Lewy body dementia (LBD) is a type of dementia that often brings fluctuating alertness, visual changes, and movement symptoms. This short guide explains common signs in everyday language and offers simple ways to support calmer days.

What is Lewy body dementia?

LBD is linked to protein changes in the brain (called Lewy bodies). People may have good days and harder days, or even hours that feel different from one another. Memory can be affected, but attention, alertness, and visual processing are often bigger challenges.

How it can look different

• Fluctuations: alertness and thinking may vary—clear at times, foggy at others.
• Visual changes: seeing things that aren’t there (visual hallucinations) or misreading visual information.
• Movement symptoms: stiffness, slowness, or changes in posture and balance (Parkinsonian features).
• Sleep issues: acting out dreams (REM sleep behavior disorder) or restless nights.

(These patterns are common, not universal—every person is unique.)

Common signs (in everyday words)

• Attention drifting in and out; conversation is easier some days than others
• Visual experiences—“seeing visitors” or animals—often non-threatening
• Shuffling or slow movement; more falls or unsteadiness
• Sensitive to certain medications (some can worsen confusion or movement)

How it’s diagnosed

Only a clinician can diagnose LBD. They will consider:

• History & symptoms: fluctuations, visual changes, movement, sleep
• Thinking tests: attention, planning, and memory
• Scans and sleep studies if needed
  Share a full medication list—some drugs can worsen symptoms. Always consult a clinician before starting or stopping medicines.

Everyday support that helps

• Plan for good windows: tackle tasks when the person is most alert.
• Keep environments calm: reduce visual clutter and strong patterns; use good lighting.
• Offer steady routines: simple schedules lower stress and confusion.
• Gentle validation: don’t argue about visual experiences; reassure and redirect.
• Safe movement: clear walkways, supportive shoes, and handrails as needed.

Communication tips

• Gain attention first: say the person’s name, make eye contact, then speak.
• Short, clear sentences: one idea at a time; allow extra time to respond.
• Either/or questions: “Tea or water?” helps decision-making.
• Praise effort: encourage, even when results vary day to day.

Calming activities

• Familiar music to set a relaxed pace
• Short, large-print stories read together (5–10 minutes) can be reassuring
• Light stretching or seated movement if safe
• Photo browsing with gentle comments, not memory tests

Safety & wellbeing

• Falls: review home safety; consider a physical therapy assessment.
• Sleep: keep regular bedtimes; discuss dream enactment with a clinician.
• Medications: ask about drugs that may worsen confusion or movement.
• Caregiver care: build in short breaks; accept help.

When to seek help

• Sudden changes in confusion, behavior, or mobility
• Frequent falls or new injuries
• Distressing hallucinations or severe sleep disturbance
• Caregiver exhaustion—reach out to healthcare and community supports

Quick FAQ

Is LBD the same as Parkinson’s disease dementia?
They are closely related. The timing of symptoms helps clinicians tell them apart.

Are hallucinations always scary?
Not always. Many are neutral or even comforting. Focus on reassurance and safety.

What helps today?
Calm spaces, steady routines, simple choices, and short, gentle activities shared together.ons, give extra time, and share short, calming activities together.

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Part of the series: Dementia Explained: An Easy Guide
See the overview page for links to other types (vascular, Lewy body, frontotemporal, mixed, and Parkinson’s disease dementia).