Lewy Body Dementia Signs: Key Symptoms you Need to Know

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There are many Lewy Body Dementia signs. But first, let’s look at what Lewy Body Dementia (LBD) is and then dive deep into the signs and symptoms.

Lewy Body Dementia signs
Lewy Body Dementia signs include changes in behavior, movement, and thinking.

Lewy Body Dementia is a type of progressive dementia that leads to a decline in thinking, reasoning, and independent function. The disease is caused by the build-up of Lewy bodies in the brain. These Lewy bodies are made up of a protein that is found in nerve cells. The protein helps to regulate neurotransmitters, which are chemicals that transmit messages between nerve cells. When there are too many Lewy bodies in the brain, it causes problems with neurotransmitter regulation and leads to changes in thinking, behavior, and movement.

The most common signs of Lewy Body Dementia include: changes in mood and behavior, problems with memory and thinking, hallucinations, delusions, and Parkinson’s disease-like symptoms such as tremors and stiffness. Lewy Body Dementia can also cause sleep disruptions, fatigue, and anxiety. We’ll take a look at the signs and provide some real-life examples in this post.

Hallucinations are Big Lewy Body Dementia Signs

Lewy Body Dementia signs
A key Lewy Body Dementia sign is hallucinations, often of animals.

Lewy Body Dementia is one of the most common types of degenerative dementias, and hallucinations are one of its most distinguishing symptoms. Lewy Body Dementia typically affects older adults, but unlike other types of degenerative dementias, its symptoms can start appearing early in the disease process. Hallucinations associated with Lewy Body Dementia are often vivid and lifelike and can take many different forms.

People may see animals, children, or bugs that aren’t really there, or they may experience visual or auditory hallucinations. Some people may even hallucinate the presence of a loved one who has died. Hallucinations can come in the form of olfactory (smell), tactile (touch), or auditory (sound).

My loved one with LBD started hallucinations early in the disease. He saw a mouse in the corner counting money. He would see his brother-in-law who passed away, gypsies, and small flying insects. These hallucinations tapered off for some time and then became more prevalent until he started taking Nuplazid that almost completely stopped them.


The National Institute on Aging states that up to 80% of people with Lewy Body Dementia have hallucinations.

Delusions in LBD are Frequent Lewy Body Dementia Signs

Delusions are prevalent with LBD. These are false beliefs that are not based on reality. One common delusion associated with Lewy Body Dementia is the belief that a spouse is cheating. This can be a result of paranoia or suspiciousness and can cause stress and conflict in relationships. Other delusions may include believing they still have a job when they have been retired for some time, or that people who have died are still alive.

A person with delusions of guilt may believe they have committed a crime, such as murder or theft, when this is not true. They may feel guilty for events that have not occurred.

Capgras Syndrome

Capgras syndrome and Lewy Body Dementia
Capgras syndrome is a condition that causes a person to believe that someone has been replaced by an impostor.

Capgras syndrome is a condition that causes a person to believe that someone has been replaced by an impostor. The syndrome is named after Joseph Capgras, the French psychiatrist who first described the condition in 1923.

People with Capgras syndrome usually have a delusional belief that identical or near-identical impostors have replaced one or more people close to them. The impostors are often perceived as being mechanical robots or aliens. They are not limited to people and may also be about pets or even their homes. The syndrome is most commonly associated with brain damage, schizophrenia, and dementia.

Body and Muscle Stiffness as Lewy Body Dementia Signs

Body and muscle stiffness and rigidity are common symptoms of Lewy Body Dementia. The stiffness is often most noticeable in the morning, after lying down or resting for a period of time. It may improve with activity but can worsen as the day goes on.

The stiffness can cause problems with mobility and make it difficult to perform everyday activities. In some cases, the stiffness may be severe enough to cause falls or other injuries. Treatment for the stiffness is typically focused on relieving symptoms and improving quality of life. Physical therapy and exercise can also greatly help.

Stiffness was one of the first symptoms we noticed in my loved one with Lewy Body Dementia. He noticed that he could not reach his arms behind his head. We didn’t think much of it until we mentioned it to his neurologist and he included it as another sign of LBD.


Leaning — The Lewy Lean

Leaning while sitting or standing is very common. It is even nicknamed sometimes as the “Lewy Lean”. The Lewy Lean is a type of imbalance that can cause people with LBD to fall or feel off-balance. It is caused by damage to the parts of the brain that control balance and movement. The Lewy Lean can be mild or severe, and it can get worse over time.

When sitting they have a prominent lean to one side, typically the left side but not always. When standing they may lean to the side and be hunched over. This makes it particularly harder to walk and have a proper gait.

Swallowing Problems

Swallowing may become difficult for those with Lewy Body Dementia. This is because the muscles used for swallowing can be affected by the disease. When this happens, food and liquids can end up going into the lungs instead of the stomach. This can lead to pneumonia and other health problems.

There are ways to help make swallowing easier for those with Lewy Body Dementia. Options include thickening liquids, eating softer foods, and sitting upright when eating. Swallowing difficulties can be a serious issue for those with Lewy Body Dementia and it is important to talk to a doctor about any concerns. A swallow study may be performed to see if they are swallowing properly. There are also exercises that can be done to help. A speech therapist can prescribe these exercises.

Issues with Memory

As people age, they may experience more memory problems. But this is especially true for those with Lewy Body Dementia. While memory problems are common symptoms, not all memories are affected equally. Long-term memories are often better than short-term memories. Unlike Alzheimer’s disease, memory problems might not start at the beginning.

This can be frustrating for caregivers and loved ones, as it can be difficult to engage in conversation about recent past events. One approach to encourage conversation is to ask open-ended questions that encourage storytelling, such as “What was your favorite childhood memory?” or “Tell me about a time when you felt really proud.” Another strategy is to focus on activities that stimulate the senses, such as listening to music from the era in which the person with LBD grew up or looking at old photos together.

Cognitive Impairment

Cognitive impairment is an important part of the clinical picture of Lewy Body Dementia. This can include memory loss, difficulty thinking and concentrating, and problems with language. People with LBD often have difficulty remembering things, making decisions, and controlling their emotions.

Bradykinesia or Slowness of Movement – Lewy Body Dementia Signs

Bradykinesia refers to a slowness of movement. This can manifest as a progressive hesitation or halting of movements as they are continued. Bradykinesia is a common symptom of Parkinson’s disease, and can also be seen in Lewy Body Dementia. Physical therapy and medications can help reduce the symptoms of bradykinesia and help patients maintain their independence.

Not Remembering Words

One of the many symptoms of Lewy Body Dementia is difficulty remembering words. This can make it hard to have a conversation or follow a train of thought. The memory loss can be mild at first, but it can get worse over time.

There are some things you can do to help manage this symptom. First, try to keep a list of the common words they forget. Have this by them so it helps them remember words later. You can also try speaking more slowly and using simpler words.

This was also one of the first issues we noticed before the diagnosis. We had just moved into a new house and were making frequent trips to Home Depot. He could never remember the name of the store. He would often say Best Buy but knew that was wrong.


Gait Problems

Gait problems are a common symptom of LBD and can be one of the first signs that something is wrong. They might shuffle their feet, move slow or even freeze, which is prevalent in Parkinson’s Disease. Using a walker can help. Canes are often difficult to use because it can be a problem synchronizing steps with the cane.

Paranoia and Mistrust

People with Lewy Body Dementia often become paranoid. A person with Lewy Body Dementia may become paranoid for a variety of reasons. One common reason is that the person is experiencing hallucinations. When a person with LBD experiences a hallucination, they may see or hear things that are not actually there. This can be very confusing and frightening and may lead to paranoia.

Another reason why a person with LBD may become paranoid is because of their declining cognitive abilities. As the disease progresses, people with LBD often have trouble processing information correctly. This can lead to them misunderstanding what others are saying or doing and mistrusting those around them. Lastly, people with LBD may become paranoid due to the changes in their brain chemistry that the disease causes.

Sleeping Problems with Lewy Body Dementia

Sleep disruptions are common in LBD, and can include trouble falling asleep, waking up frequently during the night, and daytime drowsiness. These disruptions can lead to further problems with thinking and memory, as well as increased anxiety and depression. As LBD progresses sometimes people will sleep for long hours of the day. They might sleep for 20 hours or so a day.

There are a few things that can be done to help manage sleep problems in LBD. Creating a regular sleep schedule and avoiding caffeine and alcohol before bedtime can help promote better sleep. Establishing a relaxing bedtime routine can also be helpful. If sleep disruptions persist, talk to your doctor about possible medications or other treatments.

Flat Affect or Face is one of the Lewy Body Dementia Signs

People with Lewy Body Dementia can sometimes exhibit a “flat face” or affect. This means that their faces show little emotion. They have lessened expressions and displays of emotion. They may also speak in a more monotone way.

I never noticed this in my husband, but the doctors did. Two of his neurologists mentioned at the very beginning, before his diagnosis, that he had a “flat face”.



Depression is a common symptom of LBD, affecting up to 80 percent of people with the disease. People may experience changes in mood and personality, including depression.

It is characterized by feelings of sadness, emptiness, or hopelessness. They may also lose interest in activities they once enjoyed, and feel fatigued or irritable. Depression can make it difficult to perform daily activities and can interfere with relationships.

Balance Problems

Someone with Lewy Body Dementia may have trouble with their balance. This can make it hard to walk and do other activities. Balance problems happen because LBD affects the parts of the brain that control movement.

There are several things you can do to help with balance problems:

  • Get regular exercise. This can help improve your balance and strength.
  • Do balance exercises. These exercises help train your brain to control your body better.
  • Use a cane or walker. This can help you stay steady on your feet.
  • Talk to your doctor about medicine. There are some medicines that can help withbalance problems in people with LBD.

Excessive Drooling and LBD

A common symptom of Lewy Body Dementia is excessive drooling. This can be a result of the disease affecting the muscles in the mouth and throat, or it may be due to problems with swallowing. Either way, it can be a very distressing symptom for both the person with the disease and their caregivers.

There are a few things that can be done to help manage excessive drooling. First, try to keep the person’s mouth as clean as possible. This may mean using a cloth or sponge to wipe away any saliva buildup. Second, provide plenty of fluids throughout the day to keep the mouth moist. Third, talk to your doctor about medications that may help reduce saliva production or make swallowing easier.

Excessive drooling can be a very frustrating symptom of Lewy Body Dementia, but there are ways to manage it.

In conclusion:

In conclusion, there are many Lewy Body Dementia signs that may be present in an individual. It is important to be aware of these signs so that proper diagnosis and treatment can be administered. If you or someone you know is displaying any of these symptoms, please consult a medical professional.

Elizabeth Crane

Elizabeth Crane grew up not wearing a helmet, drinking from the hose and not wearing a seat belt. She managed to survive and now spends her time developing websites, drinking coffee, and eating chocolate.