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Lewy Body DementiaDementia with Lewy Bodies: Causes, Symptoms, Treatment, and Life Expectancy

Commonly asked questions about Lewy body dementia:

What is Lewy Body Dementia?

LBD is a common disease, but is not diagnosed as often as other forms of dementia like Parkinson’s or Alzheimer’s. LBD is closely related to these two diseases, as they reflect the same biological changes in the brain, although early symptoms may differ. Over time, people with Parkinson’s and people with LBD suffer from very similar cognitive, physical, sleep, and behavioral symptoms. Despite these similarities, many doctors or physicians are still not familiar with the Lew body form of dementia.

What Causes Lewy Body Dementia?

Lewy Body dementia is characterized by an abnormal buildup of proteins in mass amounts, known as Lewy Bodies. These proteins underlie the cause of both Parkinson’s and LBD. Patients diagnosed with Lewy Body disease also have the plaques and tangles associated with Alzheimer’s disease.

What are the Symptoms of Lewy Body Dementia?

  • Changes in critical thinking and judgement
  • Confusion and alertness varying hourly or daily
  • Visual Hallucinations
  • Delusions
  • Decline in understanding visual information
  • REM sleep disorder, such as acting out dreams
  • Malfunctions of the autonomic nervous system
  • Memory loss (significant, but less prominent than Alzheimer’s)
  • Hunched posture, balance problems and rigid muscles (Parkinson’s symptoms)

What are the Risk Factors Associated with LBD?

  • Advanced age
  • Male sex
  • History of depression or anxiety
  • Family history of Parkinson’s disease
  • History of stroke
  • APOE genetic variant

What is the Treatment for Lewy Body Dementia?

LBD is a multifaceted disease that requires a comprehensive treatment approach involving multiple physicians to agree on medication that enhances comfort and reduces painful symptoms without worsening other symptoms.

  • Cognitive: Medications such as cholinesterase inhibitors are considered the standard treatment for patients with LBD. Although these medications were originally developed to treat  Alzheimer’s disease, research suggests that patients with LBD are more reactive to the treatment than those with Alzheimer’s.
  • Movement: Parkinson’s medication, specifically levodopa, can be used to treat patients with LBD
  • Visual Hallucinations: Cholinesterase inhibitors, a type of dementia medication, have shown to be effective in treating hallucinations and other psychiatric symptoms that appear in the last stages of LBD.
  • REM Sleep Behavior Disorder (RBD): Melatonin or clonazepam are usually prescribed to help with sleep symptoms.
  • Neuroleptic Sensitivity: Neuroleptics, also known as antipsychotics, are medications used to treat hallucinations and other mental illnesses. Although these medications can be used to treat LBD, they can also cause serious side effects. Hallucinations must be treated seriously, using the lowest dose possible under careful observation.

Non-Medical Treatments

  • Physical Therapy: Cardiovascular, strengthening, and flexibility exercises, as well as gait training are all LBD treatment options. Physicians also recommend aerobics or water exercises.
  • Speech Therapy: This may prevent swallowing difficulties and improve muscular strength for a patient with poor enunciation.
  • Occupational Therapy: Promotes function and independence by maintaining basic skills. Music and aroma therapy can also help reduce anxiety and depression by elevating mood.
  • Individual and Family Psychotherapy: This can be used to address family and individual concerns, as well as to learn strategies for managing a patient’s emotional and behavioral symptoms.
  • Support Groups: Patients as well as caregivers may benefit from support groups by learning how to deal with daily frustrations and fostering a strong support system.

How is Lewy Body Dementia Diagnosed?

Thorough dementia evaluations include physical and neurological examinations, patient and family interviews, and neuro-psychological and mental status tests. In addition, functional ability, attention, language, visuospatial skills, memory, and executive functioning are assessed. Brain imaging such as CT or MRI scans, blood tests, and other tests may be performed.

This evaluation will provide a clinical diagnosis. Currently, a conclusive diagnosis of LBD can be obtained from an autopsy; some research studies may offer autopsy evaluations as part of their protocol.

What is the Life Expectancy for LBD?

Today there is no current cure for Lewy Body Dementia, and the average life expectancy for people with LBD after the onset of symptoms is 5-8 years. However, a life expectancy estimate depends on age and severity of symptoms, as individuals have lived anywhere between 2 and 20 years with a diagnosis.

LBD can vary, but it is usually characterized as “progressive but vacillating.” This means that patients weaken over time, but can have periods where they return to a high functioning level.

How do I Prevent Dementia from Lewy Bodies?

  • Minimal to moderate alcohol: Drinks such as wine have been shown to lower mortality rates from cardiovascular disease and cancer
  • Regular Exercise: Exercise may be beneficial in lowering the risk of Alzheimer’s and vascular dementia, as it increases blood and oxygen flow to the brain.
  • Healthy Diet: Heart-healthy eating may also protect the brain, as it limits sugar intake. Eating a variety of fruits, vegetables, and whole grain foods facilitates blood flow throughout the body.
  • Social Connections and Intellectual Activity: Exercising mental capacities daily as we age may lower the risk of cognitive decline and onset of Alzheimer’s. Intellectual activity is known to stimulate the connections between the nerve cells in the brain

What Drugs are Used to Treat LBD?

  • Donepezil
  • Rivastigame
  • Melatonin
  • Clonazepam
  • Levodopa
  • Neuropletics

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