Dementia with Lewy Bodies: Understanding the Symptoms

Dementia with Lewy bodies (DLB) is a progressive neurological disorder that leads to a decline in cognitive abilities. One of the earliest and most noticeable signs is a gradual worsening of cognitive function, particularly in areas such as attention and visual-spatial skills. Among these, visual-spatial impairment tends to be the most pronounced, affecting the person's ability to judge distances and perceive objects accurately.

Fluctuating Cognitive Abilities

A hallmark symptom of DLB is fluctuating cognition. This means that the person may experience unpredictable variations in their thinking, attention, and alertness. These fluctuations are often persistent and may appear early in the disease progression, making them a key indicator for diagnosis.

Recurrent Visual Hallucinations

Visual hallucinations are another common and often early symptom of Lewy body dementia. These hallucinations are typically vivid and detailed, with patients describing scenes or images that feel extremely real to them. These episodes may occur frequently and can be distressing for both the individual and their caregivers.

Motor Symptoms Similar to Parkinson's Disease

As the disease progresses, patients may develop movement-related symptoms similar to those seen in Parkinson's disease. These include increased muscle rigidity, slowed movement (bradykinesia), and difficulties with posture and gait. Walking may become unsteady, with a shuffling or dragging motion, and movements may appear stiff or repetitive.

Medication Sensitivity and Sleep Disturbances

Individuals with DLB often show a heightened sensitivity to certain antipsychotic medications, known as neuroleptics. This sensitivity can lead to severe side effects, so caution is required when prescribing such drugs. Additionally, many patients experience REM sleep behavior disorder, where they physically act out their dreams, sometimes leading to injury or disrupted sleep.

Episodes of Fainting and Autonomic Dysfunction

Autonomic nervous system dysfunction is also a significant aspect of DLB. Patients may suffer from cardiovascular issues, including orthostatic hypotension, which can cause dizziness or fainting when standing up. Brief episodes of unconsciousness, lasting only a few minutes, may also occur. Recurrent falls and fainting spells are not uncommon and can pose a risk for injury.