Early Signs of Lewy Body Dementia

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Lewy body dementia (LBD) and dementia with Lewy bodies are sometimes used interchangeably, but Lewy body dementia is actually the umbrella term for two types of dementia: dementia with Lewy bodies and Parkinson’s disease dementia. Lewy body dementia affects more than 1 million adults in the United States.

More men than women are diagnosed with this neurodegenerative disease characterized by abnormal protein deposits in the brain called Lewy bodies. The Lewy bodies affect how the brain chemicals work and cause a gradual decline in the ability to remember, reason and think clearly. Some people with Parkinson’s disease develop Lewy bodies in the brain and begin to show symptoms of dementia. This is called Parkinson’s disease dementia.

Lewy body dementia may be under-recognized and underdiagnosed because early symptoms can be confused with other types of dementia or diseases, such as schizophrenia or Alzheimer’s disease. This means there could be more people with the disease than doctors know.

Early Symptoms of Lewy Body Dementia

Lewy body dementia most commonly affects people in their 50s, although a definitive diagnosis can take years. The lifespan after diagnosis can vary considerably. The disease typically lasts from 5 to 8 years, but this depends on when the disease is finally diagnosed and the overall health of the person affected. For some people, the time span from diagnosis to death can be as short as two years; for others it can be as long as 20 years.

In the early stages of Lewy body dementia, it may not seem like much is wrong. The symptoms may be mild, allowing people with the disease to carry on their normal life with some adaptations. Not everyone with LBD experiences the same symptoms, but the most common early symptoms include:

  • Decreased or lost sense of smell

  • Interruption in the rapid eye movement (REM) stage of sleep or acting out while dreaming

  • Visual hallucinations

  • Misidentifying objects in low-light environments

  • Confusion

  • Difficulty maintaining attention

  • Memory loss

  • Changes in handwriting

  • Muscle rigidity or stiffness

  • Falling or difficulty with balance

  • Drowsiness

  • Loss of motivation

How Lewy Body Dementia Differs from Other Types of Dementia

Dementia is a term that describes the gradual loss of the ability to think, reason or remember. The most common form of dementia in the U.S. is associated with Alzheimer’s disease, but dementia can also be caused by Lewy body dementia, frontotemporal dementia, and vascular dementia, among others. Although they all have dementia in common, the symptoms of these diseases differ because they affect different parts of the brain.

Lewy body dementia affects many parts of the brain, starting with the outer layer of the brain, called the gray matter or cerebral cortex. The cerebral cortex is responsible for language, thinking, perception and judgment. This is why some of the earlier symptoms of Lewy body dementia include changes in visual perception, delusions or hallucinations, difficulty paying attention, and misidentifying objects.

As other parts of the brain become affected, more symptoms appear, such as difficulty forming new memories, changes in behavior, difficulty sleeping or excessive sleepiness, and difficulty moving and maintaining balance.  

Although overall Lewy body dementia symptoms are similar to other types of dementia like Alzheimer’s disease or frontotemporal dementia, there are some key differences. For example, early symptoms of Alzheimer’s disease are forgetfulness or getting lost in familiar places. The earliest symptoms among people with frontotemporal dementia tend to be changes in personality or the inability to bring out the correct words.

Treatment for Early LBD Symptoms

Over time, the symptoms of Lewy body dementia become more pronounced or frequent. It is a progressive disease and there is no cure for either dementia with Lewy bodies or Parkinson’s disease dementia. However, some of the symptoms may be treatable with medications and complementary therapies, such as pet therapy, music therapy, or art therapy.

Managing the symptoms can help reduce anxiety and other feelings that may accompany dementia. It can take some trial and error to find effective medications or therapies, but these treatments may help people with Lewy body dementia maintain their quality of life for longer.

If you are a caregiver for someone with Lewy body dementia, speak with your loved one’s healthcare team and support groups for ideas on how to best manage dementia symptoms and cope with the challenges of caregiving.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 20
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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