Lewy body dementia vs Alzheimer’s disease

Question: Which is more more challenging Lewy body dementia or Alzheimer’s disease.

Answer:  I don’t claim to be an expert in dementia and have very little experience of Alzheimer’s disease or any other type of dementia. However from what I have observed from other residents in the care home where Mum lived, and from what I have read and researched, I truly believe that dementia with Lewy bodies is the most challenging type of dementia to manage.

Why is dementia with Lewy bodies so challenging?

Dementia with Lewy bodies is unique because not only is cognition affected, which happens with other types of dementia, but movement and autonomic processes (key involuntary functions  such as breathing, heart rate, digestive processes and body temperature) are also affected.

In addition cognitive symptoms, such as hallucinations and problems with visual perception, appear early in the progression of the disease whereas with Alzheimer’s, for example, the same symptoms do not appear until later.

Because these very challenging symptoms occur in the earlier stages of the disease, the loss of independence happens much sooner, which has a significant impact on both the person living with dementia and their caregivers.

Also there are few approved drugs available for the treatment of dementia with Lewy bodies, there is only limited evidence about what treatments work and everyone responds differently. Another problem is that medication prescribed to improve cognition or hallucinations can make movement problems worse and vice/versa. Also people with dementia with Lewy bodies may have a severe reaction to antipsychotic drugs which are often used to treat hallucinations, a common feature of the disease.

I now truly believe that to be able to provide adequate care and support for someone with Lewy body dementia, you have to understand the disease. So this section of the website is dedicated to Lewy body dementia, to pass on everything I have learnt, often the hard way! It is also why I have written a book which includes, in more detail, our journey with Mum through her illness. The book includes all the key information I think you need to know if you are caring for someone with this dreadful disease.

Lewy body dementia vs Alzheimer’s disease

Alzheimer’s is the most common form of dementia and although Alzheimer’s and dementia with Lewy bodies have several similarities, there are also some clear differences between the two diseases, which I also wanted to highlight. The main differences are:

  • Memory loss tends to be a more prominent symptom in early Alzheimer’s disease than in dementia with Lewy bodies.
  • Movement symptoms are more likely to be an important cause of disability in early dementia with Lewy bodies, although Alzheimer’s can cause problems with walking, balance and getting around as the disease progresses to moderate and severe stages.
  • Hallucinations, delusions and misidentification of familiar people (see the section on Capgras syndrome in chapter 40) are significantly more frequent in early stage dementia with Lewy bodies than with Alzheimer’s.
  • Dementia with Lewy bodies patients experience more depression than do Alzheimer’s patients.
  • REM sleep behaviour disorder is more common in early dementia with Lewy bodies than in Alzheimer’s disease.
  • Disruption of the autonomic nervous system, causing a blood pressure drop on standing, dizziness, falls and urinary incontinence is much more common in early dementia with Lewy bodies than in Alzheimer’s disease.
  • Life expectancy is slightly shorter for dementia with Lewy bodies than for Alzheimer’s patients.