NEW ORLEANS—Two years after disease onset, patients with dementia with Lewy bodies (DLB) have a significantly worse quality of life than do patients with Alzheimer’s disease or Huntington’s disease, reported researchers at the 64th Annual Meeting of the American Academy of Neurology.

Lewy body dementia typically begins at age 50 or older, although sometimes younger people have it. LBD appears to affect slightly more men than women.

Like others with LBD, muscle weakness may affect his swallowing ability. This can lead to aspirating food or liquid, resulting in pneumonia, a common cause of death in advanced dementia. Even without problems with aspiration, he’d probably succumb to pneumonia or heart failure after months of being bedridden.

Symptoms of Lewy body dementia include:

• Changes in thinking and reasoning.
• Confusion and alertness that varies significantly from one time of day to another or from one day to the next.
• Slowness, gait imbalance and other parkinsonian movement features.
• Well-formed visual hallucinations.
• Delusions.

There are no tests that can definitively diagnose LBD. Currently, only a brain autopsy after death can confirm a suspected diagnosis. However, researchers are studying ways to diagnose LBD earlier and more accurately during life.

Alzheimer’s affects the brain’s ability to store new information in the form of memories, while Lewy body dementia targets a different set of cognitive functions – specifically problem-solving and reasoning. Hallucinations occur early in Lewy body dementia but only after about four years in Alzheimer’s disease.

Disease Progression Lewy body dementia does not progress the same way Alzheimer’s disease does. It does have characteristics that often can be categorized as likely to occur in the earlier stages and other symptoms that are likely to develop as it progresses.

The biggest difference between Parkinson’s disease dementia and dementia with Lewy bodies is the order of onset of the symptoms. Clinicians usually distinguish between these by asking which set of symptoms (body or brain) appeared first.