Provided by Parkinson's UK
Dementia with
Lewy bodies
Dementia with Lewy bodies is diagnosed when someone has the symptoms of dementia either before or at the same time as developing Parkinson’s-like problems with movement (called motor symptoms). But in some cases of dementia with Lewy bodies, no motor symptoms may develop at all.1
The name comes from the Lewy bodies – tiny protein deposits – that can be found in certain parts of the brain of people with the condition.
This information sheet looks at the symptoms and causes of dementia with Lewy bodies. It provides some practical advice on how life can be made easier for the person affected and their family, friends and carers.
What is dementia?
Dementia symptoms are caused by a significant loss of brain
function. There are different forms of the condition and each person will
experience dementia in a different way.2
Some people develop dementia after living with Parkinson’s
for some time. When someone has Parkinson’s motor symptoms for at least a year
before experiencing dementia, this is known as Parkinson’s dementia.3
Dementia with Lewy bodies is diagnosed when someone has the symptoms of
dementia either before or at the same time as developing Parkinson’s-like
problems with movement.
Find out more: see our information sheet Parkinson’s dementia.
What are the symptoms of dementia with Lewy bodies?
“Occasionally, my mum is very confused when I first arrive,
then improves and becomes more lucid by the end of a visit.” Barbara,
whose mum has dementia with Lewy bodies
Dementia with Lewy bodies affects a person’s, memory,
language, concentration and attention. It also affects their ability to
recognise faces, carry out simple actions and their ability to reason.
People with this form of dementia commonly experience visual
hallucinations, which can be quite vivid. This can happen early on in the
condition. They might also experience difficulty in judging distances and
movements, which can cause them to fall over for no apparent reason.1
The condition can also cause someone to experience episodes
of confusion, which can change a lot from hour to hour or over weeks or months.1
Some people may also develop Parkinson’s-type symptoms, such
as slowness of movement, stiffness and tremor. In some cases, a person’s heart
rate and blood pressure can also be affected.4
What causes dementia with Lewy bodies?
Lewy bodies are tiny protein deposits that develop inside
some nerve cells in the brain, causing these cells to die. The loss of these
cells causes dementia. It’s not yet understood why Lewy bodies occur in the
brain and how they cause this damage.
Dementia with Lewy bodies shares similarities with
Alzheimer’s and Parkinson’s. It’s progressive, so the symptoms will get worse
over time.2
Dementia is age related, so it’s rare that someone under the
age of 65 will develop dementia.
How is dementia with Lewy bodies diagnosed?
A specialist will diagnose dementia with Lewy bodies based
on the person’s symptoms, their medical history and the results of an
examination. There is no specific blood test for this condition, but tests on
memory and thinking will help confirm what the problem is. In some cases, a
specialist may request a brain scan to determine what kind of dementia a person
has.2
What can be done to help?
Medication
There isn’t a cure or specific treatment for dementia with
Lewy bodies at the moment, but there are medications that some people may find
effective.
Recent research suggests that some people may benefit from
dementia medications called cholinesterase inhibitors.5 But it’s
important to note that not all cholinesterase inhibitors are licensed for use
in the UK.6
Some people may respond well to Parkinson’s medication,
especially if they have Parkinson’s-type symptoms like stiffness or rigidity.
However, some side effects of these drugs can make the symptoms of dementia
worse, especially confusion.7
Since hallucinations and delusions may often be associated
with this condition, some doctors may recommend the use of antipsychotic (also
known as ‘neuroleptic’) medications. In general, these medications should be
avoided, because they may make problems with movement worse.8 But in
some cases, if behavioural symptoms are becoming especially problematic, very
low doses of these medications may have to be used. If this medication is
prescribed, the healthcare professionals in charge of a person’s care should
monitor the situation carefully.5
If you have any questions about medication, speak to your
GP, specialist or Parkinson’s nurse (if you have one) for more advice and information.
Support from professionals
Using medication to treat dementia can be helpful. But it’s
also useful for people to get treatment from a wide range of healthcare
professionals, such as physiotherapists, occupational therapists, dietitians
and speech and language therapists. They can help the person with dementia and
those supporting them.
You can be referred to these health professionals through
your GP, specialist or Parkinson’s nurse. In some areas, you may be able to
refer yourself at your local hospital or community health clinic.
Legal matters
If you have been diagnosed with early stage dementia, you
may want to make some important decisions about things like your finances or
Will, and what sort of health and social care you’d like in the future. You may
also want to choose someone you trust to handle your affairs. You may want to
make a legal agreement, such as a Lasting Power of Attorney.
For more information and advice, you can contact the Office
of the Public Guardian (England and Wales), the Office of Care and Protection
(Northern Ireland) or the Office of the Public Guardian (Scotland). Contact
details are listed at the end of this information sheet.
Find out more: Parkinson’s UK has information available that can help you think about and put plans in place for the future. See our booklet Preparing for end of life: a practical guide
Caring for someone with
dementia
“My wife’s clarity of mind can vary drastically. But when
she has a good spell, these times are of great value to me.” David, a carer
If someone becomes less able because of their dementia, it
might be necessary for their family or friends to start helping with things
such as shopping, housework or cooking. If this is the case, the person with
dementia may be able to apply for Attendance Allowance or Disability Living
Allowance, which will help provide some financial support.
Find out more: see our information sheets Attendance Allowance and Disability Living Allowance.
If you are in a position where you are dedicating a lot of
time caring for a loved one, you may be able to claim Carer’s Allowance.
Find out more: see our information sheet Carer’s Allowance and our booklet The Carer’s guide.
Accessing local support services
It might be useful to consider support services such as day
care, respite and home care. If you’re caring for someone with dementia, these
services can give you a chance to have time to yourself.
Parkinson’s UK information and support workers can help you
access local support services. Go to parkinsons.org.uk/isw
or contact the helpline for more details about information and support workers
in your area.
Local groups
Parkinson’s UK has local groups that can offer invaluable
support to anyone affected by Parkinson’s and dementia. Go to parkinsons.org.uk/localgroups or
contact the helpline for more details.
The Alzheimer’s Society has local branches that offer
support to everyone affected by dementia. These groups often provide various
activities for people with dementia and also run carers’ groups, which can help
you meet other people in similar circumstances. See the more information and
support section for contact details.
Practical advice
If you are caring for someone with dementia, there are some
practical things you can do that can help reduce their agitation or confusion
and make life a bit easier:
- Keep to a daily routine as much as you can to help them remember when certain things like meal times will happen.
- Try to use familiar objects and phrases.
- Avoid unfamiliar environments – these can be quite stressful.
- Encourage someone with dementia to keep engaging and interacting with people. Hobbies are also a great way to keep memory and thinking as active as possible.
Helping with communication
The following information has been provided by the
Alzheimer’s Society.9 You can find this and more helpful advice on
the Alzheimer’s Society website. Visit www.alzheimers.org.uk
Difficulties with communication can be upsetting and frustrating
for the person with dementia and for those around them. But there are some
basic things you can do to make life a little bit easier.
- Listen carefully to what a person with dementia says.
- Make sure you have their full attention before you speak.
- Pay attention to body language.
- Speak clearly.
- Consider whether any other factors are affecting their communication.
- Use physical contact to reassure the person.
- Show respect and keep in mind they have the same feelings and needs as they had before developing dementia.
Listening skills
- Try to listen carefully to what they are saying, and give them plenty of encouragement.
- If a person with dementia has difficulty finding the right word or finishing a sentence, ask them to explain in a different way. Listen out for clues.
- If you find their speech hard to understand, use what you know about them to interpret what they might be trying to say. But always check back with them to see if you are right − it's infuriating to have your sentence finished incorrectly by someone else.
- If someone is feeling sad, let them express their feelings without trying to 'jolly them along'. Sometimes the best thing to do is to just listen, and show that you care.
Attracting the person's attention
- Try to catch and hold their attention before you start to communicate.
- Make sure they can see you clearly.
- Make eye contact. This will help them focus on you.
- Try to minimise competing noises, such as the radio, TV, or other people's conversation.
Using body language
- Someone with dementia will read your body language. Agitated movements or a tense facial expression may upset them, and can make communication more difficult.
- Be calm and still while you communicate. This shows them that you are giving them your full attention, and that you have time for them.
- Never stand over someone to communicate – it can feel intimidating. Instead, drop below their eye level. This will help them feel more in control of the situation.
- Standing too close to someone can also feel intimidating, so always respect their personal space.
- If someone is struggling to speak, pick up cues from their body language. The expression on their face, and the way they hold themselves and move about, can give you clear signals about how they are feeling.
Speaking clearly
- As the dementia progresses, people will become less able to start a conversation, so you may have to start taking the initiative.
- Speak clearly and calmly. Avoid speaking sharply or raising your voice, as this may distress them even if they can't follow the sense of your words.
- Use simple, short sentences.
- Processing information will take someone longer than it used to, so allow enough time. If you try to hurry them, they may feel pressured.
- People with dementia can become frustrated if they can't find the answer to questions, and they may respond with irritation or even aggression. If you have to, ask questions one at a time, and phrase them in a way that allows for a 'yes' or 'no' answer.
- Try not to ask the person to make complicated decisions. Too many choices can be confusing and frustrating.
- If the person doesn't understand what you are saying, try getting the message across in a different way rather than simply repeating the same thing.
- Humour can help to bring you closer together, and is a great pressure valve. Try to laugh together about misunderstandings and mistakes − it can help.
Whose reality?
- As dementia progresses, fact and fantasy can become confused. If someone says something you know isn't true, try to find ways around the situation rather than responding with a flat contradiction.
- Always avoid making the person with dementia feel foolish in front of other people.
Physical contact
- Even when conversation becomes more difficult, being warm or affectionate can help carers to remain close to their loved ones, or for the person with dementia to feel supported.
- Communicate your care and affection by the tone of your voice and the touch of your hand.
- Don't underestimate the reassurance you can give by holding or patting their hand or putting your arm around them, if it feels right.
Show respect
- Make sure no one speaks down to the person with dementia or treats them like a child, even if they don't seem to understand what people say. No one likes being patronised.
- Try to include a person with dementia in conversations with others. You may find this easier if you adapt the way you say things slightly. Being included in social groups can help a person with dementia to keep their sense of identity. It also helps to protect them from feeling excluded or isolated.
- If you are getting little response from someone with dementia, it can be very tempting to speak about them as if they weren't there. But disregarding them in this way can make them feel very cut off, frustrated and sad.
Other causes of communication difficulty
It is important to bear in mind that communication can be
affected by other factors in addition to dementia − for example:
- pain, discomfort, illness or the side-effects of medication. If you suspect this might be happening, talk to the person's GP at once
- problems with sight, hearing or ill-fitting dentures. Make sure the person's glasses are the correct prescription, that their hearing aids are working properly, and that their dentures fit well and are comfortable.
- Parkinson’s symptoms can cause difficulties with communication.
Find out more: see our information sheet Communication.
More information and support
Parkinson’s nurses
Parkinson’s nurses provide expert advice and support to
people with Parkinson’s and those who care for them. They can also act as a
liaison between other health and social care professionals to make sure your
needs are met.
Parkinson’s nurses may not be available in every area, but
your GP or specialist can give you more details on local services.
Information and support workers
Our information and support workers can also provide details and
links to local services. They provide support for anyone affected by
Parkinson’s.
For details of the local information and support worker in
your area, contact our helpline on 0808
800 0303 or email hello@parkinsons.org.uk. You can
also find out more on our website at parkinsons.org.uk/isw
Our helpline
Contact our free confidential helpline for general advice
and information. Call 0808 800 0303
(calls are free from UK landlines and most mobile networks) or email hello@parkinsons.org.uk
Local groups
Support is available through Parkinson’s UK local groups.
Visit parkinsons.org.uk/localtoyou
or call our helpline for details of your nearest meeting.
Online forum
Speak to others in a similar situation through our online
discussion forum at parkinsons.org.uk/forum
The Alzheimer’s Society
can provide information, advice and support for people with dementia and their families.
020 7423 3500
enquiries@alzheimers.org.uk
www.alzheimers.org.uk
can provide information, advice and support for people with dementia and their families.
020 7423 3500
enquiries@alzheimers.org.uk
www.alzheimers.org.uk
Alzheimer Scotland
www.alzscot.org
Office of the Public Guardian (England and Wales)
0300 456 0300
customerservices@publicguardian.gsi.gov.uk
customerservices@publicguardian.gsi.gov.uk
www.direct.gov.uk/mentalcapacity
Office of Care and Protection (Northern Ireland)
officeofcare&protection@courtsni.gov.uk
www.courtsni.gov.uk