DementiaRoadmap Wales

This Alzheimer’s Society factsheet outlines the causes, symptoms and treatments available for Dementia with Lewy bodies (DLB).

Download the Alzheimer’s Society factsheet What is dementia with Lewy bodies (DLB)?

DLB is also known as Lewy body dementia, Lewy body variant of Alzheimer’s disease, diffuse Lewy body disease, cortical Lewy body disease and senile dementia of Lewy body type.

Causes

Lewy bodies are tiny deposits of protein in nerve cells which cause progressive death of nerve cells and loss of brain tissue.

Symptoms

DLB affects people in different ways and the progression of the disease also varies. However, people with DLB typically experience:

• Problems with attention, alertness, planning and organising
• Difficulties with judging distances and perceiving objects in three dimensions
• Visual and auditory hallucinations
• Physical symptoms such as difficulties with walking, unsteadiness and balance
• Sleep disorders

In the later stages people with DLB may experience:

• unusual behaviours such as agitation, restlessness, shouting out
• falls as a consequence of increasing difficulty with walking
• problems with speaking and swallowing

Diagnosis

Patients present to their GP with the symptoms above practitioners are encouraged to request a brain scans help to clarify the diagnosis.

Computed tomography or magnetic resonance imaging scans may rule out brain conditions (eg brain tumour, increased pressure) with overlapping symptoms. They may also help to distinguish DLB from vascular dementia.

A more specialised brain scan can confirm a diagnosis of DLB if it shows reduced density of dopamine nerve cells at the base of the brain.

Treatments

Practitioners can encourage a range of interventions to help manage the condition to maximise the person’s overall quality of life and help them to live well with DLB.

Hallucinations

Practitioners should:

• Avoid prescribing medication to improve mental abilities or hallucinations as these can make movement problems worse
• Avoid the prescription of antipsychotic drugs for hallucinations or delusions as these drugs do not work in everyone and are known to increase the risk of stroke and death in people with dementia.

Movement problems

Practitioners should avoid prescribing medication to improve movement problems may have a negative effect on mental abilities or make hallucinations worse

Sleep disorders

To help tackle sleep disorders, practitioners can encourage the patient to:

• Increase physical exercise
• Reduce daytime napping
• Avoid alcohol, caffeine and nicotine late at night