Dementia with Lewy Bodies
Often called DLB, Dementia with Lewy Bodies is a form of dementia that impacts a person’s ability to reason and think while also causing a decline in independent brain function. The Alzheimer’s Association states that this particular form of dementia accounts for up to 10 percent of all cases.
What Is Dementia with Lewy Bodies?
Dementia with Lewy Bodies is named after the neurologist who first discovered the condition in the early 1900s, Frederick H. Lewy. The term “Lewy Bodies” refers to specific brain abnormalities based on alpha-synuclein proteins and, while science is working to better understand these proteins, it does not yet recognize how they play a role in normal brain function.
Lewy Bodies are a type of protein deposit that builds up on the nerve cells located in the brain. They typically attach to areas that impact a person’s ability to remember events, people and places, as well as the ability to think properly. They can also develop on nerve cells associated with movement or motor control.
Dementia with Lewy Bodies is a progressive disease, meaning that symptoms and problems associated with the disease develop slowly and get worse as time goes on.
What Are the Symptoms of Dementia with Lewy Bodies?
Like most types of dementia, it can be hard to determine if a person has DLB. The following are some of the most common symptoms associated with DLB:
Hallucinations: This is perhaps the most common type of DLB symptom and is typically one of the first to occur. Some people will report seeing shapes, others will see animals or people. Other types of hallucinations are possible, including smells, sounds and feelings, such as experiencing a touch. Hallucinations may continue throughout the disease’s progression.
Body Function Regulation Complications: Some individuals will experience trouble regulating the normal functions of the body. This can include digestive, blood pressure and cooling functions. Regulation problems can then lead to bowel issues, trouble with dizziness, falling and similar conditions. These symptoms are key because they point to the area of the brain typically impacted by DLB.
Movement Problems: Many with DLB experience symptoms that are much like those of Parkinson’s disease. This includes rigid muscles, shuffling when walking, moving very slowly and having tremors. This often leads to falls that compromise safety and add to frustration.
Cognitive Decline: All forms of dementia, including dementia with Lewy Bodies, include thinking-related problems due to a decline in cognitive function. This can include poor attention, confusion, difficulty with memory and visual-spatial problems.
Attention Difficulties: Along with cognitive decline, some individuals experience changes in attention span. They may stare into space for a long period of time. They may have short episodes of drowsiness. Others may have difficulty completing sentences.
Trouble Sleeping: While drowsiness and the need for naps are common in those who have DLB, many will still have a lack of quality sleep. This can include rapid eye movement sleep behavior disorder, which can cause people to act out their dreams. Acting out dreams can be dangerous, so if you notice this symptom in a friend or relative, seek professional medical assistance or supportive care immediately.
What Are the Stages of Dementia with Lewy Bodies?
DLB symptoms can present suddenly and escalate quickly, making the disease’s progression difficult to pin down. In general, however, experts identify four general stages.
Early DLB Stages: During the early stages of DLB, a person may exhibit a few of the symptoms from time to time. Most commonly, this begins with hallucinations. A person may think they saw something or feel as though they remember smelling something that is not present.
Early Mid Stage: DLB will continue to advance, sometimes quite rapidly. Most of the time, by the middle stages, individuals will experience some common Alzheimer’s disease symptoms. This may include day-to-day memory problems, changes in behavior and more trouble with routine activities like self-care or sleeping normally.
Late Mid Stage: As the condition progresses, a person will become more likely to have serious problems with their cognitive function. This typically includes mood changes such as apathy and depression. At this stage, a person may recognize what they are dealing with but no longer have the ability to control what is happening to their mind or body. This realization often triggers depression.
Late Stage: When DLB worsens, it can become difficult or unsafe for individuals to manage on their own. They may no longer recognize people, could lose control over their movements and may have a high risk of illness due to changes in blood pressure and heart rate. Most often, they will progress rapidly through the final stages.
Even in the early stages of DLB, it’s common for individuals and their families to seek supportive living arrangements. Communities with nursing or memory care options have the staff and training needed to support people living with DLB, ensuring they’re safe and empowered to live a full life. By the mid to late stage of the disease most, if not all individuals will need some type of professional care, often including 24-hour support to ensure their safety.
What Is the Progression of Dementia with Lewy Bodies?
The progression of DLB tends to be rapid. In some situations, a person may have very few symptoms of the condition and periods of time where they have many. This can even change quickly through the course of a day, which makes it hard to know how far along in the disease’s progression a person is. The rapid progression of this disease makes it even more important to address management of day-to-day needs as soon as possible.
There are many cases in which a person will learn they have DLB while they are already in the middle stages. However, unlike other forms of dementia, this is less common. Because hallucinations can become evident quickly, these early warning signs make it easier to diagnose than other forms of dementia.
On average, dementia with Lewy Bodies plays out over the course of five to eight years. However, the disease’s progression can be as short as two years and as long as 20 years.
What Causes Dementia with Lewy Bodies?
DLB is brought on by a buildup of proteins within the brain. These proteins, Lewy Bodies, are normally present, but build up to abnormal levels in older individuals with dementia, impacting the nerve endings and causing cognitive decline.
Lewy Bodies, along with the development of plaques and tangles on nerve endings, damage the brain’s ability to function normally, leading to the symptoms of DLB. Why Lewy Bodies and plaques begin to build up in the brain is less understood. Research into the disease is ongoing.
What Are the Risk Factors for Developing Dementia with Lewy Bodies?
Because the underlying cause of DLB is not fully understood, it is hard to know which specific factors make a person more likely to develop this condition over other forms of dementia. However, there are a few key things that are commonly found in those who have this condition.
It is more likely for people who are over the age of 60 to develop this condition, though it can occur in those who are younger as well. The risk of developing DLB grows as a person ages, like with most forms of dementia. In addition, DLB tends to impact men more commonly than women, though it is present in both sexes.
There is also some understanding of the genetics behind this condition. If a person has a family member that has had DLB, they are more likely to have it as well. Additionally, a family history of Parkinson’s disease can increase the chances of developing DLB.
How Is Dementia with Lewy Bodies Diagnosed?
Most forms of dementia are difficult to diagnose accurately due to the wide range of symptoms. There is no single test that provides good insight into what is happening, and a definitive diagnosis can only occur through an autopsy. However, there are clinical diagnosis options available to doctors. This means doctors can gather information about a patient’s medical history and their symptoms and determine that this is likely the condition they have.
Most of the time, a doctor will gather information based on both the symptoms a person remembers experiencing as well as what close family members observe. A full physical is done to understand and rule out other health conditions. Diagnosis tends to occur when two of the following are present:
- A person has visual hallucinations on a repeated basis
- Fluctuating alertness and cognitive function decline
- Parkinson’s disease symptoms
- A person suffers from REM sleep behavior disorder (in which they act out their dreams while they are sleeping)
Doctors will assess mental abilities and conduct a neurological exam to get a full picture of the individual’s condition. Brain scans can also be used to provide more in-depth information.
What Is the Treatment for Dementia with Lewy Bodies?
There is no cure for DLB, but there are treatment routines that can help slow its progression. Once doctors determine that a person likely has DLB, they will work to treat the condition as aggressively as possible. Much like with other types of dementia, treatment will focus on symptoms, not root cause, since there is no cure for DLB.
Experts prescribe different treatment routines based on an individual’s health and how far along they are in the disease’s progress. Medications such as cholinesterase inhibitors can be used to increase the number of chemical messengers in the brain to improve memory and thought processes. These can help with reducing hallucinations as well. Parkinson’s disease medications may also be helpful in minimizing muscle and movement-related symptoms.
What Type of Care Does a Person with Dementia with Lewy Bodies Need?
It is quite common for people who have these dementia symptoms to need more routine and round-the-clock care by the time they enter the mid-stages of this condition. Dementia care, including memory care living arrangements, may offer some of the best support to minimize the condition.
Most people will need to have support to help them manage hallucinations in a safe manner as well as a modified environment that can help to reduce distractions and allow for more focus. A routine can be helpful for most people, along with support that helps with daily tasks such as dressing, bathing and managing medications.
Because of the complications of this form of dementia, many people will need medical support over time. This may include monitoring their behavior and safety, but it may also require help tending to small abrasions that happen during falls or episodes of confusion.
By the late stages of dementia with Lewy Bodies, most individuals need round-the-clock support from a trained staff that’s familiar with supporting memory impairments. However, with the right support, individuals with DLB and other forms of dementia can live full lives.
For more information on memory impairments and support for dementia with Lewy Bodies, contact our staff. We have extensive experience working with various forms of dementia and enabling individuals to manage their disease in the most positive way possible.