Materiały źródłowe

• #1 Treatment Options – Lewy Body Dementia Association

  https://www.lbda.org/treatment-options/

  LBD is a multi-system disease and typically requires a comprehensive treatment approach, meaning a team of physicians from different specialties, who collaborate to provide optimum treatment of each symptom without worsening other LBD symptoms. A comprehensive treatment plan may involve medications, physical, occupational, speech or other types of therapy, and counseling. […] There are many treatments that can help with the symptoms; all medications prescribed for LBD are approved by the Food and Drug Administration to treat symptoms in other diseases, like Alzheimers disease and Parkinsons disease. These medications can offer symptomatic benefits for cognitive, movement, sleep, mood and behavioral changes in LBD. There are not yet any medications that slow or stop the progression of LBD.

• #1 Treatment Options – Lewy Body Dementia Association

  https://www.lbda.org/treatment-options/

  Medications called cholinesterase inhibitors are considered the standard treatment for cognitive symptoms in LBD. […] Movement symptoms may be treated with a Parkinsons medication called carbidopa/levodopa (Sinemet), but if the symptoms are mild, it may be best to not treat them in order to avoid potential medication side effects. […] Cholinesterase inhibitors are sometimes effective in treating hallucinations and other psychiatric symptoms of LBD. In addition, newer atypical antipsychotic medications may be tried. Most LBD experts prefer quetiapine or clozapine when treatment is necessary for safety or quality of life concerns. […] RBD can be quite responsive to treatment, so your physician may recommend a medication like melatonin and/or clonazepam. […] Other types of treatments include lifestyle interventions, physical therapy, speech therapy, occupational therapy, music and aromatherapy, individual and family psychotherapy, and support groups.

• #2 Lewy body dementia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lewy-body-dementia/diagnosis-treatment/drc-20352030

  There’s no cure for Lewy body dementia, but many of the symptoms can improve with targeted treatments. […] Cholinesterase inhibitors. These Alzheimer’s disease medicines work by increasing the levels of chemical messengers in the brain, known as neurotransmitters. These chemical messengers are believed to be important for memory, thought and judgment. They include rivastigmine (Exelon), donepezil (Aricept, Adlarity) and galantamine (Razadyne ER). The medicines may help improve alertness and thinking. They also may reduce hallucinations and other behavioral symptoms. […] In some people with moderate or severe dementia, an N-methyl-d-aspartate (NMDA) receptor antagonist called memantine (Namenda) might be added to the cholinesterase inhibitor. […] Parkinson’s disease medicines. Medicines such as carbidopa-levodopa (Sinemet, Duopa, others) can help reduce rigid muscles and slow movement. However, these medicines also can increase confusion, hallucinations and delusions.

• #2 Lewy body dementia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lewy-body-dementia/diagnosis-treatment/drc-20352030

  Antipsychotic medicines can cause severe confusion, severe parkinsonism, sedation and sometimes death. Very rarely, certain second-generation antipsychotics, such as quetiapine (Seroquel) or clozapine (Clozaril, Versacloz) might be prescribed for a short time at a low dose. But they’re offered only if the benefits outweigh the risks. […] Antipsychotic medicines can worsen Lewy body dementia symptoms. It might be helpful to first try other approaches, such as: […] Tolerating the behavior. Some people with Lewy body dementia aren’t distressed by the hallucinations. If this is true, the side effects of the medicine might be worse than the hallucinations themselves. […] Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to function. Caregivers’ responses sometimes worsen behavior. Avoid correcting and quizzing a person with dementia. Offer reassurance and validation of his or her concerns. […] Creating daily routines and keeping tasks simple. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day can be less confusing.

• #3 Lewy Body Dementia (LBD): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17815-lewy-body-dementia

  Lewy body dementia is a progressive disease, meaning symptoms start slowly and get worse over time. […] Theres no cure for LBD, but the symptoms can be managed with certain medications. You or your loved one may also benefit from nonmedical treatments like physical therapy and speech therapy. […] Theres no cure for Lewy body dementia (LBD). Medications and nonmedical therapies, like physical, occupational and speech therapies, manage symptoms as much as possible. […] Medications that can help manage the symptoms of LBD include: Cholinesterase inhibitors: This type of medication, which includes rivastigmine, galantamine and donepezil, helps manage the cognitive symptoms of LBD. […] People with LBD can take part in different therapies to improve their quality of life, including: Physiotherapy. Occupational therapy. Speech therapy. Support groups. Individual and family psychotherapies (talk therapies). Exercise. […] In advanced cases of Lewy body dementia, palliative care care that provides symptom relief, comfort and support to people living with serious illnesses may be more appropriate than highly aggressive medical interventions or hospital care.

• #4 How Is Lewy Body Dementia Treated and Managed? | National Institute on Aging

  https://www.nia.nih.gov/health/lewy-body-dementia/how-lewy-body-dementia-treated-and-managed

  Lewy body dementia (LBD) is a common form of dementia that can lead to problems with thinking, movement, behavior, and mood. While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. A comprehensive treatment plan may involve medications, physical and other types of therapy, and counseling. Changes to make the home safer, equipment to make everyday tasks easier, and social support are also important. […] People with LBD may benefit from physical therapy and exercise. Talk with your doctor about what physical activities are best. A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers. […] A comprehensive treatment plan may involve medications, physical and other types of therapy, and counseling.

• #4 How Is Lewy Body Dementia Treated and Managed? | National Institute on Aging

  https://www.nia.nih.gov/health/lewy-body-dementia/how-lewy-body-dementia-treated-and-managed

  Some medications used to treat Alzheimers disease also may be used to treat the cognitive symptoms of LBD. These drugs, called cholinesterase inhibitors, act on a chemical in the brain that is important for memory and thinking. They may also improve behavioral symptoms. […] LBD-related movement symptoms may be treated with a Parkinsons disease medication called levodopa. This drug can help improve functioning by making it easier for the person to walk, get out of bed, and move around. […] A physician can order a sleep study to identify underlying sleep disorders such as sleep apnea, restless leg syndrome, or REM sleep behavior disorder. […] Clonazepam, a drug used to control seizures and relieve panic attacks, is often effective for REM sleep behavior disorder at very low dosages. […] Behavioral and mood changes in people with LBD can arise from hallucinations or delusions, pain, illness, stress or anxiety, feeling overwhelmed, or an inability to express frustration and fear.

• #4 How Is Lewy Body Dementia Treated and Managed? | National Institute on Aging

  https://www.nia.nih.gov/health/lewy-body-dementia/how-lewy-body-dementia-treated-and-managed

  Antidepressants can be used to treat depression and anxiety, which are common in LBD. Two types of antidepressants, called selective serotonin reuptake inhibitors and norepinephrine reuptake inhibitors, often work well in people with LBD. […] Cholinesterase inhibitors may reduce hallucinations and other psychiatric symptoms of LBD. […] In some cases, antipsychotic medications, which are used to treat hallucinations, delusions, or agitation, are prescribed to treat LBD-related behavioral symptoms. […] If antipsychotics are prescribed, it is very important to use the newer kind, called atypical antipsychotics. […] People with LBD may have severe reactions to or side effects from antipsychotic medications. […] In addition to typical antipsychotics, other antipsychotics, including olanzapine and risperidone, should be avoided, if possible, because they are more likely than others to cause serious side effects. […] Simple measures such as leg elevation, elastic stockings, and, when recommended by a doctor, increasing salt and fluid intake, can help. […] The use of vitamins and supplements to treat LBD symptoms has not been studied extensively and is not recommended.

• #4 How Is Lewy Body Dementia Treated and Managed? | National Institute on Aging

  https://www.nia.nih.gov/health/lewy-body-dementia/how-lewy-body-dementia-treated-and-managed

  Doctors often work with other types of health care providers as part of a care team. Depending on an individuals particular symptoms, these professionals may be helpful: Physical therapists can help with movement problems through cardiovascular, strengthening, and flexibility exercises, as well as gait training and general physical fitness programs. […] Support groups are another valuable resource for people with LBD and their caregivers. Sharing experiences and tips with others in the same situation can help people find practical solutions to day-to-day challenges and get emotional and social support. […] Several drugs and other treatments are available to treat LBD symptoms. It is important to work with a knowledgeable health professional because certain medications can make some symptoms worse. Some symptoms can improve with nondrug treatments.

• #5 Get Lewy Body Dementia Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/lewy-body-dementia-treatment

  Lewy body dementia has no cure, so we focus on managing your symptoms, improving your quality of life and keeping you comfortable and safe. […] Your care team will use what they learned in your physical exam and testing to craft a treatment plan that addresses your individual symptoms and needs. As the disease worsens, your treatment may change, so we’ll make sure your care team and plan are flexible enough to adapt over time. […] Your care team understands what it takes to manage Lewy body dementia with medications. We know how each drug works and how it may influence your symptoms. Together, we’ll find the option that works best for you. […] Taking medication for Lewy body dementia can improve your thinking ability (cholinesterase inhibitors), reduce hallucinations (pimavanserin) and control motor symptoms (carbidopa-levodopa). They can also help you sleep at night or keep you awake during the day. Other drugs help ease anxiety or depression. Additionally, you may need medications to regulate parts of your nervous system, which controls things like blood pressure and digestion.

• #6 Treatment – Lewy Body Dementia Association

  https://www.lbda.org/treatment/

  The importance of early treatment is supported by recent data suggesting that patients with LBD, might respond better to cholinesterase inhibitors than patients with AD. […] An early diagnosis of DLB will help treating physicians know which medications to avoid or use cautiously, especially the antipsychotics (aka neuroleptics). […] It is estimated that a high percentage of DLB patients exhibit worsening parkinsonism, sedation, immobility, or even neuroleptic malignant syndrome (NMS) after exposure to antipsychotics. […] The heightened risk of NMS in DLB mandates that typical or traditional antipsychotics (such as haloperidol, fluphenazine. or thioridazine) should be avoided. […] Atypical antipsychotics have been available for treating mental illness for 25 years and may be safer to use in patients with DLB, but only with extreme caution.

• #6 Treatment – Lewy Body Dementia Association

  https://www.lbda.org/treatment/

  Comprehensive, palliative management of LBD should begin at diagnosis to promote the best quality of life for the person with LBD and the family and caregivers. […] An early, wide-ranging discussion of symptoms and goals of treatment will proactively inform both the provider and the primary family care partner about important future decisions. […] The goals of care may change as the illness progresses due to emerging or evolving issues of safety, caregiver burden, or comorbid illness. […] Acetylcholinesterase inhibitors (AChEIs): AChEIs are the current standard of care for treating cognitive and psychiatric symptoms of LBD. […] Rivastigmine is the only one of the three that is FDA-approved for treating LBD, specifically PDD. […] AChEIs are generally well-tolerated by patients with LBD, but not always.

• #6 Treatment – Lewy Body Dementia Association

  https://www.lbda.org/treatment/

  Memantine (Namenda) is another drug (with a different pharmacological mechanism of action) approved for AD but not LBD and is also used off label as an add-on therapy to AChEIs, typically in patients with more severe dementia. […] Levodopa is an effective and relatively safe drug for treating motor symptoms in PD; most patients with LBD respond with improvement in motor function, without side effects, as long as the dosing is kept at the lowest, most effective level. […] The overarching goal of managing psychotic and behavioral disturbances in LBD is to improve outcome without compromising safety of the patient and others. […] If hallucinations (usually visual) are not frightening to the patient, even if they are considered bothersome by the family, treatment with a drug may not be needed, especially if the patient understands that the hallucinations are not real.

• #6 Treatment – Lewy Body Dementia Association

  https://www.lbda.org/treatment/

  The first line intervention should be non-pharmacologic measures including evaluation for acute physical ailments that may be provoking behavioral disturbances. […] Although little evidence exists to guide specific pharmacotherapy for hallucinations and behavioral symptoms in LBD, the following background literature review should be helpful. […] Deficits in the brains supply of the neurotransmitter acetylcholine probably contribute to cognitive impairment and psychosis in LBD. […] A few published reports have shown behavioral improvement in patients with LBD treated with the AChEI rivastigmine. […] Typical antipsychotics (neuroleptics) should always be avoided in the management of patients with LBD, especially DLB, who risk severe worsening of all symptoms. […] Atypical antipsychotics, especially those with high D2 receptor antagonism (such as olanzapine and risperidone), should also be avoided due to the risk of severe neuroleptic sensitivity reactions.

• #6 Treatment – Lewy Body Dementia Association

  https://www.lbda.org/treatment/

  If long-term treatment with AChEIs is ineffective, or more acute symptom control of behavior is required, it may be difficult to avoid a cautious trial of an atypical antipsychotic. […] Quetiapine and clozapine are preferred when psychosis warrants drug treatment. […] The FDAs black box warning indicates both typical and atypical antipsychotics are associated with an increased risk of mortality and morbidity in elderly patients with dementia-related psychosis. […] Refer to LBDAs publication, Understanding Behavioral Changes in Dementia, which can be downloaded at https://lbda.org/content/understanding-behavioral-changes-dementia. […] Refer to LBDAs publication, Emergency Room Treatment of Psychosis, which can be downloaded at https://lbda.org/go/er.

• #7

  https://www.nhs.uk/conditions/dementia-with-lewy-bodies/treatment/

  There’s currently no cure for dementia with Lewy bodies, but there are treatments that can help manage the symptoms. […] Medicine cannot stop dementia with Lewy bodies getting worse, but for some people it can help reduce some of the symptoms. […] Acetylcholinesterase (AChE) inhibitors, such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl), may help improve hallucinations, confusion and sleepiness in some people. […] Memantine is used for moderate or severe dementia with Lewy bodies. It’s suitable for those who cannot take AChE inhibitors. […] Other medicines that may help control some symptoms of dementia with Lewy bodies include: levodopa this can help with movement problems, but it can also worsen other symptoms and needs to be carefully monitored by a doctor, antidepressants these may be given if you’re depressed, clonazepam this can help if you experience a particular type of rapid eye movement (REM) sleep behaviour disorder, antipsychotics (such as quetiapine) these may help with behaviour that’s putting you or others at risk of harm, but they can cause serious side effects and should be avoided whenever possible.

• #7

  https://www.nhs.uk/conditions/dementia-with-lewy-bodies/treatment/

  In addition to medicine, there are a number of therapies and practical measures that can help make life easier for someone with dementia. […] These include: occupational therapy to identify problem areas in everyday life, such as getting dressed, and help make life easier, speech and language therapy to help improve communication or dysphagia (swallowing problems), physiotherapy to help with movement, psychological therapies, such as cognitive stimulation (activities and exercises designed to improve memory, problem solving skills and language ability), relaxation techniques, such as massage, and music or dance therapy, social interaction, leisure activities and other dementia activities, such as memory cafes (drop-in sessions for people with memory problems and their carers to get support and advice), home modifications, such as removing trip hazards, ensuring the home is well lit, and adding grab bars and handrails.

• #8 Lewy Body Dementia Treatment & Management: Approach Considerations

  https://emedicine.medscape.com/article/1135041-treatment

  Hallucinations and agitation are especially troublesome in dementia with Lewy bodies (DLB). When these symptoms are mild, no medical treatment may be necessary. When medication is used, acetylcholinesterase inhibitors should usually be tried first. For example, double-blinded, placebo-controlled studies have demonstrated that the cholinesterase inhibitor rivastigmine may decrease psychiatric symptoms associated with DLB, particularly apathy, anxiety, hallucinations, and delusions. […] Studies have also shown that patients with DLB treated with cholinesterase inhibitors do better on neuropsychological tests than do subjects treated with placebo. […] Cholinesterase inhibitors that may be effective in the treatment of DLB also include donepezil and galantamine. In a small minority of patients, motor features are worsened with cholinesterase inhibitors.

• #8 Lewy Body Dementia Treatment & Management: Approach Considerations

  https://emedicine.medscape.com/article/1135041-treatment

  Most experts recommend atypical neuroleptics such as clozapine, quetiapine, or aripiprazole when cholinesterase inhibitors are ineffective. Avoid standard neuroleptics, such as haloperidol, because of neuroleptic sensitivity. […] Studies suggest that memantine improves cognitive function and neuropsychiatric features in patients with DLB. A multicenter, double-blinded, placebo-controlled trial revealed significant improvement in 2 important measurement tools in patients who received the drug: the Alzheimer’s Disease Cooperative Study clinical global impression of change score (memantine vs placebo, 3.3 vs 3.9) and the Neuropsychiatric Inventory score (memantine vs placebo, -4.3 vs 1.7). […] Levodopa/carbidopa may improve motor function in some patients with DLB; however, in many patients this combination has no effect and may exacerbate psychiatric symptoms or confusion.

• #8 Lewy Body Dementia Treatment & Management: Approach Considerations

  https://emedicine.medscape.com/article/1135041-treatment

  Depression is frequent in patients with DLB; it may occur as a result of damage in the dorsal raphe and locus ceruleus and/or as a psychological response to impaired function. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice for treating depression in DLB. […] A Cochrane Database review revealed that mild to moderate cognitive stimulation exercises are of benefit for mild and moderate dementia with improvements in memory and quality of life measures.

• #9 Comprehensive treatment of dementia with Lewy bodies | Alzheimer’s Research & Therapy | Full Text

  https://alzres.biomedcentral.com/articles/10.1186/s13195-015-0128-z

  DLB-associated deficits in attention, executive function, and visuospatial ability respond well to cholinesterase inhibitor treatment. Cholinesterase inhibitor treatment is associated with reduced mortality; mortality odds ratios in treatment trials are 0.28 (P=0.03) despite increases in adverse events on therapy (odds ratio 1.64, P=0.0003). […] There are no head-to-head trials comparing efficacy of the cholinesterase inhibitors in DLB or PDD, but rivastigmine has the widest evidence base. Special care is needed when starting cholinesterase inhibitors in patients with DLB because of frequent disease-associated autonomic dysfunction. […] Hallucinations occur in 60 to 70 % of DLB patients. Electing not to treat these symptoms is often appropriate, but cholinesterase inhibitor therapy is safe and effective. In one study of PDD, more than 90 % of patients reported reduced visual hallucinations with cholinesterase inhibitor use.

• #9 Comprehensive treatment of dementia with Lewy bodies | Alzheimer’s Research & Therapy | Full Text

  https://alzres.biomedcentral.com/articles/10.1186/s13195-015-0128-z

  The motor symptoms and signs of DLB are similar to those found in PD, including rigidity, bradykinesia, tremor, and gait difficulties. They may respond to physical therapy and home safety modification. […] The most common autonomic complications of synucleinopathy are under-recognized: 89 % of PD patients have constipation or diarrhea. Directed questions and early treatment with a high-fiber diet, exercise, stool softeners, psyllium, polyethylene glycol, methylcellulose, docusate, and misoprostol are effective. […] Rapid eye movement sleep behavior disorder is 98 % specific to the disorders of synuclein. Randomized controlled trials demonstrate that melatonin, rivastigmine, and bed alarms that play soothing messages from caregivers are effective rapid eye movement sleep behavior disorder treatments. The short half-life of melatonin means that a second dose may be needed if sleep is interrupted. Low-dose clonazepam is a recommended second-line therapy. […] DLB is a complex disease with many challenging treatment decisions. Treatment options can improve quality of life, but do not alter the course of the disease. For many symptoms, the best treatments are nondrug treatments. Regular reviews aimed at rationalizing therapy can be beneficial.

• #9 Comprehensive treatment of dementia with Lewy bodies | Alzheimer’s Research & Therapy | Full Text

  https://alzres.biomedcentral.com/articles/10.1186/s13195-015-0128-z

  The management of DLB is replete with quandaries: in choosing to treat one symptom, we often produce complications in other facets of the disease. For example, dopamine replacement for motor symptoms frequently exacerbates a patients neuropsychiatric symptoms, antipsychotic treatment of hallucinations risks a potentially fatal adverse reaction, and cholinesterase inhibitor treatment of cognitive symptoms can complicate cardiac and gastrointestinal dysautonomia. These quandaries make the treatment of DLB challenging, yet just as rewarding as navigating between Scylla and Charybdis. […] Many symptoms of DLB are noncognitive in nature, and many are under-recognized. It can be helpful to divide the array of symptoms into five symptom categories: cognitive, neuropsychiatric, movement, autonomic, and sleep. Patients often view DLB as a purely cognitive disease, and consequently will not volunteer noncognitive symptoms since they do not believe they are a consequence of the disease. Directed questions in each of the five categories can form the basis of a comprehensive treatment strategy that can improve the patients quality of life.

• #10 Dementia with Lewy Bodies | Parkinson’s Foundation

  https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/dementia/lewy-bodies

  While there are currently no medications that slow or reverse DLB, there are many treatments aimed at relieving symptoms and helping ensure safety. People living with dementia with Lewy bodies benefit most from comprehensive, team-based healthcare that includes a mental health professional. […] Caring for the body and the mind through medication, physical and mental exercise is essential for people living with DLB. […] Symptom management is tailored to a persons unique needs and can include: […] Medications such as donepezil (Aricept), galantamine (Razadyne) or rivastigmine (Exelon), may improve cognitive symptoms. […] Selective serotonin reuptake inhibitors (SSRIs) and Serotonin and norepinephrine reuptake inhibitors (SNRIs) medicines are used to address depression and anxiety. […] Clozapine (Clozaril), quetiapine (Seroquel) and pimavanserin (Nuplazid) are used to lessen hallucinations.

• #11 Treatment – Lewy Body

  https://www.lewybody.org/information-and-support/treatment/

  Parkinsons disease medications: These medications, such as Sinemet (levodopa with carbidopa) can help reduce parkinsonian symptoms, such as rigid muscles and slow movement. But they may also sometimes increase confusion, hallucinations and delusions. […] Other medications: To treat symptoms including sleep or movement problems. […] Antipsychotic drugs: These drugs are generally not recommended as they can be dangerous to people with Lewy body dementia and in general they should be avoided unless your doctor is fully aware of your diagnosis and the implications. However, sometimes they may be suggested as a way to deal with extremely distressing symptoms. […] Occupational, physical and speech and language therapy can all be beneficial. […] Environmental considerations such as lighting, visual stimulation, aromatherapy or music therapy can all make a difference. […] A daily routine, physical activity and changes to the home environment are all helpful in managing Lewy body dementia day-to-day.

• #12 Dementia with Lewy Bodies and Parkinson Disease Dementia – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/delirium-and-dementia/dementia-with-lewy-bodies-and-parkinson-disease-dementia

  In about half of patients with dementia with Lewy bodies, extrapyramidal symptoms respond to antiparkinsonian medications, but psychiatric symptoms may worsen. If such medications are needed, levodopa is preferred. […] In dementia with Lewy bodies, traditional antipsychotics, even at very low doses, tend to acutely worsen extrapyramidal symptoms and are best avoided. […] Pimavanserin, a nondopaminergic selective inverse agonist of the serotonin 5-HT-2A receptor, can be used to treat psychosis (hallucinations, delusions) in patients with Parkinson disease dementia. […] Consider use of rivastigmine and sometimes other cholinesterase inhibitors to try to improve cognition in patients who have dementia with Lewy bodies or Parkinson disease dementia.

• #13 Dementia with Lewy Bodies: An Emerging Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0401/p1223.html

  No studies have examined the impact of nonpharmacologic interventions in dementia with Lewy bodies, but a wide range of interventions have been beneficial in Alzheimers disease and other forms of dementia. […] Pharmacologic management of dementia with Lewy bodies can be challenging. […] Patients with significant visual hallucinations are reported to have better response to cholinesterase inhibitor therapy than other patients with dementia. […] Patients who have dementia with Lewy bodies should not be given the older, typical D2-antagonist antipsychotic agents such as haloperidol. […] Atypical antipsychotics may be tried in low doses, but these can cause similar adverse effects and increase the risk of stroke. […] The goal of antiparkinsonian medication is to improve mobility without inducing or exacerbating psychotic symptoms or confusion. […] Management of the REM sleep behavior disorder is reported to improve fluctuations in cognition and markedly benefit quality of life for patients who have dementia with Lewy bodies and their families.

• #14 Treatments and support for dementia with Lewy bodies (DLB) | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/dementia-with-lewy-bodies-treatments

  Rivastigmine and, less often, donepezil may also reduce hallucinations and delusions in people with DLB. […] Antipsychotic drugs are sometimes prescribed for hallucinations or delusions in DLB. However, they can have dangerous side effects and rarely benefit people with dementia. […] A person with DLB should talk to their GP about sleep problems. Drugs such as melatonin or clonazepam can be effective short-term drug treatments for some sleep problems. […] The drug levodopa, used to treat Parkinsons disease, is sometimes given to people with DLB who have movement problems. Levodopa is less effective in DLB than in Parkinsons disease. It improves falls and movement problems in around one-third of people with DLB.

• #14 Treatments and support for dementia with Lewy bodies (DLB) | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/dementia-with-lewy-bodies-treatments

  There is currently no cure for DLB. The persons care and treatment should support them to live as well as possible. This should include drug and non-drug treatments. […] After a diagnosis of DLB, both the person and their carer will need support. There are many ways to help someone to live well with DLB that dont involve drugs. These include information, advice, support, therapies and activities. […] Ways to improve and maintain general wellbeing, mental abilities and mood include: social interaction with friends or family, or a local group. Try video calls to stay in touch, keeping a routine, talking therapies, such as counselling, which can help someone come to terms with their diagnosis or discuss their feelings, cognitive behavioural therapy (CBT), which may be offered if the person develops depression or anxiety, cognitive stimulation therapy, a popular way to help keep the mind active. It involves doing themed activity sessions over several weeks, cognitive rehabilitation, in which a person is helped to retain skills and cope better, adaptations in the home to help the person with DLB to remain independent and safe, life story work, in which the person is encouraged to share their life experiences and memories, reminiscence work, usually enjoyed as a persons dementia progresses, music, singing or art.

• #15 Dementia with Lewy bodies (DLB) | Symptoms & Causes | alz.org

  https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies

  Dementia with Lewy bodies (DLB) is a type of progressive dementia that leads to a decline in thinking, reasoning and independent function. […] There are no treatments that can slow or stop the brain cell damage caused by dementia with Lewy bodies. Current strategies focus on helping symptoms. If your treatment plan includes medications, it’s important to work closely with your physician to identify the drugs that work best for you and the most effective doses. Treatment considerations involving medications include the following issues: […] Cholinesterase inhibitor drugs are a common approach for addressing thinking changes in Alzheimer’s. They also may help certain DLB symptoms. […] Antipsychotic drugs should be used with extreme caution in Lewy body dementia, including both dementia with Lewy bodies and Parkinson’s disease dementia. Although physicians sometimes prescribe these drugs for behavioral symptoms that can occur in Alzheimer’s, they may cause serious side effects in as many as 50% of those with Lewy body dementia.

• #15 Dementia with Lewy bodies (DLB) | Symptoms & Causes | alz.org

  https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies

  Antidepressants may be used to treat depression, which is common with DLB, Parkinson’s disease dementia and Alzheimer’s. The most commonly used antidepressants are selective serotonin reuptake inhibitors (SSRIs). […] Like other types of dementia that destroy brain cells, dementia with Lewy bodies gets worse over time and shortens lifespan.

• #16 Medications – Lewy Body Dementia Resource Center

  https://lewybodyresourcecenter.org/what-is-lbd/treatment-important-information/medications/

  Some antipsychotics, including olanzapine (Zyprexa) and risperidone (Risperdal), should be avoided, if possible, because they are more likely than others to cause serious side effects. […] Antipsychotic medications increase the risk of death in elderly people with dementia, including those with LBD. […] People with Lewy body dementia are often sensitive to prescription and over-the-counter medications for other medical conditions. […] Make sure you and your care partner talk to your doctor about anesthesia prior to surgery. Many people with LBD are extremely sensitive to certain anesthesia just as they are to particular medications. […] Because antipsychotic drugs can worsen Lewy body dementia symptoms, it might be helpful to initially try non-drug approaches, such as: […] Merely tolerating the behavior. Many times a person with Lewy body dementia isn’t distressed by the hallucinations and even recognizes them as such.

• #16 Medications – Lewy Body Dementia Resource Center

  https://lewybodyresourcecenter.org/what-is-lbd/treatment-important-information/medications/

  Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to focus and function. […] Modifying your responses. A caregiver’s response to a behavior can make the behavior worse. […] Modifying tasks and daily routines. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day also help reduce confusion in people with dementia.

• #17

  https://www2.hse.ie/conditions/dementia-lewy-bodies/treatment/

  There is no cure for dementia with Lewy bodies. But there are treatments that can help manage the symptoms. […] Medicine cannot stop dementia with Lewy bodies getting worse. But for some people it can help reduce some of the symptoms. […] Some medicines can help: reduce symptoms of confusion or hallucinations, reduce movement-related symptoms such as stiffness, slowness or tremor, manage symptoms such as low mood, anxiety or disturbed sleep. […] Acetylcholinesterase (AChE) inhibitors may help improve hallucinations, confusion and sleepiness in some people. […] This medicine blocks the effects of a large amount of a chemical in the brain called glutamate. […] Other medicines that may help control some symptoms of dementia with Lewy bodies include: levodopa – this can help with movement problems but it can make other symptoms worse, so your GP will monitor this closely, antidepressants – these may be given if you are depressed, clonazepam – this can help if you have a particular type of rapid eye movement (REM) sleep behaviour disorder, antipsychotics (such as haloperidol) – these may help with behaviour that’s putting you or others at risk of harm but they can cause serious side effects.

• #17

  https://www2.hse.ie/conditions/dementia-lewy-bodies/treatment/

  There are some therapies and practical things you can do to make daily tasks easier for someone with dementia. […] These include: occupational therapy to identify problem areas in everyday life – such as getting dressed, speech and language therapy to help improve communication or swallowing problems, physiotherapy to help with movement, psychological therapies – activities and exercises to improve memory and problem-solving skills, relaxation techniques – such as massage and music or dance therapy, social interaction and leisure activities, such as visiting a dementia cafe, home modifications – such as removing trip hazards and adding grab bars and handrails, assistive technologies to promote independence, communication and safety.

• #18 What is Lewy body dementia and how is it treated? – Webinar notes Stanford PD Community Blog

  https://parkinsonsblog.stanford.edu/2020/04/what-is-lewy-body-dementia-and-how-is-it-treated-webinar-notes/

  Lewy body dementia (LBD) is an umbrella term for diseases caused by the same abnormal protein, including Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). […] Current treatment approaches […] We do not yet have an existing treatment to stop or slow the progression of LBD, except one: physical exercise! Evidence shows that physical exercise not only slows the progression of the disease, but also lowers the risk for those who have not yet developed it. […] Medications are often prescribed to help manage the symptoms of LBD: cognitive symptoms, sleep, anxiety & depression, and motor symptoms can sometimes be addressed. […] Acetyl-cholinesterase inhibitors are the first-line group of medications used to improve alertness, hallucinations, and delusions; they include the drugs donepezil (Aricept), galantamine, and rivastigmine (Exelon).

• #19 Lewy Body Dementia: Reddy Care Physical & Occupational Therapy: Physical Therapists

  https://www.reddycare.net/blog/lewy-body-dementia

  Physical Therapy and Occupational Therapy are able to improve a person with LBD’s quality of life. People with LBD lose their mobility, causing balance and gait issues. Physical therapists help their patients become more mobile, stronger in their core and legs. Physical therapy and Occupational Therapy works on balance to avoid falls. Examples of balance exercises are practiced through walking, marching, dancing and flexibility exercises. Specific motor function training can help enhance physical movements, stabilize posture, and improve body mechanics. Additional treatments, such as manual therapy or pelvic floor rehab, can help improve common problems that affect patients who suffer from LBD, such as arthritic pain, osteoporosis, and incontinence. […] Occupational therapy can help a person with LBD learn how to bathe safely, dress themselves and feed themselves. OT can also help with cognitive skills, stretching, simplifying words and hand and eye coordination. Occupational therapists observe the person with LBD in their home and recommend changes to make it easier and safer for them to be more independent. The OTs goal is to keep creating a safety plan based on the person’s needs and their caregivers. They may suggest adding safety equipment, such as bathroom grab bars, commodes and adaptive equipment. […] Reddy Care’s therapists work closely with primary care physicians to create an effective treatment plan. If you or a loved one suffers from LBD or any similar disease, talk to a staff member today at Reddy Care Physical and Occupational Therapy to find out how they can help.

• #20 Lewy Body Dementia | Neurosurgery | Mercy Health

  https://www.mercy.com/health-care-services/neurology/conditions/lewy-body-dementia

  Many patients experience side effects from using medicine to manage their Lewy body dementia. If a medication’s side effects outweigh the benefits, non-medical therapies may be effective. […] Physical therapy and exercising physical therapy can help Lewy body dementia patients improve their gait and cardiovascular health as well as strengthen their bodies. […] Speech therapy for patients who are having trouble with speech volume and enunciation, speech therapy can help improve muscle strength in the vocal cords. […] Occupational therapy occupational therapy helps patients maintain functional skills, which can impact their feeling of independence. […] Modify the environment and simplify routines patients with Lewy body dementia do better with structure and simplified routines in their day.

• #21

  https://www.nhs.uk/conditions/dementia-with-lewy-bodies/

  There’s currently no cure for dementia with Lewy bodies or any treatment that will slow it down. […] But there are treatments that can help control some of the symptoms, possibly for several years. […] Treatments include: […] medicines to reduce hallucinations, confusion, drowsiness, movement problems and disturbed sleep […] therapies such as physiotherapy, occupational therapy and speech and language therapy for problems with movement, everyday tasks and communication […] psychological therapies, such as cognitive stimulation (activities and exercises designed to improve memory, problem solving skills and language ability) […] activities for dementia, such as memory cafes (drop-in sessions for people with memory problems and their carers to get support and advice).

• #22 Alternative Lewy Body Dementia Treatments: Therapy & More

  https://neuraleffects.com/blog/alternative-lewy-body-dementia-treatment/

  There are many other ways to help patients with Lewy body dementia, including specific types of therapy to address specific symptoms and lifestyle changes to increase quality of life. […] Ways to improve mental well-being and mood include: Keeping a good social life with friends, family members, or local support groups. […] Engaging in meaningful and enjoyable activities to increase confidence and self-esteem. […] Engaging in talking therapies, such as counseling or cognitive behavioral therapy (CBT), for example. […] Engaging in cognitive rehabilitation, where the patient learns ways to retain cognitive skills to perform everyday tasks and to compensate for impairments. […] Engaging in reminiscence therapy, where patients talk about past events. […] Engaging in music therapy or art therapy, which can slow down cognitive decline as well as improve behavior and well-being in patients and their carers.

• #23 What Is Lewy Body Dementia?

  https://www.alzheimers.gov/alzheimers-dementias/lewy-body-dementia

  Support groups can also be a valuable resource for people with LBD and their caregivers to share experiences and tips with others in the same situation. Nonprofit organizations and community organizations may provide online or in-person support groups. National Institute on Aging-funded Alzheimers Disease Research Centers also may offer education and support groups.

• #24 Lewy Body Dementia: Symptoms, Stages, & Treatment

  https://www.webmd.com/alzheimers/dementia-lewy-bodies

  Right now, there arent any drugs that can stop or reverse Lewy body dementia. But medications can help relieve your symptoms for a few months. These drugs include: […] Some drugs, called neuroleptic or antipsychotic medicines, can treat severe hallucinations or behavior problems for people with Alzheimers, but theyre often not good for people with LBD. They can worsen some symptoms, such as hallucinations, trouble moving, or thinking problems. If you need these drugs, your doctor will have to watch you very carefully for bad side effects. Besides medications, you can do other things to ease your LBD symptoms: […] A person with LBD can benefit from a care team of professionals, such as a: […] Researchers are testing several novel therapies to help Lewy body dementia. For example, the drugs nilotinib and neflamapimod have shown promise in clinical trials. […] Clinical trials help scientists learn about different diseases and test new treatments. Some organizations that provide information about clinical trials for LBD are: […] If you find a study near you, contact the study coordinator to see if you or your loved one may qualify.

• #25

  https://link.springer.com/article/10.1007/s40120-023-00467-8

  Reviews of randomized clinical trials (RCTs) in dementia with Lewy bodies (DLB) are essential for informing ongoing research efforts of symptomatic therapies and potentially disease-modifying therapies (DMTs). […] We found 25 agents in 40 trials assessing symptomatic treatments and DMTs for DLB: 7 phase 3, 31 phase 2, and 2 phase 1 trials. […] There is increased interest in disease-modifying therapies in dementia with Lewy bodies that currently represent 55.5% of ongoing clinical trials (5 studies). […] Current challenges for dementia with Lewy bodies drug development include increased diagnosis at earlier stages of the disease, disease-specific outcome measures and biomarkers, augmenting global representation, and including more diverse populations. […] The need for therapy to prevent, delay onset, slow progression, and improve symptoms in DLB is driven by the worldwide growth in the size and proportion of older people and the steep increase in DLB incidence with age.

• #25

  https://link.springer.com/article/10.1007/s40120-023-00467-8

  Discoveries regarding DLBs underlying disease mechanisms have led to a growing number of clinical trials targeting potentially disease-relevant processes. […] We found 7 phase 3 clinical trials, all of them for symptomatic treatment: 3 (43%) cognitive enhancers, 3 (43%) for neuropsychiatric and behavioral symptoms, and 1 (14%) for motor symptoms. […] We found 31 phase 2 clinical trials: 23 (74.2%) symptomatic and 8 (25.8%) DMTs. […] All DMTs investigated were small molecules. […] The remaining DMTs under investigation are: CT1812, AHT-1017 (fosgonimeton), and ambroxol. […] All 4 active clinical trials investigating symptomatic treatments target neurotransmitter receptors, 3 are cognitive enhancers (CST-103/CST-107, NYX-458 and memantine) and 1 targets hallucinations (ondansetron).

• #26 $21 Million Grant Furthers Study into Drug Development for Lewy Body Dementia – InventUMPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–button

  https://news.med.miami.edu/21-million-grant-lewy-body-dementia-drug-development/

  There is no approved treatment, but there could soon be hope. Based on some promising initial findings, and a new three-year, $21 million grant from the National Institute on Aging, researchers at the University of Miami Miller School of Medicine are launching a Phase 2b study of neflamapimod for Lewy Body dementia. […] Neflamapimod holds potential as a neuroprotective medication if given early enough in the course of LBD, said principal investigator James E. Galvin, M.D., M.P.H., professor of neurology, psychiatry and behavioral sciences, the Alexandria and Bernard Endowed Chair in Memory Disorders, and founding director of the Comprehensive Center for Brain Health at the Miller School. […] Neflamapimod works as a very specific inhibitor of an enzyme that leads to loss of brain cells that make acetylcholine. This therapy could work on two fronts, helping to preserve both cognitive function and motor function seen in LBD.

• #27 Lewy body dementias | Dementia Australia

  https://www.dementia.org.au/about-dementia/lewy-body-dementias

  There is no known cure for Lewy body dementia yet, but the conditions are manageable and some symptoms can be treated. Support is available. […] There are ways to manage your condition, however. Your doctor might prescribe anti-depressant or anti-anxiety medication. They may also prescribe medications for your heart, urinary and other symptoms. […] People with Lewy body dementia can have severe reactions to antipsychotic medications. […] Counselling and exercise help you stay active and social. […] If you’re at risk of falls, talk to an occupational therapist. […] Some other tips to help you and your family manage Lewy body dementia include: Ask people you trust for help. Family and friends can help you make legal, financial and medical decisions if you’re having trouble with thinking and planning.

• #27 Lewy body dementias | Dementia Australia

  https://www.dementia.org.au/about-dementia/lewy-body-dementias

  Have a back-up plan. If you find some social or physical situations difficult, you might need to quickly change your plans. Make that plan early, so you’re not stressed in the moment. […] Be prepared. Accidents happen. Keep a kit with wipes, bags and a change of clothes so you’re always ready, just in case. […] Have one-on-one time. If big groups of people are stressful, organise your social time in smaller groups, or even just with one person, in a quiet place where you feel safe.

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