Lewy body dementia (LBD) is the second most common form of neurodegenerative disease, after Alzheimer's disease. It occurs when proteins called Lewy bodies accumulate in the brain and impair thinking, movement, mood, behavior, and sleep.
UPMC neurology experts provide advanced care for people with LBD, including medications and lifestyle changes to help manage symptoms.
On this page:
What Is LBD?
LBD is a type of dementia that happens when abnormal deposits of a protein called alpha-synuclein build up in the brain.
The protein deposits, called Lewy bodies, affect certain chemicals in the nervous system that are vital for:
- Behavior
- Memory
- Movement
- Sleep
- Thinking
What is the difference between Alzheimer’s and LBD?
Though the two disorders have some symptoms in common, LBD differs from Alzheimer's in a few ways:
- Memory problems tend to occur later in LBD — Loss of memory is often one of the first clear symptoms of Alzheimer's.
- Movement-related symptoms may appear earlier in LBD — A hunched posture or shuffling gait are common movement problems.
- Delusions aren't a common symptom of Alzheimer's disease — Having visual hallucinations occurs in up to 80% of people with LBD, even in the early stages. People with LBDmay also hear and smell things that aren't there.
- Sudden changes in mood or behavior are more common with LBD — People with LBDmay be alert and attentive one minute and confused and drowsy a short time later. Their behavior may change from day to day, not following any routine or pattern.
- Disruption of the autonomic nervous system is more common in LBD — This can cause a sudden drop in blood pressure, leading to falls and dizziness. It may also cause bladder control issues.
What are the types of LBD?
LBD is a term that describes two related brain disorders, including:
- Dementia with Lewy bodies — Causes thinking ability to decline before physical problems occur.
- Parkinson's disease dementia — Starts as a movement disorder, with tremors or shaking. Most people with Parkinson's have Lewy bodies in their brain. Dementia symptoms start more than a year after other symptoms, though not all people with Parkinson's will have dementia.
How common is LBD?
LBD is the second most common type of neurodegenerative disease after Alzheimer's disease. More than 1 million people in the U.S. have LBD.
What causes LBD?
Doctors don't know the exact cause of LBD.
LBD risk factors
LBD risk factors include:
- Age — LBDalmost always occurs in people over 50.
- Sex — LBDaffects more men than women.
- Parkinson's disease — This degenerative nerve disease is often linked to LBD.
- REM sleep behavior disorder — People with LBDmay also have this disorder, which causes them to physically act out their dreams. They may shout, punch, or kick in their sleep.
- Family history — Having a family member with LBD increases your chances of getting it.
Complications of LBD
Complications of LBD include:
- A decline in thinking and reasoning ability.
- Balance problems.
- Death.
- Depression.
- Increased fall risk.
- Worsening tremors.
How can I prevent LBD?
Currently, there is no proven way to prevent LBD because its exact causes are not fully understood. However, maintaining a healthy lifestyle may support brain health and potentially reduce overall dementia risk.
A healthy lifestyle includes:
- Eating a heart-healthy diet.
- Engaging in mentally stimulating activities.
- Getting quality sleep.
- Limiting alcohol.
- Managing chronic conditions, such as high blood pressure or diabetes.
- Managing stress.
- Participating in regular exercise or physical activity.
- Staying socially active.
- Stopping smoking or never starting.
What Are the Signs and Symptoms of LBD?
LDB symptoms mostly affect people after age 50. Symptoms start slowly and get worse over time. Eventually, most people with LBDdevelop mental and physical symptoms that may lead to a loss of independence.
LBDshares some symptoms with other types of dementia, such as confusion and memory loss.
Other symptoms of LBD include:
Cognitive symptoms
- Changes in thinking and reasoning.
- Confusion.
- Hallucinations.
- Memory loss.
- Poor judgment.
- Trouble understanding visual material.
Mood and behavioral symptoms
- Agitation
- Anxiety
- Apathy
- Depression
Physical and movement symptoms
- Balance issues and frequent falls.
- Changes in handwriting.
- Dizziness and fainting.
- Lack of facial expression.
- Shuffling gait.
- Slow movement or frozen stance.
- Stooped posture.
- Trouble swallowing.
- Quiet, weak voice.
Sleep symptoms
- Insomnia.
- Excessive daytime sleepiness.
- REM sleep behavior disorder.
When should I see a doctor about my LBD symptoms?
If you have symptoms of LBD or any type of dementia, you should schedule an appointment with your doctor right away. Your doctor may refer you to a neurologist who specializes in diagnosing and managing different types of dementia.
How Do You Diagnose LBD?
It's crucial to get an expert diagnosis for any type of dementia. Diagnosing LBD is complex because symptoms may be similar to other types of dementia. Sometimes, a person will have more than one type of dementia at a time (mixed dementia).
To diagnose LBD, your doctor will perform physical and neurological examinations and review your symptoms and medical history. Your doctor may also order tests to confirm your diagnosis or rule out other problems.
What to expect during your visit
During your visit, your doctor will:
- Ask you about your symptoms.
- Order tests.
- Perform a physical and neurological exam.
- Review your medical history.
Tests to diagnose LBD
There's no conclusive test to diagnose LBD. However, your doctor may order tests to provide information or rule out other problems, including:
- Blood tests — Checks for abnormalities and rules out other conditions.
- Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab.
- Magnetic resonance imaging (MRI) — Creates images of your brain using contrast dye to look for damaged or abnormal areas.
- Neurological examination — A noninvasive test to check your reflexes, balance, movement, memory, and ability to think.
- Neuropsychological examination — Checks your ability to think, reason, and remember.
- Skin biopsy — Involves taking a small sample of your skin to look for proteins associated with LBD.
- Sleep study — Records information about how your body works while you’re sleeping to diagnose sleep disorders.
LBD prognosis
LBD is a progressive disease that gets worse over time and may eventually cause a loss of independence. Your prognosis after LBD diagnosis depends on how quickly your condition progresses, your overall health, and other factors.
What is the life expectancy of someone with LBD?
The average time from LBD diagnosis to death is five to eight years. But some people can live up to 20 years. There are many factors that might extend a person's lifespan, such as their overall health and age at diagnosis.
How Do You Treat LBD?
There is no cure for LBD. However, treatment can help manage LBD symptoms.
Treatment options may include:
Medication for LBD symptoms
Common medications to treat LBD symptoms include:
- Antidepressants — Treat depression, which is common with LBD.
- Cholinesterase inhibitors — Used for Alzheimer's and may also help LBDsymptoms.
- Clonazepam — May help with REM sleep disorder, which many people with LBDhave. Doctors sometimes prescribe it with melatonin, a calming and natural hormone.
- Antipsychotics — Sometimes help LBD, but in some people, they may cause symptoms to get worse.
- Parkinson's disease medications — May help manage movement-related symptoms.
Lifestyle changes for LBD
Lifestyle changes may help to reduce LBD symptoms.
Your doctor may recommend:
- Increasing exercise in the daytime to help with sleep at night.
- Avoiding long naps.
- Staying away from caffeine and alcohol.
- Going to physical therapy to help with movement and balance problems.
Why Choose UPMC for LBD Care?
When you choose UPMC for LBD care, you will receive:
- Multidisciplinary care — Our team of dementia experts will work with you and your loved ones to develop a customized treatment plan that optimizes your quality of life and reduces your risk of complications.
- Access to advanced clinical trials — Our team participates in national, multicenter clinical trials evaluating new treatment options, giving you the opportunity to contribute to research advancing dementia care.
- Seamless, ongoing treatment — If you are diagnosed with LBD, our team will develop a plan for your follow-up care, including ongoing symptom management and long-term care planning, as needed.
