Dementia with Lewy Bodies
Dementia with Lewy Bodies (DLB) is a progressive neurodegenerative disorder often mistaken for Alzheimer’s due to overlapping symptoms. It’s characterized by abnormal protein deposits called Lewy bodies, composed of alpha-synuclein, which disrupt brain function.[1] DLB is the second most common dementia after Alzheimer’s, affecting about 1.4 million Americans.[2]
Symptoms typically begin after age 50, with survival averaging 5-8 years post-diagnosis, though this varies widely.[3] Early recognition of its distinct features can improve management and quality of life.
Signs and Symptoms
DLB presents a unique combination of symptoms:[1]
Cognitive Fluctuations: Significant variations in alertness and thinking, ranging from clarity to confusion.[4]
Visual Hallucinations: Vivid, recurrent visions of people or objects, affecting over 70% of patients.[5]
Parkinsonism: Muscle stiffness, tremors, slow movement, and gait changes, seen in up to 85% of cases.[1]
Sleep Disorders: REM sleep behavior disorder (RBD), where individuals act out dreams, occurs in about 75% of DLB patients.[6]
Attention and Alertness: Profound fluctuations mimicking epilepsy or fainting.[3]
Autonomic Dysfunction: Orthostatic hypotension, constipation, and urinary incontinence.[1]
Neuropsychiatric Symptoms: Depression, anxiety, and delusions, affecting over 50% of cases.[5]
Diagnosis
Diagnosing DLB relies on clinical evaluation, as no single test confirms it. Doctors use patient history, neurological exams, and imaging (e.g., MRI, DaTscan) to rule out other conditions.[1] Core features like cognitive fluctuations, hallucinations, and parkinsonism, plus biomarkers like RBD, guide diagnosis.[4]
Management
Treatment focuses on symptoms:[3]
Cholinesterase Inhibitors: Drugs like donepezil improve cognition and hallucinations.[7]
Levodopa: May help parkinsonism, though response is limited compared to Parkinson’s.[1]
Sleep Medications: Melatonin or clonazepam can manage RBD.[6]
Caregivers need strategies for hallucinations and falls, often requiring home safety modifications.[2]
Prognosis and Research
DLB progresses over years, with life expectancy varying from 5-8 years post-diagnosis.[3] Ongoing research aims to improve diagnostics (e.g., via alpha-synuclein biomarkers) and develop targeted therapies.[5] Awareness efforts enhance recognition and support.
For more DLB resources, visit our Resource Links!
Donate