are a result of REM sleep abnormalities.”
C. The motor disturbances seen in Lewy Body dementia patients resemble those of
Parkinson’s disease.
a. Lewy Body dementia and Parkinson’s disease are both accompanied by
dopamine impairments.
b. Both diseases involve uncoordinated muscle movements and tremors.
c. Levodopa, which is a synthetic dopamine medication, may be used to treat
both Parkinson’s disease and Lewy Body dementia.
D. Many patients affected with Lewy Body dementia complain of depressive
symptoms.
a. Yamane Yumiko, Department of Psychiatry at Kobe University: Lewy
Body dementia patients scored twice as high on the geriatric depression
scale as those with Alzheimer’s disease.
b. There was no significant difference between male and female depression
rates.
c. A loss of dopamine transmitters may give explanation to the frequency of
depressive symptoms.
II. Lewy Body dementia affects the brain in many ways.
A. Lewy bodies are protein deposits in the neurons of the neocortical region of the
brain.
a. Neurofibrillary tangles and plaque accompany the presence of Lewy body
deposits and inhibit proper brain function.
b. The transmission of dopamine is inhibited, and a lack of muscular
coordination follows.
B. Magnetic Resonance Imaging, or MRI, scans show muscular atrophy, or decline
in the visual and balance areas of the brain.
a. Atrophy of the temporal lobe was shown to be more severe in Lewy Body
dementia patients than in a control group of healthy older adults.
b. Young patients pre-disposed toward probable REM sleep disorder had a
higher chance of developing Lewy Body dementia later in life.
C. Patients suffering from dementia with Lewy Bodies generally have poor
visuospatial skills and are thus predisposed to experience visual hallucinations.
a. Patients who experience hallucinations often also experience cone
damage, which leads to visual impairments.
b. Lewy Body dementia patients are more likely to experience visual
impairment than are Alzheimer’s dementia patients.
III. Treatment options include both pharmacological and non-pharmacological
interventions.
A. Levodopa medication may reverse or at least prevent further deterioration of
impaired brain function.
a. Levodopa has been shown to improve motor function and alertness,
particularly in Parkinson’s patients.
b. Neurologist Claudio Lucetti found that fifty-five percent of Lewy Body
patients treated with levodopa showed a positive response within six to
twelve months of treatment, but rapid decline followed.
c. The effects of Levodopa on dementia patients are still in the process of
being tested.
B. The effects of occupational therapy on dementia patients are not well-known, but
motor abilities could potentially improve with treatment.
a. Intervention may slow but not prevent the gradual loss of voluntary
muscle function.
b. A case study of a woman with Lewy Body dementia showed improvement
in functional skills following occupational therapy sessions.

Conclusion
Dementia with Lewy Bodies is a misunderstood but prevalent form of dementia in the
geriatric population. Hallucinations, sleep disturbances, and depression are among the most
severe signs and symptoms of the disease. Neurofibrillary tangles and Lewy Body protein
deposits alter brain function and inhibit the transmission of dopamine, and muscular atrophy and
a decline in muscle coordination follow. Levodopa medication and occupational therapy may
slow the progression of Lewy Body dementia, but as of now, a cure has not been discovered.
References
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with dementia with Lewy bodies and Alzheimer’s disease. International Journal of

Geriatric Psychiatry, 15(11), 1028-1033.

Hamilton, J. M., Salmon, D. P., Galasko, D., Raman, R., Emond, J., Hansen, L. A., Thal, L. J.

(2008). Visuospatial deficits predict rate of cognitive decline in autopsy-verified

dementia with Lewy bodies. Neuropsychology, 22(6), 729-737.

Hovendon, B., & Kaufman, M. (2015). Dementia with Lewy Bodies: An Overview. McGill

Science Undergraduate Research Journal, 10(1), 45-48.

Johns, E. K., Phillips, N. A., Belleville, S., Goupil, D., Babins, L., Kelner, N., and Chertkow, H.

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Lucetti, C., Logi, C., Del Dotto, P., Berti, C., Ceravolo, R., Baldacci, F., and Bonuccelli, U.

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