Robin Williams & Dementia: Did it Lead to Suicide?

We mourned the loss of the comedic genius, Robin Williams. He suffered from Lewy Body Dementia, a disease affecting 1.4 million Americans.

The recent “exclusive” from TMZ says that Robin Williams may have died as a result of advanced Lewy Body Disease. His autopsy showed his brain had Lewy Bodies throughout. The report states dementia, and the news media cited that his suicide may have been the result of advanced Lewy Body Dementia which can have profound visual hallucinations.

But the use of “dementia” in the autopsy report does not mean Robin Williams suffered from clinical signs of dementia. Lewy Body Dementia in an autopsy report means that the Lewy bodies (which are tangled proteins) were found throughout Williams’ brain.

Could Robin Williams have had a sudden decline because of Lewy Body Disease?
Likely not. Sudden decline in patients is related to medications, infections, or a compromise of the immune system. Much like Alzheimer’s disease, Lewy Body disease is rapid, but in terms of a few years, not a few months.

Was Robin Williams diagnosis of Parkinson’s Disease a misdiagnosis?’
Yes. William’s wife said that he was battling “the early stages of Parkinson’s disease.” Lewy Body disease often presents with similar symptoms to Parkinson’s disease. The autopsy confirms the Lewy bodies and the early symptoms Robin Williams had were undoubtedly Lewy Body Disease.

Both Parkinson’s disease and Lewy body disease have similar symptoms, but a different pattern. There is more cognitive (mental alertness) and psychiatric components of the diseases.

What about Robin Williams’ other symptoms?
Robin Williams was under treatment for Parkinson’s disease, but was also experiencing depression, anxiety, and paranoia – which can occur in both Parkinson’s disease, Lewy Body disease, and the chronic depression Williams was known to suffer from.

It was reported that Williams slept in a separate bedroom from his wife because he was having difficulty sleeping- which is another symptoms of Lewy Body Disease.

Could Robin Williams have had dementia?
There is no mention that Robin Williams had any of the symptoms of dementia. His television work, including his recently cancelled show, was brilliant, and Williams was considered by his cast members to have exhibited his usual genius with the show. Given the disease found at autopsy, it is likely he would have ultimately developed this.

Did Robin Williams have hallucinations?
There is no evidence that Williams suffered from hallucinations. Typically the hallucinations are vivid and non-threatening, and do not lead to suicide.

Did Robin Williams know he had Lewy Body Disease?
There is no “test” for Lewy Body disease – but there is a complicated set of clinical symptoms that specialists (neurologists) use to make the diagnosis. The only definitive diagnosis currently is found at autopsy. A more comprehensive list of symptoms are below. Two out of three people do not know they have the disease. Looking backward, we know he had the disease, but it is unlikely that he knew it. It is estimated that 1.4 million Americans suffer from this disease.

What was Williams prognosis with Lewy Body Disease?
This is a progressive deteriorating neurological disease, that ultimately leads to death. From diagnosis to death is an estimated 5-7 years, although some have lived with Lewy Body Disease for as long as 20 years. Williams had diffuse Lewy Bodies throughout his brain, and was probably going to survive five years or less.

What are the symptoms of Lewy Body Disease and what did Robin Williams Have?
There are three core features of the disease:
(1) Early and more defining symptoms are cognitive – the ability to think and reason, and ability to keep attention. as well as alertness.
(2)Visual hallucinations, which are very well-formed, vivid, and detailed are a feature of the advanced disease.
(3)Parkinson-like symptoms are another core-feature.

Williams had the Parkinson-like symptoms. No evidence that he had hallucinations. He reported that he did not like the medication he was taking, which is a minor clue of the disease. His depression may have been exacerbated by the disease.

Other Symptoms:
Sleep disorders (REM sleep) are common. That Williams had sleep disorders, for which he slept in another bedroom, is another sign of the disease. Because of hallucinations patients will often be treated with anti-psychotic drugs (called neuroleptics). Lewy Body patients often respond poorly to these drugs and the patient’s response can point to Lewy body disease. That Williams didn’t tolerate the Parkinson’s disease drugs is another common feature of Lewy Body Disease.

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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