I finally got a definitive diagnosis on my mother today. Lewy Body Disease, aka Dementia with Lewy Bodies. It is like a cross between Parkinson's (problems with gait and balance, stiffening up) and Alzheimers, with one not-very attractive addition, hallucinations and even delusions. I found this information at Welcome to Neurology | Neurology
Cognitive Profile of Dementia with Lewy Bodies and Parkinson’s Disease Dementia
In both DLB and PDD, the cognitive profile includes problems with attention, executive functions, and visuospatial function. Much of the literature on the neuropsychology of DLB compares DLB versus AD, consistently finding that higher-order attention and visuospatial function are more impaired in DLB than in AD, and that episodic memory and language function are more impaired in AD than in DLB.4,5 The impairment in attention in DLB may relate to the fluctuations that are characteristic of the disorder. However, examination of the nature of attentional impairment in DLB reveals that simple attention (e.g. digit span) is less impaired than higher-order attention (visual search and set shifting, Wechsler Adult Intelligence Scale [WAIS] digit symbol).4 Some have suggested that the attention deficits in DLB and PDD reflect the executive demands of the tests.6 Executive function comprises a group of cognitive operations that encompass planning, anticipating, sequencing, and monitoring complex cognitive operations. Executive function is consistently found to be impaired in DLB and PDD.5
OK, when I am totally off nicotine, my problems are well described by the first sentence above.
The article discuses Nicotine as treatment:
Trials of cholinergic agonists are also rational in PDD and DLB. Studies showing that transdermal nicotine improves attention in healthy nonsmokers24 implicates nicotonic receptors in the cognitive domain that is most impaired in PDD and DLB. Nicotine has also been shown to improve attention in healthy elderly with memory loss25 and even in AD.26 Nicotine has also been shown to improve attention in patients with PD.27 Although nicotine is not a viable therapeutic option itself, nicotinic agonists in development may be viable agents for DLB and PDD.
I must write to the authors to ask them "why" regarding the final sentence above.
Cognitive Profile of Dementia with Lewy Bodies and Parkinson’s Disease Dementia
In both DLB and PDD, the cognitive profile includes problems with attention, executive functions, and visuospatial function. Much of the literature on the neuropsychology of DLB compares DLB versus AD, consistently finding that higher-order attention and visuospatial function are more impaired in DLB than in AD, and that episodic memory and language function are more impaired in AD than in DLB.4,5 The impairment in attention in DLB may relate to the fluctuations that are characteristic of the disorder. However, examination of the nature of attentional impairment in DLB reveals that simple attention (e.g. digit span) is less impaired than higher-order attention (visual search and set shifting, Wechsler Adult Intelligence Scale [WAIS] digit symbol).4 Some have suggested that the attention deficits in DLB and PDD reflect the executive demands of the tests.6 Executive function comprises a group of cognitive operations that encompass planning, anticipating, sequencing, and monitoring complex cognitive operations. Executive function is consistently found to be impaired in DLB and PDD.5
OK, when I am totally off nicotine, my problems are well described by the first sentence above.
The article discuses Nicotine as treatment:
Trials of cholinergic agonists are also rational in PDD and DLB. Studies showing that transdermal nicotine improves attention in healthy nonsmokers24 implicates nicotonic receptors in the cognitive domain that is most impaired in PDD and DLB. Nicotine has also been shown to improve attention in healthy elderly with memory loss25 and even in AD.26 Nicotine has also been shown to improve attention in patients with PD.27 Although nicotine is not a viable therapeutic option itself, nicotinic agonists in development may be viable agents for DLB and PDD.
I must write to the authors to ask them "why" regarding the final sentence above.
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