7 Stages Of Lewy Body Dementia: Understanding The Progression For Informed Care


Has one of your close relatives been diagnosed with Lewy body dementia? Though you may be familiar with terms such as Alzheimer’s and dementia, you might have never heard about this disease before. However, the shocking part is that Lewy body dementia has become common and about 1.4 million Americans are affected by this disease.

What is Lewy body dementia?

To explain in simple terms, Lewy body dementia (LBD) is a brain disorder that can cause problems associated with thinking, behavior, movement, and mood. Though even young people may be affected by LBD, it generally starts at the age of 50 or later. After being diagnosed with this disorder, the patient may live on average five to eight years. However, the life span may even be reduced to two years or it may go up to even 20 years. 

What Are The 7 Stages Of Lewy Body Dementia

7 stages of Lewy body dementia

There are 7 stages in Lewy body dementia. In the below section, we take you through all the 7 stages and some common characteristics found among patients in each stage.

Stage 1: No cognitive decline

In this stage, the patient will show no symptoms or experience any cognitive decline. He/she will continue to perform their daily activities as usual. Thus, the disease will go unnoticed by the patient, close relatives, and doctors. Having said that, an MRI scan or CT scan conducted as part of routine health checkups may lead to the incidental finding of LBD.

The advantage of an early diagnosis is that it helps lower the pace of progression. However, there are rare cases where the patient may experience some symptoms of dementia such as hallucinations or mood changes in the first stage itself.

Stage 2: Very mild cognitive decline

In the second stage, the patient will start showing very mild symptoms. This includes subtle changes in behavior and memory function. However, it will be difficult to diagnose as these symptoms generally go unnoticed.

The patient may experience mild forgetfulness and thus it becomes hard for them to remember names, solve problems, and locate familiar objects. However, they will be able to carry out their daily activities as these symptoms will be mild.

Stage 3: Mild cognitive decline

There are only minor differences in the symptoms of stages 2 and 3. The patient goes through mild cognitive decline, the symptoms become more noticeable and it gets close to the diagnosis stage. Some of the symptoms include mild memory loss, forgetfulness, and a problem concentrating. Due to declining cognitive abilities, there is a higher risk of falls. It adversely affects their daily routine and they will experience difficulty in performing them in the normal way.

Stage 4: Moderative cognitive decline

It is in stage 4 that LBD gets officially diagnosed. The reason is that it becomes easy to detect cognitive decline. The patient may experience symptoms such as life-disrupting forgetfulness and out-of-character difficulty in carrying out daily responsibilities. Tasks such as managing finances and going to new locations become difficult.

Some other common symptoms include choking, too much drooling, aspiration, and difficulty in swallowing. Constant supervision will be required at this stage. The patient may sleep more during the daytime but with fewer hallucinations.

Stage 5: Moderately severe cognitive decline

The main characteristic of the fifth stage is the moderately severe cognitive decline. Memory loss aggravates and it becomes difficult for the patient to recall details such as address or phone number.  The other symptoms include fever and more prone to infections and skin diseases.

Due to delusions and hallucinations, he/she may become more paranoid and get confused often. The patient may also need assistance in carrying out tasks such as preparing meals and bathing.

Stage 6: Severe cognitive decline

If there is severe cognitive decline, it is an indication that your loved one has reached stage 6 of LBD. In this stage, the patient needs a high level of support to live comfortably. There will be major memory loss and they will be only able to recall memories related to their early life.

Some of the common symptoms include urine and bowel incontinence and it is at this stage that the patient may lose their ability to speak. There may be also a personality change and it may last for around 2.5 years. The patient may also face difficulty in recognizing their family members.

Stage 7: Very Severe cognitive decline

It is the last stage that is characterized by very severe cognitive decline. It generally lasts for 1.5 to 2.5 years and the patient needs palliative care at this stage. The symptoms range from a loss of ability to communicate and an inability to walk.

Treatments for Lewy body dementia

The sad part is that there is no cure for LBD. However, some targeted treatments help manage the symptoms:

1. Cholinesterase inhibitors

These medicines are used in the treatment of Alzheimer’s disease. They work in such a way that they increase the levels of chemical messengers in the human brain called neurotransmitters. These chemical messengers play a vital role in memory, thought, and judgment.

Some of these medicines are donepezil (Aricept, Adlarity), rivastigmine (Exelon), and galantamine (Razadyne ER). The main benefits of these medications are that they help improve alertness and thinking. They also aid in reducing hallucinations and other behavioral symptoms. 

However, there are certain side effects associated with these medicines such as muscle cramps, stomach upset, and urination frequently.

2. Medicines for Parkinson’s disease

Carbidopa-levodopa (Sinemet, Duopa, others) are medicines that aid in relaxing rigid muscles and slow movement. However, the drawback of these medicines is that they may increase confusion, delusions, and hallucinations.


Hope the article throws light on the lesser-known aspects of the 7 stages of Lewy body dementia. Last, but not least, stay away from certain medicines that can worsen the memory of the patient. Some of them are sleep aids that contain diphenhydramine (Advil PM, Aleve PM). Also, cut down on the usage of sedatives and sleeping medicines.


  • Spillantini MG, Schmidt ML, Lee VM, Trojanowski JQ, Jakes R, Goedert M. Alpha-synuclein in Lewy bodies. Nature. 1997;388(6645):839–840. doi: 10.1038/42166. [CrossRef]
  • Bostrom F, Jonsson L, Minthon L, Londos E. Patients with Lewy body dementia use more resources than those with Alzheimer’s disease. International journal of geriatric psychiatry. 2007;22(8):713–719. doi: 10.1002/gps.1738. [PubMed]

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Dr. David G Kiely is a distinguished Medical Reviewer and former General Medicine Consultant with a wealth of experience in the field. Dr. Kiely's notable career as a General Medicine Consultant highlights his significant contributions to the medical field.

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