Lewy body dementia (LBD) is a form of dementia that affects a person’s cognitive abilities and movement. The condition is progressive, which means the symptoms worsen over time.

LBD occurs due to unusual brain deposits of a protein known as alpha-synuclein. Experts call these protein deposits Lewy bodies.

In an unaffected brain, alpha-synuclein plays an important role, particularly in the synapses. With LBD, Lewy bodies form inside the synapses, causing the neurons (nerve cells) to work less effectively and die.

Lewy bodies can also cause changes to brain chemicals, affecting a person’s mental abilities, mood, and behavior.

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LBD affects an estimated 1.4 million people in the United States. It is the third most commonTrusted Source form of dementia, after vascular dementia and Alzheimer’s disease.

There are two types of LBD:

  • Dementia with Lewy bodies: This occurs when the Lewy bodies initially develop in the brain stem and cerebral cortex.
  • Parkinson’s disease dementia: This occurs when the Lewy bodies initially develop in the brain stem and extend to the cerebral cortex over time.

Both forms result from the same brain changes. While the early signs differ, people with either type of LBD will eventually develop similar symptoms.

Researchers do not know why LBD occurs. However, it typicallyTrusted Source affects people over the age of 50.

Symptoms are typicallyTrusted Source mild in the beginning and become more pronounced over time.

Cognitive symptoms

Visual hallucinations may be one of the first symptoms to develop, causing people to see things that are not there. This symptom affects up to 80%Trusted Source of people with LBD.

Other hallucinations, such as hearing or smelling things that are not there, are less common but may also occur.

Additional cognitive symptoms may include:

The severity of these symptoms can fluctuate, which may help a healthcare professional distinguish between LBD and Alzheimer’s disease.

Dementia symptoms also cause difficulties with:

  • language
  • numbers
  • planning
  • problem-solving
  • spatial abilities

Movement symptoms

LBD may cause movement difficulties, including:

Sleep and LBD

Sleep difficulties oftenTrusted Source occur in people with LBD. People may experience:

Behavioral and mood symptoms

Protein deposits in the brains of those with LBD can cause behavioral and mood conditions, such as:

Other symptoms

LBD can cause many other changes to the body and brain, which may lead to symptoms such as:

There is no specific test for LBD. Specialists, such as neurologists and psychiatrists, typically diagnose the condition based on a combination of test results and the person’s symptoms.

A healthcare professional may use the following tests to rule out similar conditions or reach alternative diagnoses:

  • a review of symptoms and the person’s medical history
  • neurological and physical examinations
  • an assessment of memory and thinking
  • blood tests
  • sleep studies
  • imaging tests

There is no cureTrusted Source for LBD. However, the following treatments may help manage symptoms and improve a person’s quality of life.

Cognitive symptoms

Drugs called cholinesterase inhibitors may helpTrusted Source with cognitive symptoms, such as changes to memory and thinking. These drugs may also reduce hallucinations and delusions.

A healthcare professional may also prescribe atypical antipsychotics off-label. Off-label use is when doctors prescribe a drug for a purpose other than what it’s approved for. However, people should take these with caution due to the risk of severe side effects and worsening movement symptoms.

Movement-related symptoms

Treatments for movement-related symptoms may include:

  • Carbidopa-levodopa: Side effects of carbidopa-levodopa (Sinemet) include hallucinations and confusion. For this reason, a healthcare professional may prescribe this medication with caution and startTrusted Source a person on a low dose.
  • Physical therapy and exercise: Exercise and physical therapy can improve strength and balance, which may help with managing symptoms that affect movement.

Behavior and mood-related symptoms

To treat or manage symptoms that relate to behavior and mood, a healthcare professional may:

  • check for physical conditions that may be contributing to behavioral or mood issues, such as injuries or infections
  • review medication use, as some drugs’ side effects affect behavior and mood
  • suggest changes to a person’s environment to help reduce stress and anxiety and ensure they are getting appropriate levels of stimulation

A healthcare professional may alsoTrusted Source prescribe selective serotonin reuptake inhibitors (SSRIs).

Sleeping difficulties

Sleeping difficulties may respond to drugs and lifestyle changes, includingTrusted Source:

  • Clonazepam (Klonopin): Clonazepam can help people with REM sleep disorder. However, it can cause dizziness and cognitive issues.
  • Stimulants: These drugs may help people stay awake if they experience excessive daytime sleepiness.
  • Melatonin: Melatonin is a naturally occurring hormone available in synthetic form. It can treat insomnia by making it easier to fall asleep.
  • Sleep hygiene: Changing diet and behaviors can improve sleep for some people. Examples of better sleep hygiene include being more active during the day, having a set bedtime and wake time, and avoiding caffeine and sugar in the evening.

Complementary therapies, especially those that help manage anxiety and mood, may be helpful for people with LBD. Examples include:

LBD can affect many areas of a person’s life. Therefore, having a specialist care team can help a person receive the most comprehensive support and care.

In addition to neurologists and other doctors, specialists that can help may includeTrusted Source:

Caregivers play an important role in the lives of people with LBD. To ease a person’s symptoms and improve their quality of life, it can be helpful to:

  • Establish structure and routines: Daily routines around everyday activities, such as mealtimes, exercise, and bedtimes, may ease anxiety and confusion.
  • Simplify tasks: Breaking tasks into easier steps and using adaptive tools and equipment, such as special cutlery, can make life easier for people with LBD.
  • Change the environment: It is best to reduce environmental stressors, such as clutter, bright lights, and loud noises.
  • Provide enough stimulation: Boredom can make cognitive and mood symptoms worse. It may help to provide sources of stimulation for people with LBD, including audiobooks, puzzles, games, and music.
  • Encourage social and physical activities: Meeting friends and family, exercising, and getting out in nature may enhance the lives of those with LBD.
  • Offer a balanced diet of appropriate foods: It is important to adapt foods to the individual’s needs. Some people may need very soft foods, especially if they have difficulty swallowing. People with sleep issues may need to limit their caffeine and sugar intake.

It is important to adapt activities and actions to the needs of the person, which can change over time and from one day to the next.

Tips for communication

Because people with LBD can experience confusion and anxiety, it may help to employ the following tips when speaking with a person who has this condition:

  • Speak clearly and at an appropriate volume.
  • Use simple words and short sentences.
  • Adopt a soothing, reassuring tone.
  • Present only one idea at a time.
  • Point to objects or use picture cards to help with clarity.
  • Avoid quizzing the person, which can be distressing.
  • Maintain eye contact.
  • Wait for a response, which may take time.
  • Let the person know you have heard and understood them.
  • Validate any concerns or fears they may have.

It may also help to regularly let them know what is happening, especially during periods of transition, such as around mealtimes, bedtimes, or going on an outing.

This type of communication helps minimize uncertainty and may reduce anxiety and distress.

While often rewarding, caring for others can be challenging. Burnout among caregivers is a valid concern. Therefore, it is important that they also take steps to look after themselves.

As well as asking for help when necessary, the following strategies may be beneficial:

  • exercising regularly
  • eating a balanced diet
  • trying to get enough rest and sleep
  • making time for hobbies and enjoyable activities
  • joining a support group for caregivers
  • considering the use of in-home health services, if possible
  • practicing stress relief strategies, such as meditation, yoga, or other approaches
  • speaking with a doctor or mental health professional if feeling overly stressed, anxious, or unwell

Caregivers can find additional help and support on the websites of the following organizations:

LBD is a progressive condition involving worsening symptoms. Complications may include:

  • changes in mood, including depression, anxiety, and aggression
  • loss of mobility
  • increased risk of falls and injury
  • worsening dementia

On average, a person’s life expectancy after receiving an LBD diagnosis is 5 to 8 yearsTrusted Source. However, this can vary from 2 to 20 yearsTrusted Source.

It is important to seek medical help if a person is showing signs of LBD, including changes in cognition, behavior, movement, or sleep.

The doctor will typically perform some tests and may refer the person to a specialist, such as a neurologist or psychiatrist.

To prepare for the appointment, it may be helpful to write down the following:

  • a detailed list of all symptoms, including when they began and their severity
  • all current and recent medications and supplements
  • any relevant medical history or family history
  • a list of questions for the doctor

If a person is experiencing these symptoms themselves, it can be a good idea for them to bring along a family member or a close friend to provide support and give the doctor more information about symptoms, if needed.

Is LBD genetic?

Researchers do not know the exact cause of LBD. According to the National Institutes of Health (NIH)Trusted Source, it is not a genetic condition, but having a family member with LBD may increase a person’s risk of developing it.

Researchers associate variants in the APOE, GBA, and SNCA genes with a higher risk of LBD.

Can people prevent LBD?

According to the NIHTrusted Source, there is no way to prevent LBD. However, future research may change this.

Can people reverse LBD?

Currently, it is not possibleTrusted Source to cure LBD. However, treatments, including medications, physical therapy, and counseling, may help slow the condition’s progression.

Lewy body dementia (LBD) is a progressive condition that affects cognition, movement, behavior, and mood. LBD can be challenging for those who develop the condition, as well as their loved ones and caregivers.

However, doctors and mental health professionals can help a person manage LBD. Treatment can help with symptoms and improve a person’s quality of life. Various organizations can also provide support to people with the condition and their loved ones.

People with LBD can still enjoy time with family and friends and a range of exercises and activities throughout their illness.