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Lewy Body Dementia: How Symptoms Can Resemble Alzheimer’s, Parkinson’s

October 07, 2021

Everyone’s heard of Alzheimer’s disease, often used loosely to describe all levels and types of forgetfulness. But the lesser-known dementia with Lewy Bodies (DLB), according to epidemiological studies, is the second-most common disease causing dementia and can be equally debilitating.

October is DLB Awareness Month and the clinicians at the Hartford HealthCare Ayer Neuroscience Institute Memory Care Center hope to educate people about this form of dementia, which affects 1.4 million people a year. Robin Williams, Bill Buckner of the Red Sox, media mogul Ted Turner and Casey Kasem of American Top 40 fame are among the famous names who have had DLB.

“DLB is widely underdiagnosed because its symptoms closely resemble those of Alzheimer’s and even Parkinson’s disease,” said Dr. Amy Sanders, director of the Memory Care Center at the Hartford HealthCare Ayer Neuroscience Institute. “DLB is actually the second-most common of the diseases that cause dementia, second only to Alzheimer’s.”

Further complicating the understanding and diagnosis of DLB is the fact that people will experience symptoms that can occur in both Alzheimer’s and Parkinson’s.

These include:

• Confusion.
• Trouble paying attention.
• Vivid visual hallucinations.
• Sleep disturbances, including REM sleep behavior disorder, so named because people lose the normal muscle paralysis during REM sleep and appear to act out their dreams.
• Memory problems.
•  Rigidity.
• Slow and small movements, and trouble walking.
•  Mood changes, depression.

Because the body’s autonomic nervous system is also affected by DLB, people might experience changes in blood pressure, heart function and even gastrointestinal function, with constipation being a concern.

“The order in which patients experience these symptoms is different from Alzheimer’s,” Dr. Sanders said. “Early on, DLB patients will report fluctuations in attention, problem solving and spatial awareness. Significant memory loss comes much later than for patients with Alzheimer’s.”

At the same time, some symptoms are more pronounced in DLB, including the tendency to swing from alertness to confusion and to experience muscle stiffness.
The exact cause of DLB is not known, but Dr. Sanders said patients are affected by widespread deposits of a protein called alpha-synuclein in neurons in the brain.

These inclusions are known as “Lewy bodies,” after Dr. Fritz Heinrich Lewy, who first described them in 1912. To diagnose the disease, a doctor considers symptoms and biomarkers that can be obtained through blood tests, neuropsychological tests, medical imaging and polysomnography, a type of sleep study used to detect REM sleep disorder.

Like Alzheimer’s disease, there is currently no cure for DLB, although there are medications that can help slow its progression. Patients can be prescribed medication and lifestyle changes, similar to those recommended for Alzheimer’s, to relieve symptoms.

“We have noticed that some of the medications and lifestyle changes like adhering to a daily routine and adding physical activity if possible have a more positive effect on people with DLB, which is some good news,” Dr. Sanders said. “We do need to tailor treatment to each patient, though because some people with DLB can be highly sensitive to certain medications, such as ones often used to control hallucinations.”

For help with the diagnosis and treatment of DLB or Alzheimer’s, click here.