7 Stages of Lewy Body Dementia: What to Expect

Health7 Stages of Lewy Body Dementia: What to Expect

Lewy body dementia is one of the most common types of dementia, affecting over one million people in the United States.

This condition stems from abnormal deposits of protein, called Lewy bodies, that cause chemical changes in a person’s brain.

People usually develop symptoms of this disease when they’re 50 years old and above, but young people can experience it, too.

Understanding the 7 stages of Lewy body dementia can help you prepare for this challenging condition and properly care for loved ones who have it.

Remember that support and treatment options to relieve symptoms are always available for individuals with Lewy body dementia.

Stage 1: No Cognitive Decline

During the earliest stage, persons with Lewy body dementia show little to no signs of the disease. They’re able to function and live normally with no complaints of memory loss, confusion, or cognitive difficulties. Friends and family members won’t notice any issues at all.

This phase can occur during a person’s early 40s or 50s and can be missed when it’s unexpected. A health professional might not spot any memory problems during an interview. However, an MRI or CT scan may show incidental findings during a routine examination.

There are rare cases wherein people at this stage start to experience symptoms such as mood changes or visual hallucinations. Their brain structure and functioning slowly begin to deteriorate.

Stage 2: Very Mild Cognitive Decline

This stage of Lewy body dementia presents subtle changes, such as difficulty in finding the right words, trouble locating frequently used items, or forgetting well-known names. However, these memory issues are still difficult to notice and can easily be overlooked as a normal sign of aging. 

Individuals can still be able to overcome their memory issues, communicate normally, and function in and out of the house during this phase. They can still pass memory tests during clinical interviews with a healthcare professional.

Stage 3: Mild Cognitive Decline

At stage three, small changes in a person’s thinking, reasoning, and memory become more noticeable. They start to have trouble functioning at work, experience moments of forgetfulness, and find it hard to focus. They can also struggle to handle their finances or appointments.

Simple tasks, such as taking medications on time and navigating in unfamiliar places, can also become harder for an individual. Other symptoms include retaining little information after reading, losing important items, and forgetting the names of people they’ve recently met.

You may also notice them staring blankly or acting confused. They can react to this by denying their memory problems or by reporting feelings of anxiety. The individual might need extra care as they start to become a fall risk at this phase.

Stage 4: Moderate Cognitive Decline

When a person reaches stage four, they start to experience more difficulty with their day-to-day living than in the previous stage. Problem-solving becomes trickier, and the following are harder to recall:

  • Familiar names and faces
  • Regular driving routes
  • Recent events
  • Location of everyday items, like their phone or wallet

Doctors and healthcare providers are more likely to detect cognitive decline and provide a confirmed diagnosis during this stage of Lewy body dementia. Affected individuals may still be able to recall close acquaintances and significant life events at this phase.

Other symptoms during this stage include difficulties with motor skills, including slowed or repetitive movements. People with this disease may start to rely on family members, friends, and caretakers for support and supervision doing routine tasks, like doing the laundry. 

Stage 5: Moderately Severe Cognitive Decline

People who are experiencing this advanced stage of Lewy body dementia start to lose track of where they are or what day of the year it is. They might have trouble sleeping, and their movements appear more rigid and limited. They also show the following behaviors:

  • Repeatedly asking the same questions
  • Changes in mood or personality
  • Confusion, disorientation, hallucinations, or paranoia
  • Increased need for assistance with eating and personal hygiene
  • Difficulty controlling their bladder or bowel movement
  • Inappropriate or unpredictable behavior
  • Struggle in performing basic serial subtraction, like counting backward from 30 by 3s

Stage 6: Severe Cognitive Decline

At stage six, a person’s memory, awareness, communication, and ability to perform basic functions increasingly fade and deteriorate. As a result, you might want to consider hiring a caretaker for 24-hour at-home support and supervision, as the person can’t be left alone.

Common occurrences include getting lost and confused, unusual eating habits, and sleeping during the day instead of at night. Severe mood swings and delusions are also present at this phase. The patient may become bedridden or need a wheelchair due to loss of mobility.

Supportive care would involve gentle massages for the individual’s stiff muscles and a drip for adequate nutrition. They may still be able to recall memories from their early life, but they’ll struggle to recognize the names and faces of close family members and friends.

Here are some other symptoms to look out for during this stage:

  • Bowel and bladder incontinence
  • Tendency to wander
  • Obsessive actions, like repetitively cleaning items
  • Aggression and uncharacteristically violent behavior
  • Loss of willpower and inability to hold a thought long enough to complete a task

Stage 7: Very Severe Cognitive Decline

The seventh stage is the final stage of Lewy body dementia. This can be an extremely painful and difficult time for the patient and family members. At this point, the patient will be completely dependent and will require round-the-clock care to survive. 

They may need to stay in bed most of the time due to severe loss of muscle control. This includes difficulty turning their neck or moving their limbs. They’ll also lose their ability to speak and will only utter unintelligible words. Loved ones become totally unrecognizable to them.

Unfortunately, there’s no cure for Lewy body dementia. However, supportive care and an LBD treatment plan can help patients manage their symptoms. Therapy, counseling, and medication are some of the treatment options for individuals with this type of disease.


1: What is Lewy body dementia?

Lewy body dementia is a type of dementia stemming from abnormal deposits of protein, called Lewy bodies, in the brain. It affects the person’s cognition and function.

2: How many stages are there in Lewy body dementia?

Lewy body dementia has seven stages, ranging from no cognitive decline to very severe cognitive decline.

3: At what age does Lewy body dementia typically manifest?

Symptoms of Lewy body dementia usually develop when individuals are 50 years old and above, although younger people can also experience it.

4: What symptoms might someone experience in the early stages of Lewy body dementia?

Early symptoms might include subtle changes like difficulty finding words or forgetting well-known names, and difficulty in locating frequently used items.

5: How does Lewy body dementia progress?

As Lewy body dementia progresses, individuals may experience increased difficulty with cognitive tasks, changes in mood, personality, and sleep disturbances, among others. In later stages, individuals may become completely dependent on caregivers.

6: Can Lewy body dementia be cured?

Currently, there is no cure for Lewy body dementia. However, supportive care and treatment plans can help manage symptoms.

7: What kind of support is available for individuals with Lewy body dementia?

Support and treatment options for Lewy body dementia may include therapy, counseling, medication, adult day centers, and support groups.

Final Thoughts on Lewy Body Dementia

As a progressive disease, Lewy body dementia (LBD) involves symptoms that appear slowly and worsen over time. How fast certain symptoms develop can vary from one patient to another, with factors like age, sex, health, and treatment affecting an individual’s experience. 

If you or a loved one is struggling with Lewy body dementia, don’t hesitate to reach out to your family and follow your healthcare provider’s medical advice. There are many sources of assistance for persons with this disease, including adult day centers and support groups.

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