While Alzheimer's disease is considered the most common type of dementia, there are other types as well. Dementia with Lewy Bodies (DLB) is considered a separate and distinct type of dementia.
Background
DLB has similarities to both Alzheimer's disease and Parkinson's disease, a movement disorder that can also be associated with dementia (PDD). DLB was originally described in 1996, but the way this disease is understood is still evolving and controversial.
Treatment of Dementia with Lewy Bodies
Studies support the use of cholinesterase inhibitor medications for the cognitive and behavioral symptoms of DLB. Since DLB is known to have more of a reduction in acetylcholine system activity than Alzheimer's disease, some clinicians believe DLB may be more responsive to treatment with cholinesterase inhibitors than Alzheimer's disease.
The skepticism that some doctors feel about using cholinesterase inhibitors for Alzheimer's disease should not apply to DLB. Specifically, a study showed that Exelon (rivastigmine) helps some of the behavioral disturbances in patients with DLB, including anxiety, apathy, and hallucinations. Sinemet(carbidopa/levodopa) has variable success in treating the Parkinsonian features of DLB.
Managing agitation and learning how to deal with hallucinations are extremely important in DLB. Antipsychotic medications are best avoided in DLB since bad reactions to them actually may indicate a person has DLB in the first place. These reactions may include increased confusion, as well as severe motor and autonomic side effects.
Sources:
McKeith I, et al."Efficacy of rivastigmine in dementia with Lewy bodies:A randomised, double-blind, placebo-controlled international study."The Lancet 2000 vol. 356, Issue 9248: 2031-2036.
McKeith IG."Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB):report of the Consortium on DLB International Workshop"J Alzheimers Dis 2006;9(3 suppl):417-423.
