Comprehensive Evaluation and Management

Dementia with Lewy bodies (DLB) is a cognitive disorder that causes a progressive decline in your ability to think and process information. Named after the scientist who discovered them, Lewy bodies are abnormal proteins that accumulate inside your brain cells and damage the areas of your brain that affect memory, movement, behavior and mental capabilities.

There are two types of DLB:

  • Dementia with Lewy bodies initially affects your memory and your ability to think and reason and reduces your ability to move as your condition worsens.
  • Parkinson’s disease dementia starts as a movement disorder and causes slowed movement and muscle tremors. It increasingly affects your cognitive abilities over time.

The multidisciplinary team of neurology experts at Penn State Health Milton S. Hershey Medical Center has advanced expertise diagnosing and treating cognitive disorders like dementia with Lewy bodies.

We understand the far-reaching impact a cognitive disorder has on every aspect of your life. We work together with you, your family and your caregivers to offer a wide range of patient-centered services that help you manage the physical, mental and emotional challenges that accompany a diagnosis of DLB.

Symptoms and Diagnosis

Dementia with Lewy Bodies Symptoms

The symptoms of DLB start slowly and worsen over time. They may resemble the signs of Alzheimer’s disease or Parkinson’s disease.

Symptoms vary for each person and may include:

  • Difficulty processing information and planning
  • Loss of memory
  • Tremors, trouble walking and other movement issues
  • Hallucinations and delusions with no basis in reality
  • Sleep disorders, including acting out dreams
  • Visual and spatial problems with decreased depth perception
  • Anxiety or paranoia
  • Varying levels of confusion and alertness that change throughout the day or from one day to the next

Diagnosing Dementia with Lewy Bodies

DLB requires a clinical diagnosis, which means it represents your doctor’s best judgment after careful evaluation of your symptoms and medical history.

The process starts with a comprehensive physical exam and detailed review of your medical history. You may require additional testing to rule out any underlying medical conditions that could be responsible for your symptoms and evaluate your mental and physical health.

Testing may include:

  • Bloodwork: helps identify underlying medical causes of cognitive impairment
  • Brain MRI: rules out reversible causes of cognitive impairment
  • Sleep study: evaluates for REM sleep behavior disorder
  • DaTSCAN: identifies dopamine dysfunction, which indicates DLB is present


There is currently no cure for DLB. There are no known therapies that stop the progressive decline of your ability to remember, process and communicate information. Most people diagnosed with DLB require increasing assistance with daily activities as their disease advances.

The typical life expectancy with DLB is about eight years. However, some people live an additional 20 years or more after diagnosis.

There is no known treatment that prevents or stops the progression of DLB. Treatment focuses on symptom management and maintaining your independence and quality of life as long as possible.

Treatment options include:

  • Medication: prescription drugs like cholinesterase inhibitors encourage brain cell communication and may reduce agitation and depression.
  • Treating associated conditions: treatment of REM sleep behavior disorder and other conditions that may accompany DLB.
  • Social work assistance: helps identify and secure needed services that provide care and support for you and your caregivers.  
  • Personal safety assessment: addresses safety issues like the ability to drive, swallow or live independently as your disease progresses.

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