Dementia with Lewy Bodies

Dementia with Lewy bodies is the second most common cause of dementia caused by a neurodegenerative disease (vascular dementia is the second most common cause for dementia overall). The disease is progressive and shortens lifespan.

Dementia with Lewy bodies can be a challenge for non-specialists to diagnosis in the early stages, because the symptoms can be so varied.  It is a disease that causes physical symptoms early-on, rather than just cognitive and/or behavioral symptoms like in the early stages of Alzheimer’s disease.

The physical symptoms of dementia with Lewy bodies may include a slowness in movement (bradykinesia), shuffling gait, muscle stiffness, and tremor, collectively known as parkinsonism. There may also be a decline in sense of smell and taste, imbalance, or lightheadedness or even passing out after standing up too quickly (due to orthostatic hypotension).

The cognitive symptoms of dementia with Lewy bodies can include memory loss, but it more commonly affects visuospatial function and executive function early-on. A person may have trouble organizing their life like before, and develop a new slowness in thinking and inability to multitask. They may forget things in conversation, but once given reminders or hints they often do much better with recalling the information.  A decline in driving skills and sense of direction may also occur early-on.

Psychiatric symptoms in dementia with Lewy bodies can be very distressing for both the patient and the caregivers. They may include apathy, depression, anxiety, delusions, and visual hallucinations.

The symptoms in dementia with Lewy bodies tend to fluctuate, creating “good days” and “bad days”. A sleep condition called REM sleep behavior disorder is very common, which can cause a person to act out dreams and even fall out of bed during sleep. Excessive daytime sleepiness can be another troublesome symptom.

There is no cure for dementia with Lewy bodies, but there are many ways to help improve a person’s quality of life.  The complex array of symptoms requires a comprehensive evaluation and treatment plan to ensure that each aspect of the condition is properly addressed. Physical therapy and/or occupational therapy or often recommended as well.

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