More About Dementia with Lewy Bodies

Dementia with Lewy bodies (DLB) is a form of progressive dementia caused by degeneration of the tissues in the brain.

People with DLB have a buildup of abnormal protein particles in their brain tissue, called Lewy bodies. Lewy bodies are also found in the brain tissue of people with Parkinson disease (PD) and Alzheimer disease (AD). However, in these conditions, the Lewy bodies are generally found in different parts of the brain.

The presence of Lewy bodies in DLB, PD, and AD suggests a connection among these conditions. But scientists haven’t yet figured out what the connection is.

DLB affects a person’s ability to think, reason, and process information. It can also affect movement, personality and memory. DLB becomes more prevalent with age. It often starts when a person is in his or her 60s and 70s.  DLB is progressive, which means it continues to develop over time. There are several types of dementia with different causes.

The main sign of DLB is a progressive decline in things like memory, thinking, and problem solving. This decline is enough to affect the ability to work and do normal daily activities. Although memory may be affected, it isn’t usually as impaired as in someone with Alzheimer disease.

DLB is generally diagnosed when at least 2 of the following features are also present with dementia:

  • Changes in attention and alertness. These changes may last for hours or days. Signs of these changes include staring into space, lethargy, drowsiness, and disorganized speech. 
  • Visual hallucinations. These hallucinations recur and are very detailed. They generally don’t bother the person having them. 
  • Movement symptoms consistent with Parkinson disease (PD), such as slow movement, shuffling gait, rigidity, and falls. The person may also have tremors, but not as pronounced as in a person with PD with dementia.

Other signs and symptoms seen in DLB include:

  • Depression
  • Sleep disorder that affects REM sleep, causing vivid dreams with body movement
  • Dizziness, feeling lightheaded, fainting, or falling
  • Urinary incontinence
In DLB, memory problems often occur later in the disease.

DLB can be confused with other forms of dementia, but it also has unique features, such as hallucinations and delirium.

The symptoms of DLB may look like other conditions. Always see a healthcare provider for a diagnosis.

Interventions used in other forms of dementia may also help people living with dementia with Lewy bodies (DLB). These include using glasses or hearing aids as needed, educating the patient and family, providing a structured environment, and teaching behavioral interventions. These will change over time as the disease progresses.

Hallucinations may be managed by ignoring them and educating the caregiver(s) about them. Improving lighting and keeping the patient around other people also helps.

It’s important to work with a healthcare provider familiar with DLB and the many aspects of the disease. Other specialists are often involved, too.