Dementia with Lewy Bodies (DLB)

A Comprehensive Guide to Understanding, Recognizing, and Managing DLB

Neurology

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Last updated: Mar 24, 2025

What is Dementia with Lewy Bodies?

Dementia with Lewy bodies (DLB) is the second most common type of progressive dementia after Alzheimer's disease. It occurs when abnormal protein deposits called Lewy bodies develop in brain regions involved in thinking, memory, and movement.

Key Symptoms

Core Features:

  • Fluctuating cognition with pronounced variations in attention and alertness
  • Recurrent visual hallucinations that are typically well-formed and detailed
  • Parkinsonism - movement problems similar to Parkinson's disease
  • REM sleep behavior disorder - acting out dreams during sleep

Supporting Features:

  • Sensitivity to antipsychotic medications
  • Falls and fainting
  • Autonomic dysfunction
  • Depression and anxiety

Diagnosis

Diagnosis involves:

  1. Detailed medical history
  2. Physical and neurological examination
  3. Cognitive testing
  4. Brain imaging (MRI or CT)
  5. Sleep studies (if needed)

Treatment Approaches

Medications

  • Cholinesterase inhibitors for cognitive symptoms
  • Levodopa for movement symptoms
  • Antidepressants when needed
  • Melatonin for sleep disorders

Non-medication Approaches

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Environmental modifications
  • Caregiver support and education

Living with DLB

Daily Management Tips:

  • Maintain regular routines
  • Create a safe living environment
  • Use memory aids and calendars
  • Stay physically active as able
  • Engage in social activities

Support Resources

  • Support groups
  • Caregiver education programs
  • Professional care services
  • Legal and financial planning

When to Contact Healthcare Providers

Seek medical attention if:

  • Symptoms suddenly worsen
  • New symptoms develop
  • Safety concerns arise
  • Caregiver stress becomes overwhelming

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