What is Lewy body dementia?

Lewy body dementia (LBD) is a common type of dementia in older adults that significantly affects daily mental functions. Dementia is generally defined as a loss of mental functions that severely impacts daily life and activities, including memory, language skills, visual perception, problem-solving abilities, and difficulty with daily tasks, in addition to difficulty concentrating and paying attention [1].

Lewy body dementia occurs as a result of the accumulation of abnormal deposits of a protein called alpha-synuclein in areas of the brain that control memory, thinking, and movement. These deposits, known as Lewy bodies, affect brain chemicals, leading to problems with thinking, movement, behavior, mood, and other body functions [2].

Types of Lewy Body Dementia

There are two main types of Lewy body dementia, both of which cause similar brain changes and similar symptoms over time, but the primary difference lies in the timing of the onset of cognitive (thinking) and motor symptoms [1]:

• Dementia with Lewy bodies: This type begins with problems in the ability to think, similar to those found in Alzheimer's disease. Later, other symptoms appear, such as movement problems, visual hallucinations, and specific sleep disorders. Problems with mental activities are often more noticeable than memory problems in the beginning [1].
• Parkinson's disease dementia: This type begins as a movement disorder, as it first causes Parkinson's disease symptoms such as slowed movement, muscle stiffness, tremors, and a shuffling walk. After that, it progresses to cause dementia [1].

Symptoms of Lewy Body Dementia

Lewy body dementia is a progressive disease, meaning that symptoms start slowly and worsen over time. Common symptoms include changes in cognition, movement, sleep, and behavior [1]:

• Cognitive changes: These include fluctuations in concentration, attention, alertness, and wakefulness, which can occur daily or even within the same day. A person may struggle with visuospatial tasks, such as putting together puzzles, and have poor problem-solving skills [2][3].
• Visual hallucinations: Seeing things that are not there; these are often realistic and detailed, such as images of people or animals. These hallucinations are very common in the early stages of the disease [1][2].
• Motor problems: Slowed movement, muscle stiffness, difficulty walking, and problems with balance and standing; this may include tremors [1][2].
• REM sleep behavior disorder: A condition where a person acts out their dreams; it may include vivid dreams, talking in sleep, violent movements, or falling out of bed. This symptom may be the earliest in some cases, appearing years before other symptoms emerge [1][3].
• Changes in behavior and mood: Such as depression, anxiety, and apathy (lack of interest in daily activities) [1].

Diagnosis of Lewy Body Dementia

There is no single test that can diagnose Lewy body dementia; diagnosis relies on a comprehensive evaluation by a specialist physician, often a neurologist. The diagnosis includes a detailed medical history review of symptoms from the patient and caregivers, physical and neurological examinations, and tests to rule out other conditions that may cause similar symptoms, such as blood tests and brain imaging tests. Neuropsychological tests are also conducted to evaluate memory and other cognitive functions [1]. It is important to distinguish between types of Lewy body dementia to determine appropriate treatment and understand the progression of the disease [1].

Management and Treatment of Lewy Body Dementia

There is currently no cure for Lewy body dementia, but treatments are available to help manage symptoms. These treatments include [1]:

• Medications: These may help alleviate some cognitive, motor, and psychological symptoms.
• Physical therapy: Can help improve movement problems.
• Occupational therapy: May help find ways to facilitate the performance of daily activities.
• Speech therapy: May be useful in cases of swallowing difficulties and problems speaking clearly.
• Mental health counseling: Can help patients and their families cope with difficult emotions and behaviors and plan for the future.
• Music or art therapy: May reduce anxiety and improve well-being.
• Support groups: Provide emotional and social support for patients and caregivers.

Due to the progressive nature of the disease, it is important to report any sudden or significant change in functional ability, symptoms, or behavior to the treating physician [2]. For more information about this disease, you can visit Lewy Body Dementia: Cognitive Fluctuations, Hallucinations, and Movement Disorders (Arabic).

Medical references

• Lewy Body Dementia
• Lewy Body Dementia
• Dementia with Lewy bodies