ALZHEIMER’S SOCIETY INFORMATION SHEET · JANUARY 2002
Dementia with Lewy bodies (DLB) Dementia with Lewy bodies (DLB) is a form of dementia that shares characteristics with both Alzheimer’s and Parkinson’s diseases. It may account for 10 to 15 per cent of all cases of dementia in older people. This information sheet outlines the symptoms of DLB, how it is diagnosed and treated. What are Lewy bodies? Symptoms characteristic of DLB
Lewy bodies (named after the doctor who first
There are also symptoms that are characteristic of
identified them in 1912) are tiny spherical protein
deposits found in nerve cells. Their presence in the
• Find that their abilities fluctuate daily, even
brain disrupts the brain’s normal functioning,
interrupting the action of important chemicalmessengers including acetylcholine and dopamine.
• Faint, fall, or have ‘funny turns’
Lewy bodies are also found in the brains of
• Experience detailed and convincing visual
people with Parkinson’s disease (PD), a progressive
hallucinations, often of people or animals.
neurological disease that affects movement. Somepeople who are initially diagnosed with PD later go
• Fall asleep very easily by day and have restless
on to develop a dementia that closely resembles
disturbed nights with confusion, nightmares and
DLB. Researchers have yet to understand fully why
Dementia with Lewy bodies (DLB) is sometimes
Who gets DLB?
referred to by other names, including Lewy body
dementia, Lewy body variant of Alzheimer’s disease,
equally. As with all forms of dementia, DLB is
diffuse Lewy body disease, cortical Lewy body
more prevalent in people over the age of 65.
disease and senile dementia of Lewy body type. All
However, in certain rare cases people under 65 may
Symptoms Diagnosing DLB
DLB is a progressive disease. This means that over
DLB can be difficult to diagnose. People are often
time the symptoms will become worse. In general
diagnosed as having Alzheimer’s disease or vascular
dementia. The diagnosis is made on the basis of the
Alzheimer’s disease, typically over several years.
symptoms, particularly visual hallucinations,
People with DLB will typically have some of the
fluctuation and the presence of the stiffness and
symptoms of Alzheimer’s and Parkinson’s diseases.
While it is always important to get an accurate
• People who have DLB often experience the
diagnosis of dementia, a proper diagnosis is
particularly important in cases of suspected DLB
communication difficulties associated with
since people with DLB have been shown to react
badly to certain forms of medication (see below).
• They may also develop the symptoms of
Parkinson’s disease, including slowness, muscle
DLB and neuroleptics
stiffness, trembling of the limbs, a tendency to
Neuroleptics are strong tranquillisers usually given
shuffle when walking, loss of facial expression
to people with severe mental health problems. In
and changes in the strength and tone of the voice.
the past they have been prescribed to people withdementia.
It is always preferable to find ways of dealing
with a person’s distress and disturbance that do not
For further information call the Alzheimer’s Helpline 0845 300 0336
ALZHEIMER’S SOCIETY INFORMATION SHEET · JANUARY 2002
involve medication. Under no circumstances should
neuroleptics be prescribed as a substitute for good
Department of Old Age PsychiatryInstitute for the Health of the Elderly
particularly dangerous. This class of drugs induceParkinson-like side-effects, including rigidity,immobility, and an inability to perform tasks or tocommunicate. Studies have shown that whenprescribed for people with DLB they may causesudden death.
If a person with DLB must be prescribed a
neuroleptic it should be done with the utmost care,under constant supervision, and they should bemonitored regularly.
The following list includes the names of many of
the major neuroleptics available. New drugs areappearing from time to time. The generic name isgiven first, followed by some of the commonproprietary (drug company) names for thatparticular compound.
Chlorpromazine (Largactil)Clopenthixol (Clopixol)Haloperidol (Haldol, Serenace)Olanzapine (Zyprexa)PromazineQuetiapine (Seroquel)Risperidone (Risperdal)Sulpiride (Dolmatil, Sulparex, Sulpitil)Trifluoperazine (Stelazine)
Treatment At the moment there is no cure for DLB. Recent research suggests that the cholinesterase inhibitor drugs used to treat Alzheimer’s disease may also be useful in treating DLB, although they are not yet licensed for this use.
Symptoms such as hallucinations may resond to
being challenged, but it can sometimes be unhelpfulto try to convince the person that there is nothingthere. It is then better to try to provide reassuranceand alternative distractions.
People who are experiencing rigidity and stiffness
owing to parkinsonism may benefit from anti-Parkinson’s disease drugs although these can makehallucinations and confusion worse. Physiotherapyand mobility aids may also help.
important to be as flexible as possible, bearing inmind that the symptoms of DLB will fluctuate.
Alzheimer’s Society, Gordon House, 10 Greencoat Place, London SW1P 1PH. Telephone 020 7306 0606. Fax 020 7306 0808. Email [email protected]. Website www.alzheimers.org.uk. Registered charity no. 296645. A company limited by guarantee and registered in England no. 2115499
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