Lewy Body Dementia

Lewy body dementia (LBD) is a form of dementia, which is a broad term for a disease of memory, thinking and/or social abilities that are severe enough to interfere with everyday activities. LBD is also a form of Parkinsonism, meaning that it causes some or all of the motor symptoms of Parkinson’s disease (tremor, stiffness, slowness, and walking/balance problems).

Additionally, LBD causes visual hallucinations (seeing things that aren’t there) and unpredictable fluctuations in a person’s level of attention or alertness. Many people will also exhibit changes in mood (such as depression) and alterations in behavior or personality (including agitation or aggression). REM sleep behavior disorder (a condition in which people act out their dreams), fainting spells and low blood pressure can also be associated.

Symptoms of LBD may seem to arise in the course of several months or may be more gradual in onset. The symptoms do, unfortunately, worsen and people with LBD will require progressively more assistance over time.

Parkinson’s vs Lewy Body Dementia

Parkinson’s disease (PD) is characterised by motor symptoms, including resting tremor, stiffness, slowness, and walking/balance problems. The diagnosis of PD relies on the presence of slowness plus tremor and/or stiffness.

Diagnosing Parkinson’s or LBD can be difficult as both have motor symptoms and memory problems. There is no test that can diagnose Lewy body dementia so doctors make the diagnosis based on your medical history and their physical examination.

When significant memory problems develop within one year of the onset of Parkinson’s motor symptoms, LBD is more likely.

 

If I have Parkinson’s will I get Lewy Body Dementia?

The vast majority of people with Parkinson’s disease have Lewy bodies — clusters of abnormally folded proteins, including alpha-synuclein, which are found in the nerve cells in the brain. Not everyone with Parkinson’s disease who has Lewy bodies gets dementia.

Treatments for Lewy Body Dementia?

There is currently no medication that slows or stops the progression of Lewy body dementia (LBD). However, there are many medications that can help with the symptoms.

For memory and thinking problems, medications called acetylcholinesterase inhibitors (e.g., donepezil, galantamine and rivastigmine), which are also used for Alzheimer’s dementia, are commonly prescribed. These drugs sometimes help control behaviour problems and hallucinations as well.

The motor symptoms that are similar to those of Parkinson’s disease (tremor, slowness and stiffness) can be treated with levodopa. Because people with LBD are usually a little more sensitive to the side effects of this medication, doctors use the lowest dosage possible.

If REM sleep behaviour disorder (a sleep disorder in which a person acts out their dreams) is present, melatonin or clonazepam may be helpful.

Can I Prevent Lewy body Dementia?

No therapies or behavioural changes have been identified that can prevent Lewy body dementia (LBD).

Recommendations that appear to reduce the risk factors of developing dementia include:

  • Eating a healthy, balanced diet
  • Exercising regularly
  • Interacting with others socially
  • Memory and thinking activities(e.g., reading, completing crossword puzzles, playing a musical instrument, etc.).
  • Decreasing stress and getting enough sleep — easier said than done! — are also beneficial for everyone, of course.

Webinar - Parkinson's vs Lewy Body Dementia

In this webinar from The Michael J. Fox Foundation, Dave Iverson moderates the discussion with an expert panel to discuss LBD, Parkinson’s disease and other disorders — MSA, PSP, essential tremor, ALS and multiple sclerosis.

Alexander, diagnosed with Lewy body dementia (LBD) also talks about his symptoms and road to diagnosis.

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