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What Are The First Signs of Lewy Body Dementia?

Have you ever heard of Lewy Body Dementia (LBD)? If the name of this disease sounds unfamiliar to you, perhaps the word Alzheimer’s would help. 

LBD may indeed resemble Alzheimer’s, but Alzheimer’s is ten times more prevalent than LBD worldwide. In terms of disease presentation, LBD is actually more feared because its symptoms are complex and there are movement disorders that resemble those of Parkinson’s Disease!

To find out what signs appear in a person with LBD, you can read this comprehensive article. But first, let’s get acquainted with LBD.

Table of Content

    What is Lewy Body Dementia?

    Lewy Body Dementia, or LBD for short, is a brain disease that slowly gets worse over time. It can affect your thinking, memory, and movement. 

    Think of your brain like a computer. All neurodegenerative conditions (think Alzheimer’s Frontotemporal Dementia, Lewy Body Dementia) have different kinds of gunk build up inside the computer.

    In LBD, the gunk is made up of Lewy bodies which accumulate in the front and sides of the brain.

    LBD isn’t as famous as other brain diseases like Alzheimer’s, but it’s still something to be aware of.

    Doctors can find it tricky to diagnose LBD for sure because the symptoms can be similar to other brain problems. There’s no magic cure, but if the neurologist or neuropsychiatrist catches it early, the caregivers may find the news dreadful, but at the same time, they may also be relieved that their loved one has been diagnosed.

    What Causes Lewy Body Dementia?

    first signs of lewy body dementia

    The exact reason why LBD happens is not yet fully understood. However, researchers think that it might be connected to the buildup of abnormal protein clumps called Lewy Bodies in the brain.

    These Lewy Bodies contain a specific protein called alpha-synuclein, which is also linked to another condition called Parkinson’s disease.

    Alpha-synuclein is a protein which is abundant in dopamine-producing nerve cells. In Parkinson’s and LBD, alpha-synuclein mis-folds and aggregates into clumps called Lewy Bodies

    So, while both conditions are related to these protein clumps, they have different effects on the brain.

    In Lewy Body Dementia, the buildup of these protein clumps is thought to be the main cause of the condition.

    In contrast, Parkinson’s Dementia, the pathology is more centered on how the dopamine-producing area of the brain progressively stops working.

    First Signs of Lewy Body Dementia

    The first signs of Lewy body dementia (LBD) can vary from person to person, but common early symptoms, especially in the behavioral variant of LBDinclude:

    1. Hallucinations: Visual hallucinations are often the first sign of LBD, affecting about 80% of people with the disease. The tricky thing is that hallucinations can be kept secret by the person suffering from it.
    2. Changes in thinking and problem-solving: Difficulty with thinking, problem-solving, and decision-making are common early symptoms.
    3. Sleep issues: Sleep disturbances, such as insomnia or excessive daytime sleepiness, are also common early indicators of LBD.
    4. Behavioral or mood changes: Changes in mood, such as depression or anxiety, and unusual behaviors like pacing, hand-wringing, or repeating words or phrases can also be early signs

    These early symptoms can be subtle and may resemble those of other conditions, making diagnosis challenging.

    It is common to mistakenly view LBD symptoms as a psychiatric condition like Depression.  

    How to Know if You Have Lewy Body Dementia?

    first signs of lewy body dementia

    To determine if you have Lewy body dementia (LBD), it is crucial to consult a doctor if you or a loved one is experiencing symptoms that resemble those of LBD. The diagnosis process involves a combination of medical history, physical examination, and various tests to rule out other health issues that could cause similar symptoms.

    Medical History and Physical Examination

    1. Symptom Report: Share your symptoms with your doctor, including any changes in thinking, mood, behavior, movement, or sleep patterns. Be specific about when these changes started and how they have progressed over time.
    2. Family History: Inform your doctor about any family history of dementia or related conditions, as this information can help in the diagnostic process.

    Tests and Evaluations

    1. Neuropsychological Tests: James Galvin came up with the “Lewy Body Composite Risk Score” (LBCRS) to effectively diagnose LBD and Parkinson’s disease dementia (PDD) in about three minutes. Compared to other run-of-the-mill examinations used by neurologists to diagnose dementia, the LBCRS is more targeted.With the LBCRS, the clinician can assess whether the patient has bradykinesia, rigidity, postural instability, or rest tremor without having to grade each extremity. 
    2. Blood Tests: Blood tests are mostly made to rule out other conditions. There is a no definitive blood test for LBD.
    3. Brain Imaging: A CT or MRI scan of your brain is mainly to determine if there are structural causes for brain dysfunction, e.g. tumor, stroke, brain swell etc. It does not definitively diagnose LBD.
    4. Sleep Tests: Sleep tests, such as those for REM sleep behavior disorder aka RBD, can help diagnose sleep-related issues that are common in LBD. 


    As with many neurodegenerative conditions, the neuropsychologist has the final say on the label of your condition. The LBCRS seems like a good test, while the others look more like tests of elimination or confirmation.

    Treatment and Support

    Although LBD cannot be cured, treatment plans are meant to manage the condition as it progresses. These plans typically involve medications, physical and other types of therapy, and counseling. Changes to make the home safer, equipment to make everyday tasks easier, and social support are also important for maintaining quality of life.

    Frequently Asked Questions (FAQ)

    How Do You Confirm Lewy Body Dementia?

    To confirm Lewy body dementia (DLB), the revised criteria for clinical diagnosis of probable and possible DLB recommend that the diagnosis be based on the presence of two or more core clinical features or one core clinical feature along with one or more indicative biomarkers. The core clinical features include visual hallucinations, Parkinsonism, cognitive impairment with fluctuations, autonomic dysfunction, and rapid eye movement sleep behavior disorder (RBD). The indicative biomarkers are not specified in the provided sources but are typically associated with the presence of Lewy bodies in the brain, such as imaging studies or cerebrospinal fluid analysis.

    At What Age Does Lewy Body Dementia Start?

    The age of onset for Lewy body dementia varies. While it is more common in older adults, it can also affect individuals younger than 65 years. The average age at diagnosis is around 76.3 years, with a higher incidence in males than females. However, the age of onset can range from the 50s to the 80s, depending on the individual case.

    What Is The One Year Rule For Lewy Body Dementia?

    The one-year rule is a guideline used to distinguish between dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) in research settings. It states that DLB is diagnosed when dementia occurs before or within one year after the onset of parkinsonism. This rule is not based on scientific evidence but is used as a practical tool to differentiate between the two conditions.

    How to Tell Someone They Have Lewy Dody Dementia?

    When informing someone of a Lewy body dementia diagnosis, it is essential to approach the conversation with empathy and understanding. Here are some general guidelines:

    1. Be honest and clear: Explain the diagnosis in simple terms, avoiding technical jargon. Use a calm and respectful tone to ensure the person feels comfortable and understood.
    2. Provide information: Offer information about the condition, its symptoms, and how it affects daily life. This can help the person better understand their situation and make informed decisions about their care.
    3. Emphasize support: Let the person know that they are not alone and that there is support available. Encourage them to seek professional help from healthcare providers, support groups, or other resources.
    4. Focus on the person: Remember that the person with Lewy body dementia is still the same individual they were before the diagnosis. Focus on their strengths, abilities, and the things they can still do, rather than their limitations.
    5. Encourage open communication: Encourage the person to express their feelings, concerns, and questions. Listen actively and respond with empathy and understanding.


    In conclusion, it’s clear that Lewy Body Dementia is a serious brain condition that shouldn’t be ignored. After learning more about it, it’s important to pay attention to loved ones, especially those over 60, and be aware of the early signs. This can help catch the disease early and improve how it’s managed, ultimately benefiting those affected.