Lewy Body Dementia: Causes, Symptoms and Treatment Options

Often misdiagnosed as Alzheimer’s or Parkinson’s disease, Lewy body dementia (LBD) is in the top four most common types of dementia. It is a very complex condition, severely impairing not only cognition but motor skills as well, and difficult to diagnose. Learn more about Lewy body dementia and the signs and symptoms.

Causes

Current research suggests LBD is caused by abnormal accumulation of the protein alpha-synuclein in the brain. Alpha-synuclein clusters, called Lewy bodies, interfere with the connections between nerve cells as well as the production of two neurotransmitters responsible for memory and learning (acetylcholine) and behavior, cognition, movement, sleep and mood (dopamine). The eventual depletion of these important chemicals causes a decline in an affected individual’s ability to think and move. Progressive in nature, Lewy body dementia worsens over time and, for some, can progress for up to 20 years.

Symptoms

Early symptoms resemble cognitive changes seen in Alzheimer's disease or vascular dementia, including confusion, depression, poor judgment and reasoning, and memory loss – although the memory loss may not be as significant. However, as LBD advances, there are some distinctive signs and symptoms.

  • Motor movement problems of Parkinsonism – e.g., tremors, rigid muscles and movements, shuffling gait, and loss of balance
  • Visual hallucinations
  • Fluctuating confusion and alertness
  • Sleep disturbances – e.g., REM sleep disorder, “acting out” or talking in one's sleep, and excessive daytime sleeping
  • Depression

For 70% of people with Lewy body dementia, motor problems arise in later stages; however, commonly in those that are older, these issues often occur before dementia symptoms. Individuals with Lewy body dementia may also experience:

  • Aggression and combativeness
  • Delusions
  • Restless Leg Syndrome
  • Urinary problems
  • Difficulty swallowing
  • Dizziness, fainting and sweating abnormalities

Treatment

Although there is no current cure for Lewy body dementia, there are medications available to help manage the symptoms. Cholinesterase inhibitors address the cognitive issues that develop, while carbidopa-levodopa is prescribed to treat some of the Parkinsonian symptoms. Antipsychotics and clonazepam can help with delusions and REM sleep disorder. Some non-pharmacological treatment options include a variety of therapies – including light, speech, occupational and more – to promote the best quality of life.

Because Lewy body symptoms overlap with Alzheimer's and Parkinson's, diagnosing this type of dementia can be difficult. No one test can conclusively identify LBD, but methods to develop an accurate diagnosis can include neurological and physical exams, memory tests, blood tests, brain scans, sleep evaluations and biomarkers. If you are seeing signs of Lewy body dementia, be sure to notify your primary care provider of any changes you are experiencing with your loved one.

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