Lewy Body Dementia: A Combination That's Easy to Misread

Lewy body dementia (LBD) is the third most common type of dementia, and it's frequently misdiagnosed early on because its symptoms overlap with several other conditions — Alzheimer's, Parkinson's, depression, and even delirium.

What Causes It

LBD is caused by abnormal protein deposits called Lewy bodies building up in the brain, disrupting how brain cells communicate. It's actually an umbrella term covering two related conditions — dementia with Lewy bodies and Parkinson's disease dementia — which share the same underlying protein changes but differ in which symptoms show up first.

The Symptom Combination That Points to LBD

A few features together are the real clue, more than any single symptom alone:

• Fluctuating cognition — a person may seem alert and engaged one hour, then noticeably confused or drowsy the next, sometimes changing over just hours.
• Visual hallucinations, often early in the disease and often quite detailed — seeing people, animals, or shapes that aren't there. These occur in most people with LBD.
• Movement symptoms similar to Parkinson's — slowness, stiffness, tremor, or balance difficulty.
• REM sleep behavior disorder — physically acting out dreams, sometimes with yelling or thrashing, which can appear years before other symptoms.

One Detail Worth Knowing Before Any Medication Decision

People with LBD can have severe, sometimes dangerous reactions to certain antipsychotic medications commonly used for agitation or hallucinations in other dementia types. If your loved one has ever had a bad reaction to a medication like haloperidol or risperidone, that itself is worth mentioning to a doctor as a possible clue toward an LBD diagnosis — and it's a good reason to make sure any treating physician knows LBD is a possibility before new medications are prescribed.

How LBD Differs From Alzheimer's

In Alzheimer's, memory loss is typically the earliest and most prominent symptom. In LBD, trouble with attention, visual-spatial skills, and planning often shows up before memory becomes a major issue — and the hallucinations and fluctuating alertness aren't typical early Alzheimer's features at all.

How Interim Approaches LBD Care

We're a non-medical home care agency, and LBD's fluctuating nature means a Care Professional needs to adapt to a person who might be sharp and engaged one visit and significantly more confused the next — consistency of routine matters even more here, since the person's own presentation won't be consistent day to day.

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Call us at (801) 401-3515 and tell us what you're seeing. We'll talk through what support could look like for your specific situation.

Learn more about our dementia care services, or read our comparison of dementia vs. Alzheimer's and our guide to vascular dementia.