The Center of Excellence (COE) on Brain Aging at NYU Langone Medical Center has established a specialty center for the diagnosis and treatment of Lewy Body Disease, a multi-system disease involving disturbances of cognition, behavior, sleep and autonomic function. Lewy Body Disease, or LBD, affects an estimated 1.3 million individuals in the United States and is widely misdiagnosed because LBD symptoms closely resemble those of other more commonly known diseases such as Alzheimer's and Parkinson's disease. The center is the first of its kind in the NYC tri-state area.
Lewy Body Disease is named for the scientist Friederich H. Lewy who discovered abnormal protein deposits that disrupt the brain's normal functioning. Though there is no cure for the disease, early detection can result in effective disease management through the use of non-phamacological approaches to start, followed by maximizing use of antidementia medications and SSRI antidepressants. Typically, Alzheimer's patients are given antipsychotic drugs to control behaviors, but patients with Lewy Body Disease can have serious reactions to certain types of these medications including trouble initiating movements and severe rigidity, even muscle breakdown and renal failure.
"Because LBD can manifest itself to resemble other neurodegenerative diseases, it is misdiagnosed eighty percent of the time, and in many cases, it can have detrimental effects for the patient because of adverse reactions to certain medications," says James E. Galvin, MD, MPH, director of clinical operations at the Center of Excellence on Brain Aging and professor of Neurology and Psychiatry at NYU Langone Medical Center. "Early, accurate diagnosis allows for timely treatment that may prolong quality of life and independence, and also allows caregivers the opportunity to prepare for long-term needs." Dr. Galvin also serves on the Board of Directors for the Lewy Body Dementia Association and has published extensively in numerous medical journals on topics relating to Alzheimer's, Parkinson's and LBD.
The LBD Center at NYU Langone offers a collaborative, patient-focused approach to diagnosis and treatment. Diagnostic evaluations involve both physical and neurological examinations, as well as patient and family interviews (including a detailed lifestyle and medical history) and neuropsychological and mental status tests. The patient's functional ability, attention, language visuospatial skills, memory and executive functioning are assessed. Patient care teams include neurologists, neuropsychologists, psychiatrists, internists and geriatric specialists, as well as social workers to provide support and care for caregivers. Innovative programs in cognitive remediation and falls prevention can be tailored to individual patient needs.
The Center also offers a wide array of comprehensive and technologically advanced testing including brain imaging such as Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) scans, sleep evaluations and other laboratory studies. Additionally, patients have the opportunity to participate in clinical research projects involving imaging, cerebrospinal fluid and other biological markers leading to development of new therapeutics that are not available elsewhere.
"A common frustration expressed by caregivers is the inability to find physicians who are knowledgeable about LBD," says Norman Loeb, the leader of the Lewy Body Dementia's Association's New York Support Group. "After an eventual diagnosis, which may take months or even years to obtain - the disease often continues to be mistreated due to lack of specialized expertise. Being able to refer patients and caregivers to a clinic specializing in LBD, that treats the physical, mental as well as emotional aspects of the disease, will be invaluable," she adds.
NYU Langone's Lewy Body Disease Center is located at the Pearl S. Barlow Center for Memory Evaluation and Treatment at the Silberstein Alzheimer's Institute at 145 East 32nd Street in New York City. Physicians, patients and families needing information can call 212.263.3210 or go to NYU Langone's Lewy Body Disease website at www.barlowcenter.org.
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