Lewy Body Dementia. Diagnosis and Symptoms – Exclusive Review

Lewy Body Dementia (LBD) is the second most common type of dementia after Alzheimer’s Disease.

It is characterized as a specific type of dementia that is associated with abnormal deposits of a protein (alpha-synuclein – known as Lewy Bodies) in the brain. These deposits develop in brain cells specifically in regions associated thinking, memory and movement. These deposits make it difficult for the cell of the brain to receive incoming signals and deal with cellular wastes. As the disease progresses and more protein is deposited, the cellular function starts to fail and leads to cell death. The death of these brain cells is what leads to the development of irreversible symptoms seen in Lewy Body Dementia.

Lewy Body Dementia affects more than 1 million people. It is a progressive disease and symptoms are expected to worsen over time. Currently this is no cure for Lewy Body Dementia but there is significant research being conducted and hopefully we will have a cure soon.

Symptoms of Lewy Body Dementia

The most common symptoms associated with Lewy Body Dementia include declining functional ability and changes in behavior. Individuals affected with the disorder are usually older than 55 years of age, though younger patients can be seen. Patients show slow progression of disease with increasing symptoms over the years.

Trouble With Thinking

This usually presents as increasing confusion, decreasing ability to think through concepts, difficulty with math, paying bills, etc.


Symptoms can include visual, auditory and olfactory hallucinations. These symptoms can lead to trouble with concentration, difficulty with attention, increasing confusion and disorganized thinking.

Behavioral and Mood Disorders

Individuals have trouble sleeping or sleep too much. They exhibit increasing anxiety, mood/personality changes, unfounded paranoia and suspicions (about family, friends and doctors).


Patients may start withdrawing socially, spending more time alone or at home. Patients are at high risk for depression.


Patients will become more confused and will have increasing paranoia and anxiety. This can lead to delusions and irregular thoughts. Delusions may lead to difficult situations and conversations.

Movement Disorders

Patients with Lewy Body Dementia also develop movement problems. This includes stiffness/rigidity of muscles, shuffling gait, mask like face, balance problems, stooped posture, difficulty swallowing and a weak voice.

General Decline

Other symptoms include weakness, falls, dizziness, incontinence, and sexual dysfunction.

Memory Problems

Memory problems may not be immediately present but often become evident as Lewy Body Dementia progresses. It will eventually affect the patient’s ability to carry out activities of daily living (ADLs – transferring, walking, continence, bathing, dressing, and eating).

Self Awareness Issues

People with Lewy Body Dementia may find it difficult for themselves to recognize they have a problem. The signs may be obvious to family and friends but the patient remains unaware there is a problem.

So What Causes Lewy Bodies?

Dementia with Lewy Bodies include both Lewy Body Dementia and Parkinson’s Disease. Findings in these dementias are similar and as a result, patients share same symptoms. Microscopic changes in the brain affect the way the brain cells work. Scientists have found plaque deposits inside and around brain cells in a predictable pattern blocking communication between cells. This disruption between communication disrupts the cells ability to survive. The depositions tend to be distributed in the part of the cell that receives inputs from other cells. Cellular communication is affected and as the disease progresses, the cell also loses the ability to process it’s wastes. Inability of the cell to remove toxins and properly process chemicals within the cell leads to its death. As brain cells die, symptoms develop. The more cells that die, the worse the symptoms get.

Diagnosis of Lewy Body dementia is made by a physician. Doctors use medical history, mental status testing, neurological exams, physical exams and diagnostic testing including brain imaging.

Stages of Lewy Body Dementia

Stage 1No or minimal symptoms
Stage 2Mild symptoms. Patients start showing mild forgetfulness. Usually still remain independent and able to maintain their daily routines.
Stage 3Symptoms more pronounced. Start showing mild memory loss, mild concentration problems. Starting to have some trouble with activities of daily living.
Stage 4Symptoms pronounced and evident. Likely has established diagnosis by this time given the extent of symptoms. Tremors present. Forgetful. Need assistance with most of activities of daily living. Now need supervision. Unsteady on feet, high risk of falls.
Stage 5Significant memory loss. At this stage, no longer able to do any activities of daily living. 24 hour supervision needed. Patients with significant confusion. High risk for aspiration. Recurrent choking and repeated infections. Delusions worsen. Patients become anxious and paranoid.
Stage 6Patients continue to decline. Start to become bedbound. Start to lose the ability to speak. Bowel and urine incontinence. No longer recognize family. Start to demonstrate personality changes, and lose social inhibition cues.
Stage 7Severe and significant symptoms. No longer speak, bedbound. Develop recurrent infections. No longer interacting with external environment. Develop recurrent infections including pneumonia, urinary tract infections, skin breakdown. Start losing significant weight and sleep for most of the day.

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How Can Hospice Help?

If you feel you or your loved are declining, the addition of hospice support can help provide much needed support. Hospice services can be provided anywhere you live (at home, independent living, assisted living, nursing home or in a hospital setting).

Hospice focuses on addressing the patient’s symptoms and addressing any underlying comorbidities that may be affecting quality of life. One of the biggest focuses for hospice care is quality of life including pain and other symptom management.

At Lenity Light Hospice, we accomplish this by scheduling regular nursing visits to assess the patient for any uncontrolled symptoms. Anything that needs to be addressed is done so under the guidance of physicians. Medications are adjusted until pain and other symptoms are controlled.

Hospice is available to the patient and caregivers 24/7 and will provide various specialties to help take care of a patient. These include physicians, nurse practitioners, nurses, CNAs (nurse aides), volunteers, therapists, chaplains, social workers and other staff. Hospice also covers most medications, supplies (gloves, briefs, bandages, etc.), medical equipment (hospital bed, commode, shower chair, wheelchairs, walkers, bed side tables, oxygen, etc.).

  • Physicians
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  • Social Workers
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  • Volunteers
  • Medications
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