Dementia with Lewy bodies (patient information)

	Dementia with Lewy bodies
Overview
What are the causes?
What are the symptoms?
Diagnosis
Treatment options
Diseases with similar symptoms
Where to find medical care for Dementia with Lewy bodies?
What to expect (Outlook/Prognosis)?
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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview[edit | edit source]

Dementia with Lewy bodies (DLB) is one of the most common types of progressive dementia.
Lewy body disease usually begins between the ages of 50 and 85. The disease gets worse over time.
The criteria for DLB is dementia symptoms and 2 or 3 of the below:

The symptoms of DLB are caused by the build-up of Lewy bodies which are accumulated bits of alpha-synuclein protein inside the nuclei of neurons in areas of the brain that control particular aspects of memory and motor control.

Researchers don’t know exactly why alpha-synuclein accumulates into Lewy bodies or how Lewy bodies cause the symptoms of DLB, but they do know that alpha-synuclein accumulation is also linked to Parkinson's disease, multiple system atrophy, and several other disorders, which are referred to as the synucleinopathies.

DLB usually occurs sporadically, in people with no known family history of the disease. However, rare familial cases have occasionally been reported.

The central feature of DLB is progressive cognitive decline, combined with three additional defining features:

Pronounced fluctuations in alertness and attention, such as frequent drowsiness, lethargy, lengthy periods of time spent staring into space, or disorganized speech;
Recurrent visual hallucinations, and
Parkinsonian motor symptoms, such as rigidity and the loss of spontaneous movement.

Treatments are aimed at controlling the cognitive, psychiatric, and motor symptoms of the disorder.

Acetylcholinesterase inhibitors, such as donepezil and rivastigmine, are primarily used to treat the cognitive symptoms of DLB, but they may also be of some benefit in reducing the psychiatric and motor symptoms.

Doctors tend to avoid prescribing antipsychotics for hallucinatory symptoms of DLB because of the risk that neuroleptic sensitivity could worsen the motor symptoms.

Some individuals with DLB may benefit from the use of levodopa for their rigidity and loss of spontaneous movement.

The similarity of symptoms between DLB and Parkinson’s disease, and between DLB and Alzheimer’s disease, can often make it difficult for a doctor to make a definitive diagnosis.

In addition, Lewy bodies are often also found in the brains of people with Parkinson's and Alzheimer’s diseases.

These findings suggest that either DLB is related to these other causes of dementia or that an individual can have both diseases at the same time.

Like Alzheimer’s disease and Parkinson’s disease, DLB is a neuro-degenerative disorder that results in progressive intellectual and functional deterioration.

Average survival after the time of diagnosis is similar to that in Alzheimer’s disease, about 8 years, with progressively increasing disability.