Lewy body dementia (LBD) is a progressive brain disorder that affects memory, thinking, and movement. It occurs when abnormal proteins build up in the brain, changing its structure and function.
People with LBD often have memory loss, confusion, sleep problems, tremors, hallucinations, and behavioral disturbances. These symptoms can be pretty similar to other conditions, like Alzheimer’s disease or Parkinson’s disease, so having the correct diagnosis is important.
While there’s no cure, applying the proper care (in the forms of medication, therapy, and support) makes a big difference for the person with LBD.

What is Lewy Body Dementia?
Lewy body dementia (LBD) is a brain disease caused by the buildup of a protein called alpha-synuclein. It affects the levels of neurotransmitters in the brain, which causes problems with thinking, movement, behavior, and mood. LBD is among the more common types of dementia. Other conditions related to dementia include Alzheimer’s disease, Parkinson’s disease, and vascular changes (called vascular dementia).
More than one million people in the United States may have LBD. It usually manifests after age 50 years, but it can affect younger patients, too. LBD seems to be a little more common in men than women. It is often incredibly hard to diagnose, as the early symptoms can be confused with other brain diseases or mental health problems. LBD can happen on its own or along with other brain disorders. [1]
LBD is progressive, and on average, it lasts five to eight years from diagnosis to death, yet this can range from two to 20 years. How quickly it worsens varies from person to person, depending on their overall health, age, and symptom severity.
In the early stages, symptoms are mild, and those affected still function reasonably normally. As the disease gets worse, people with LBD need more help as their thinking and movement abilities decline. In the later stages, they often need full-time care from others.
Diagnosing Lewy Body Dementia
Lewy body dementia can be difficult to diagnose. Doctors need to talk to the patient and their caregivers to make the diagnosis. They will ask about any issues with thinking, moving around, sleeping, behavior, and mood. They may also want to know about all the medications and supplements the patient is taking as some can make LBD symptoms worse. LBD is also often mistaken for Alzheimer’s disease or a strictly psychiatric problem at first, yet the ability to make earlier diagnoses of LBD seems to be improving.
The first step is usually seeing a primary care physician (PCP) if patients or their families recognize changes in thinking, movement, or behavior. PCPs may make preliminary assessments, or they may refer patients to a specialist, like a neurologist, geriatric psychiatrist, neuropsychologist, or geriatrician. And while there is not one specific test for LBD, making an early diagnosis remains critical for several reasons:
- Getting the proper medical care and avoiding treatments that could potentially worsen LBD.
- Having time to plan medical care, arrange daily care, and get the patient’s financial and legal affairs in order.
- Building a support team to help the patient live as well as possible.
A diagnosis of LBD is upsetting; however, it can bring relief in knowing what’s causing the symptoms.
The Diagnostic Criteria for Lewy Body Dementia
As with any disease or illness, certain criteria need to be met for a diagnosis of LBD to be made. However, symptoms of LBD can appear different in each person. Some people have more memory and thinking problems, while others struggle more with movement and behavior. There are, however, a few key clinical features that doctors look for when diagnosing LBD.
Common Symptoms of Lewy Body Dementia
Here are the more common symptoms of LBD:
- Dementia: Problems with memory and thinking that affect daily life
- Movement Issues: Stiffness, tremors, and slower movements
- Cognitive Changes: Changes in attention and alertness
- Hallucinations: Seeing things that aren’t there, often very vividly
- Sleep Changes: Tendency to act out dreams while asleep (this can be violent)
- Behavioral and Personality Changes: Often argumentative, irritable, and disruptive
Additional Symptoms that Help Confirm Lewy Body Dementia
Some more specific symptoms can help doctors more accurately confirm a diagnosis of LBD:
- Reactions to certain medications, like antipsychotics
- Frequent falls, dizziness, and fainting
- Sudden changes in blood pressure, bladder control, or a loss of a sense of smell
- Changes in the mood and personality, like depression, apathy, anxiety, or irritability
Not everyone with LBD will have all these symptoms. Yet, recognizing symptoms early on can help improve the care, safety, and treatment of LBD for the patient and their families. [2]
Testing for Lewy Body Dementia
Testing and diagnosing LBD is no simple task, and doctors use not only physical exams and clinical assessments but also several tests to differentiate LBD from other illnesses that present similar symptoms. These tests include:
- Brain scans (like PET or SPECT) to look for activity changes in certain brain parts. LBD is consistent with lower levels of dopamine in the hypothalamic region of the brain.
- Heart tests, like an electrocardiogram or echocardiogram, can help evaluate the pacemaker nodes, electrical conduction pathways, and heart rhythm, all of which can be impacted by LBD.
- Sleep studies whether someone acts out their dreams while they sleep, which is a common symptom of LBD. This is called REM sleep disorder. [3]
The most challenging part of diagnosing LBD is that there is no single test that provides a definitive diagnosis. Doctors look at the combination of information from different assessments and test results to make their diagnosis.
Differential Diagnosis
LBD can be difficult to diagnose because the symptoms can seem a lot like other types of dementia, such as Alzheimer’s disease and Parkinson’s disease. Yet, a few key differences allow doctors to treat LBD more effectively.
Lewy Body Dementia vs. Alzheimer’s Disease
Both LBD and Alzheimer’s disease cause problems with memory and thinking, but LBD has a few more unique symptoms. One big difference is that people with an accumulation of Lewy bodies may start hallucinating earlier on in the disease course. This is uncommon in cases of Alzheimer’s disease.
Another difference is that people with LBD experience sudden changes in focus and alertness. They may be clear-headed one moment and confused the next. This fluctuation in thinking and awareness doesn’t occur as often with Alzheimer’s disease. While memory loss is a big issue in Alzheimer’s disease, it is not as severe in the early stages of Lewy body dementia.
Lewy Body Dementia Vs. Parkinson’s Disease
LBD and Parkinson’s disease both cause movement problems, like stiffness, slow movements, and tremors. But with LBD, the dementia and cognitive issues show up around the same time or shortly after the movement symptoms start. In Parkinson’s disease, the dementia usually doesn’t appear until years later.
Lewy Body Dementia Vs. Other Conditions
There are a few other clues that help doctors identify Lewy body dementia. People with LBD often act out their dreams while they’re sleeping, which is known as REM sleep behavior disorder. [3] They also have extreme reactions to certain medications, especially antipsychotics.
Identifying and diagnosing LBD takes time. Doctors review clinical features, obtain test results, perform brain scans, and use sleep studies to try to distinguish it from similar conditions. While it’s not always easy, identifying unique LBD features can make a big difference in diagnosing LBD, choosing the right treatments, and getting the proper care and support.
What Happens After a Lewy Body Dementia Diagnosis?
Lewy body dementia is a challenging condition, but some treatments can help manage the symptoms and make life a little easier for the patient and their family. The first step is creating a care plan, which is a personalized guide that considers the specific needs of the person, like help with daily activities, making the home safer, or getting financial assistance. Having a plan in place makes sure that the patient gets the right support.
Medications for treating LBD
Medications can’t cure Lewy body dementia, but they can reduce and ease specific symptoms. Here are a few medications that can help:
Acetylcholinesterase (AChE) Inhibitors
Drugs like donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) help with hallucinations, sleepiness, and confusion. These help by increasing a chemical in the brain called acetylcholine that improves the ability and performance of brain cells. [3]
Memantine
Memantine is a drug that treats dementia. It blocks the effects of the brain’s chemical glutamate. The drug is used for more severe cases of dementia and is used for those who cannot take drugs, like donepezil or galantamine.
Other Medications
There are other medications used to treat movement issues, depression, or sleep problems. However, these require close monitoring because of possible side effects.
Therapies for LBD
Occupational therapy improves daily tasks, like dressing, while physiotherapy helps with movement problems caused by LBD. Speech therapy is helpful for communication challenges and relaxation activities, like music therapy, massage, and social programs, provide comfort and support.
Life with Lewy Body Dementia
Planning for the future is essential for those living with LBD. A few legal arrangements should be considered, like giving a trusted relative power of attorney. This is important for making medical wishes clear through an advance decision, reflecting choices for when the patient can’t make decisions later.
Support for caregivers is also essential. Taking breaks, joining support groups, and exploring available benefits make caregiving more manageable. Lewy body dementia affects everyone differently, but with a strong care plan and support in place, patients can maintain a good quality of life.
- National Institute on Aging. (2021). What Is Lewy Body Dementia? Causes, Symptoms, and Treatments. National Institute on Aging. https://www.nia.nih.gov/health/lewy-body-dementia/what-lewy-body-dementia-causes-symptoms-and-treatments
- Diagnosing Lewy Body Dementia: For Professionals. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/lewy-body-dementia/diagnosing-lewy-body-dementia-professionals
- Chan, P. C., Lee, H. H., Hong, C. T., Hu, C. J., & Wu, D. (2018). REM Sleep Behavior Disorder (RBD) in Dementia with Lewy Bodies (DLB). Behavioural neurology, 2018, 9421098. https://pubmed.ncbi.nlm.nih.gov/30018672/
- NHS Choices. (2020). Treatment – Dementia with Lewy bodies. NHS. https://www.nhs.uk/conditions/dementia-with-lewy-bodies/treatment/
Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.
MentalHealth.com is a health technology company guiding people towards self-understanding and connection. The platform provides reliable resources, accessible services, and nurturing communities. Its purpose is to educate, support, and empower people in their pursuit of well-being.

Michael Quinn is a writer with five years of experience unpacking everything from technology and politics to medicine and telecommunications.
Jennie Stanford is a dual-board certified physician in both family medicine and obesity medicine, holding an MD, FAAFP, and DipABOM. She has experience in both clinical practice and peer-quality reviews.
Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.
MentalHealth.com is a health technology company guiding people towards self-understanding and connection. The platform provides reliable resources, accessible services, and nurturing communities. Its purpose is to educate, support, and empower people in their pursuit of well-being.