What Are the Seven Stages of Lewy Body Dementia?

Medically Reviewed on 7/7/2022
There are seven stages of Lewy body dementia.
There are seven stages of Lewy body dementia.

Lewy body dementia (LBD) or dementia with Lewy bodies (DLB) is associated with protein deposits in the brain that cause disruptions in the normal functioning of the brain. Diagnosing the disease is extremely tough because its symptoms may resemble other brain diseases. DLB often starts with difficulty moving your body. Within a year, patients may start to have thinking and memory problems that are similar to those in Alzheimer’s disease along with changes in behavior and hallucinations. The seven stages of LBD are as follows

  • Stage one: Absolutely normal stage
    • No symptoms. Patients are absolutely normal
    • Magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain might show incidental findings during routine examinations
    • Daytime sleeping with hallucinations and mood fluctuations are noticed in some patients
  • Stage two: Very mild symptoms
    • Difficult or impossible to notice these minor symptoms
    • Mild forgetfulness (forgetting names or having trouble locating familiar objects)
    • Patients may be able to continue with their daily work and daily activities
  • Stage three: Symptoms are still mild and may include
  • Stage four: Patients may usually have a confirmed diagnosis at this stage. Symptoms are moderate and they include
    • Choking, difficulty swallowing, aspiration, and excessive drooling are the most common symptoms
    • Patients often experience tremors and difficulty speaking
    • Life-disrupting forgetfulness
    • Difficulty performing daily responsibilities
    • High risk of falls
    • Require continuous supervision
    • Increased daytime sleeping, but with fewer hallucinations
    • High risk for potential health problems
  • Stage five: Symptoms are usually moderately severe
    • Significant memory loss and may usually struggle with daily activities
    • Significant confusion, disorientation and may no longer be able to live alone
    • Fever is common and patients are at a high risk of infections and skin diseases
    • Almost 24-hour supervision may be required
    • Cannot perform simple tasks
    • Constant delusions and patients may also become increasingly paranoid and confused more often
    • Require assistance with eating and self-care
  • Stage six: This usually lasts for 2.5 years. Severity in symptoms is mostly increased
    • Urine and bowel incontinence are the most common in this stage
    • Patients usually lose their ability to speak
    • Patients may only be able to recover memories from early life
    • Require a high level of support to live comfortably
    • Worsened memory loss, difficulty recognizing family members, and some personality changes
  • Stage seven: Very severe symptoms. Stage seven typically lasts for 1.5 to 2.5 years
    • In this final stage, communication is limited and physical systems may also decline
    • Patients are unable to walk and individuals in late-stage dementia require extensive assistance with life’s activities and often need round-the-clock support

How to treat Lewy body dementia (LBD)

There aren’t any drugs that may stop or reverse Lewy body dementia (LBD) and research is still ongoing. Medications to relieve symptoms include:

  • Acetylcholinesterase inhibitors: These work by increasing the levels of a chemical called acetylcholine in the brain, which improves the ability of the brain cells to send signals to each other
  • Memantine: This works by blocking the effects of a large amount of a chemical in the brain called glutamate. It's suitable for those who cannot take acetylcholinesterase inhibitors
    • Memantine is used for moderate or severe dementia with Lewy bodies (DLB). 
    • Side effects can include headaches, dizziness, and constipation, but these are usually only temporary.
  • Other drugs:
    • Dopar and Laradopa (levodopa) may improve movement problems or rigid limbs.
    • Melatonin or Klonopin (clonazepam) may ease sleep problems.
    • Antipsychotics such as haloperidol may help with behavior changes, but they can cause serious side effects and should be monitored and avoided whenever possible.
    • Antidepressants are usually prescribed for mood fluctuations.
  • Therapies:
    • Occupational therapy, speech therapy, physiotherapy, swallowing therapy, psychological therapies, and relaxation techniques with increased social interaction may help patients.

Is Lewy body dementia a fatal disease?

  • Lewy body dementia (LBD) is usually a progressive fatal disease.
  • It gets worse over time and that shortens lifespan.
  • The average lifespan after diagnosis is between 8 and 12 years.
  • However, this is highly variable, and some people may live much longer than this with proper care and symptomatic treatment.


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10 Early signs and symptoms of dementia

The list of the 10 early signs and symptoms of dementia
There are 10 early signs and symptoms of dementia including memory loss, problem-solving, inability to finish tasks, and more.

Dementia is not a single disease; it is a broad term given to a disease complex consisting of loss of thinking, remembering, and reasoning that can be seen as one of the striking features in various neurological disorders. Alzheimer’s is the most common cause of dementia in the elderly. 

Below is a list of the 10 early signs and symptoms of dementia that are most commonly seen in Alzheimer’s disease:

  1. Memory loss: Recalling even recently learned information is difficult; relying on others to recollect the information becomes routine.
  2. Challenges in planning or solving problems: The ability to concentrate is lost; even simple things such as following a cooking recipe or making simple calculations in household bills become difficult.
  3. Inability to finish familiar tasks: Familiar tasks such as driving to a familiar location and preparing a grocery list becomes difficult.
  4. Disorientation (confusion) with time or place: It becomes hard to figure out the day, time of the day, and current location.
  5. Misjudgment of visual images and distance: Reading becomes hard because of the inability to see the words in their order; driving becomes difficult because of the inability to judge the distance between two vehicles or between the vehicle and sides of the road.
  6. Problems with communication: People with dementia may fail to communicate what they want to say exactly because of trouble with words. They may not remember the names of simple objects such as “stick” and call them with other names or related terms. Conversing with people becomes difficult for them.
  7. Frequently misplacing things: People with dementia may keep things from their original place to some other place where they usually do not keep them. Later, they forget where they have kept their things.
  8. Problems with decision-making: There may be problems in taking quick decisions or good decisions in certain matters.
  9. Isolating from work or social activities: People with dementia may start withdrawing from their household and social obligations. They begin to stay aloof by avoiding social gatherings.
  10. Mood and personality changes: People with dementia who were calm and composed earlier might start losing their patience and get irritated even by petty things. They may look confused, anxious, and depressed most of the time.

What causes dementia?

Dementia is caused by damage to the brain cells in specific regions of the brain that deal with a person’s ability to remember and think. This damage is referred to as neurodegenerative changes and can be caused by any of the diseases that include:

Dementia caused by neurodegenerative changes in the brain is permanent and worsens over time. However, dementia caused by some problems other than neurodegenerative diseases is temporary and is treatable. These problems include: 

How is dementia diagnosed?

Doctors diagnose neurodegenerative diseases that cause dementia by ruling out other easily treatable causes. For example, if dementia is due to a vitamin deficiency, vitamin supplements can correct it; thyroid problems can be corrected with hormone treatments or surgery. 

Tests that are used for diagnosing dementia with its causative disease include:

  • Neuropsychological examination
  • Psychiatric examination
  • Blood tests
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan 
  • Genetic tests

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Medically Reviewed on 7/7/2022
Medscape Medical Reference


Dementia Aide

Dementia. Available at: https://emedicine.medscape.com/article/2003174-overview

10 Early Signs and Symptoms of Alzheimer's. Available at: https://www.alz.org/alzheimers-dementia/10_signs