Dementia With Lewy Bodies

Dementia with Lewy bodies is a common type of dementia that gets progressively worse with time. Typical characteristics include progressive worsening of mental function combined with 3 other features: seeing things that are not there (hallucinations), significant fluctuations in alertness and attention, and changes in movement similar to Parkinson's disease (rigid muscles, slowed movement, and tremors). Dementia with Lewy bodies has many similar symptoms that Parkinson's disease and Alzheimer's disease has.

CAUSES

The symptoms of dementia with Lewy bodies are caused by the buildup of Lewy bodies, which are proteins that build up in brain cells and affect mental function and movement. No one knows exactly what causes the buildup of Lewy bodies, but it may be related to Alzheimer's dementia or Parkinson's disease.

SYMPTOMS

  • Memory problems.

  • Confusion.

  • Reduced attention span.

  • Hallucinations.

  • False ideas about another person or situation (delusions).

  • Trouble moving (rigid muscles, slowed movement, and tremors).

  • Shuffling movements (gait).

  • Sleep problems (acting out dreams).

  • Fluctuating attention (periods of drowsiness or lethargy, long periods of time spent staring into space, or disorganized speech).

DIAGNOSIS

There is no specific test to diagnose dementia with Lewy bodies, but your caregiver will evaluate you based on your symptoms and physical exam. Your evaluation may also include:

  • Memory testing.

  • Lab tests.

  • Brain imaging (CT scan, MRI).

  • Electroencephalogram (EEG).

  • Lumbar puncture.

TREATMENT

There is no cure for dementia with Lewy bodies. Medicines may be prescribed to help with mental function and movement.

HOME CARE INSTRUCTIONS

The care of individuals with dementia is varied and dependent upon the progression of the dementia. The following suggestions are intended for the person living with, or caring for, the person with dementia.

  • Create a safe environment.

  • Remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself in.

  • Use childproof latches on kitchen cabinets and any place where cleaning supplies, chemicals, or alcohol are kept.

  • Use childproof covers in unused electrical outlets.

  • Install childproof devices to keep doors and windows secured.

  • Remove stove knobs or install safety knobs and an automatic shut-off on the stove.

  • Lower the temperature on water heaters.

  • Label medicines and keep them locked up.

  • Secure knives, lighters, matches, power tools, and guns, and keep these items out of reach.

  • Keep the house free from clutter. Remove rugs or anything that might contribute to a fall.

  • Remove objects that might break and hurt the person.

  • Make sure lighting is good, both inside and outside.

  • Install grab rails as needed.

  • Use a monitoring device to alert you to falls or other needs for help.

  • Reduce confusion.

  • Keep familiar objects and people around.

  • Use night lights or dim lights at night.

  • Label items or areas.

  • Use reminders, notes, or directions for daily activities or tasks.

  • Keep a simple, consistent routine for waking, meals, bathing, dressing, and bedtime.

  • Create a calm, quiet environment.

  • Place large clocks and calendars prominently.

  • Display emergency numbers and the home address near all telephones.

  • Use cues to establish different times of the day. An example is to open curtains to let the natural light in during the day.

  • Use effective communication.

  • Choose simple words and short sentences.

  • Use a gentle, calm tone of voice.

  • Be careful not to interrupt.

  • If the person is struggling to find a word or communicate a thought, try to provide the word or thought.

  • Ask one question at a time. Allow the person ample time to answer questions. Repeat the question again if the person does not respond.

  • Reduce nighttime restlessness.

  • Provide a comfortable bed.

  • Have a consistent nighttime routine.

  • Ensure a regular walking or physical activity schedule. Involve the person in daily activities as much as possible.

  • Limit napping during the day.

  • Limit caffeine.

  • Attend social events that stimulate rather than overwhelm the senses.

  • Encourage good nutrition and hydration.

  • Reduce distractions during meal times and snacks.

  • Avoid foods that are too hot or too cold.

  • Monitor chewing and swallowing ability.

  • Continue with routine vision, hearing, dental, and medical screenings.

  • Only give over-the-counter or prescription medicines as directed by the caregiver.

  • Monitor driving abilities. Do not allow the person to drive when safe driving is no longer possible.

  • Register with an identification program which could provide location assistance in the event of a missing person situation.

SEEK MEDICAL CARE IF:

  • New behavioral problems develop, such as moodiness or aggressiveness.

  • Any new problem with brain function develop, such as balance, speech, or falling a lot.

  • Problems with swallowing develop.

Small changes or worsening in any aspect of brain function can be a sign that the illness is getting worse. It can also be a sign of another medical illness such as infection. Seeing a caregiver right away is important.

SEEK IMMEDIATE MEDICAL CARE IF:

  • A fever develops.

  • Confusion develops or worsens.

  • New or worsened sleepiness develops or staying awake becomes difficult.