Overview of Lewy Body Dementia

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Lewy body dementia is widely considered the second most common type of dementia, after Alzheimer's disease. Learning about its symptoms, diagnosis, prognosis, and treatment can help you better understand what to expect if you or a loved one has been diagnosed with Lewy body dementia.

Illustration of Parkinson's disease nerve cells
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Overview

Lewy body dementia refers to a type of dementia associated with abnormal protein deposits in the brain called Lewy bodies. These deposits affect how the brain functions.

Symptoms

Lewy body dementia usually causes a decline in thinking, visuospatial ability, information processing, perception, speaking, finding words, and recognizing things. Problems with memory are common and tend to occur later in the disease course.

People with Lewy body dementia also commonly experience the following symptoms:

  • Movement problems, like stooped posture, lack of facial expression, symptoms of parkinsonism, that resemble those of Parkinson's disease
  • Fluctuating alertness, such as drowsiness, fluctuating with bursts of energy
  • Recurrent visual hallucinations, especially of people and animals, which can provoke an emotional reaction, even though the person might know they are not real
  • REM sleep behavior disorder, in which a person may act out their vivid dreams
  • Behavioral and mood symptoms, including frequent falls, depression, and delusions
  • Changes in autonomic body functions, such as blood pressure control, temperature regulation, and bladder and bowel function

The condition is typically rapidly progressive, with worsening symptoms and difficulty maintaining self-care within a few years after symptoms first begin.

Diagnosis

Clinical features are used to support a diagnosis of this condition, which is considered one of the atypical parkinsonian syndromes. This includes a medical history, physical examination, and detailed cognitive testing. No singular test can definitively diagnose Lewy body dementia, and Lewy bodies can only be definitively identified through a brain autopsy.

A complete diagnostic workup is usually performed in order to rule out other possible causes of the symptoms. This may include a magnetic resonance imaging (MRI) or computed tomography (CT) scan of the brain, which can identify a stroke or brain tumor—conditions that also can cause cognitive and behavioral changes.

Sometimes blood tests are used to rule out issues like a severe infection, which can cause behavioral changes, especially in advanced age.  

Prognosis

The prognosis of someone with Lewy body dementia depends on multiple factors, including age at onset and overall health. On average, life expectancy with LBD is five to seven years, although the range is known to be between two and 20 years.

Because one of its characteristics is that its symptoms can fluctuate, progression in Lewy body dementia may vary significantly from one person to another.  

Treatments

There is currently no cure for Lewy body dementia, but there are medications that can help with symptom management. Rivastigmine (Exelon) is one drug that has been approved by the FDA to treat it.

Other Alzheimer's treatments have also been shown to be helpful. Some researchers have found that those with Lewy body dementia respond better to cholinesterase inhibitors, like Aricept (donepezil), Exelon (rivastigmine), and Razadyne (galantamine) than those with Alzheimer's disease.

Because individuals with Lewy body dementia often have Parkinson's-like movement problems, medications that are used to treat Parkinson's disease can sometimes help reduce the motor symptoms. However, these medications can also increase confusion, delusions, and hallucinations, so they are used carefully and with close monitoring by a person's healthcare provider.

In addition, antidepressants, like selective serotonin reuptake inhibitors, or SSRIs, can be used to treat the depression associated with Lewy body dementia.

Lifestyle Modifications

Non-drug strategies may also be useful for managing the difficult behavioral symptoms of Lewy body dementia. For instance, physical therapy and speech therapy may be helpful. Simple strategies, like reducing caffeine intake and providing relaxing activities in the evening, may improve sleep patterns and decrease disruptive outbursts during the night. 

Warnings

Finally, it's important to know that antipsychotic medications, which are often used to treat disorders that cause hallucinations and delusions, may have serious side effects that can be life-threatening for people who have Lewy body dementia.

A Word From Verywell

If you or a loved one has been diagnosed with Lewy body dementia, be sure to talk about all your concerns and questions with your healthcare provider. It's also a good idea to consider having a family meeting when you are ready. This way you can discuss and agree on important issues, like goals of care and treatment expectations. 

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Lewy Body Dementia Association. LBD diagnostic symptoms checklist.

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