What should you know about Lewy body dementia?

Changes may include visual hallucinations, fluctuating attention, slower thinking, stiffness, shuffling or balance problems. Memory can be affected, but early difficulty may centre on attention, planning or visual-spatial tasks. Acting out dreams, daytime sleepiness and changes in automatic body functions can also occur. A memory problem does not by itself establish the diagnosis; several conditions and medicines can cause similar symptoms.

The condition is linked with abnormal protein deposits called Lewy bodies in nerve cells. Symptoms vary between people and may change from day to day. A person may seem clear and engaged at one time, then unusually drowsy or confused later.

Arrange a GP consultation for a history, medication review, physical examination and cognitive assessment. Bring a list of medicines and examples of changes in movement, alertness, sleep, mood or thinking. A family member can help describe fluctuations that the person does not notice.

Support at home can include steady routines, good lighting, fall-prevention measures and clear communication. Do not start, stop or change medicines without medical advice, because people with Lewy body dementia can react unusually to some drugs.

Seek urgent medical help for sudden confusion, a new severe headache, weakness on one side, a fall with injury, fainting, chest pain, breathing difficulty or thoughts of self-harm. Contact a clinician promptly if hallucinations become frightening, walking worsens quickly, swallowing becomes difficult, or a person is repeatedly falling or becoming hard to wake.

Ask which symptoms support the diagnosis, what tests are appropriate, how medicines may affect alertness or movement, and what help is available for sleep, falls, hallucinations and daily activities.