Dementia with Lewy Bodies (DLB)

Dementia with Lewy bodies (DLB) is the second most common progressive form of dementia behind Alzheimer's disease. This condition is caused by the buildup of a protein known as Lewy bodies in the brain.

Symptoms

The first symptoms of DLB generally include a worsening of mental abilities such as memory and problem-solving. This decline is often severe enough to interfere with the patient's daily life.

Patients may also experience:

  • Visual hallucinations — 80 percent of patients see visual hallucinations such as people, animals, and other images that are not observable to others around them.
  • Fluctuations in attention — Patients may spend significant time staring into space and may have frequent periods of sleepiness and disorganized speech.
  • Cognitive difficulties — Patients with the condition may become more easily confused and may experience memory loss as the disease progresses.
  • Impaired regulation of body functions — The areas of the nervous system that regulate blood pressure, sweating and digestion can be affected by the accumulation of Lewy bodies. This can cause dizziness, falls, and digestive issues.
  • Movement disorders — Patients may experience movement disorders similar to those associated with Parkinson's disease. This can include muscle rigidity, slow movement, tremors or a shuffling gait.
  • Changes in sleeping behaviors — Patients may develop a sleep disorder that causes them to act out their dreams while they are sleeping.


Causes and Risk Factors

DLB is caused by the degeneration of brain tissue. This breakdown happens when the buildup of Lewy bodies interferes with the production and communication of neurotransmitters, chemicals that send information from one nerve to another.

The risk of developing DLB increases with age and is most often seen in patients between the ages of 50-85. Men and patients with a blood relative with DLB may have a slightly higher risk of developing the condition.

Diagnosis

There is no definitive test available for DLB, and the condition often has symptoms that are similar to Parkinson's disease and Alzheimer's disease.

In order to be diagnosed, the patient must show worsening mental abilities, as well as at least two other symptoms listed in the section above.

Diagnosis often involves a variety of tools in order to rule out other possibilities and to better understand the patient's condition.

The following diagnostic tests may be used:

Treatments

There is no cure for DLB. Treatment plans generally focus on addressing the symptoms of the disease. The knowledgeable and highly trained staff at the Movement Disorders Program will work with each patient and their family to determine the best treatment option. 

Medications used may include cholinesterase inhibitors, which increase the levels of certain neurotransmitters in the brain. Patients also often take medications to treat slow movement and rigidity.

Antipsychotic medications may treat the hallucinations associated with DLB, but must be carefully watched by the medical team to make sure they do not worsen the patient's movement disorders and mental abilities.

Other treatments include physical therapy and supportive care. This can include changing the patient's environment to reduce distractions and frustration, as well as helping care partners effectively respond to behavior and symptoms. Creating a structured routine and breaking down complicated tasks into smaller steps can reduce feelings of confusion and frustration.