DEAR DR. DONOHUE: My husband has Lewy body dementia. I know very little about it. What can I expect? He has no hallucinations, which, I understand, are part of this problem. — A.R.

ANSWER: “Dementia” is an all-inclusive word indicating a decline in mental function. Alzheimer’s disease is the most common kind of dementia. It accounts for more than 50 percent of dementia cases. Lewy body dementia comes in second, with 10 percent to 20 percent of cases. There are other forms. Distinguishing the various kinds of dementia is not always easy. Some of the distinguishing features of Lewy body dementia are fluctuating cognition, visual hallucinations and some Parkinson’s disease signs. “Fluctuating cognition” indicates that patients have days when they are mentally clearer and days when they are not with it. “Visual hallucination” is seeing people or animals that are not present. Parkinson symptoms are things like slow movement, walking unsteadily and rigid muscles. The mental symptoms of Lewy body dementia appear before the onset of Parkinson’s signs.

Early in the course of this illness, the most noticeable losses of mental function are trouble in decision making, great difficulty in judging distances, which makes driving impossible, and disorganized thinking. In the early stages, memory deficits are not as prominent as they are in Alzheimer’s disease, but they eventually arise.

No medicine cures Lewy body dementia, but many medicines can improve symptoms. Parkinson’s disease medicines are prescribed when patients have the signs of that illness. Medicines used in Alzheimer’s disease are often used for Lewy body dementia too. Since sleep disturbances are another prominent Lewy body dementia consequence, sleep inducers have their place. Melatonin helps patients get to sleep and stay asleep.

DEAR DR. DONOHUE: One of our children has a drinking problem recognized by our other children but not by him. He says he has no alcohol problem because he drinks only beer. He drinks 30 to 40 cans of “light” beer in one day with no visible effect. We don’t know where to turn and would appreciate your suggestions. This man does not have much money. — W.F.

ANSWER: Your son is an alcoholic by definition. His volume of consumption is proof of that. His tolerance of such an amount of alcohol is other evidence of alcoholism. Your son’s denial of alcoholism because of his drinking only beer is ridiculous. One 12-ounce can of beer contains the same amount of alcohol as does 1.5 ounces of whiskey — a shot or a jigger. Light beer has almost the same amount of alcohol as regular beer. It’s called “light” not because of reduced alcohol content but because of fewer calories. Your son faces the prospects of liver cirrhosis, possible pancreatitis, stomach bleeding and brain degeneration. He can get plenty of help for little money at Alcoholics Anonymous. First he must admit he has a true problem.

DEAR DR. DONOHUE: Your recent discussion of the spleen recalled an experience my wife had. She was hospitalized with a high fever that failed to respond to antibiotics. My wife, only half-seriously, suggested she might have a parasite. The specialist said it was an interesting thought, and they were considering babesiosis. Babesia organisms were found in her blood. It can be a fatal infection in those without a spleen. — D.H.

ANSWER: Babesiosis is caused by a one-celled organism (a protozoan) called Babesia microti, transmitted to humans by the bite of a tick. An infection can cause no symptoms or it can bring on fever, shaking chills, headache, muscle aches and breathlessness. The Babesia germ infects red blood cells and destroys them, similar to how the malaria parasite does. The illness is most prevalent in the Northeast and upper Midwest, and mostly occurs between May and September, the months of greatest tick activity. You are the first to mention this to me in a letter.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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