Dementia with Lewy bodies (DLB) is a complex condition that shares features with both Alzheimer’s disease and Parkinson’s disease. It affects about 10–15% of dementia patients, leading to symptoms such as memory loss, movement problems, sleep disturbances, and changes in behavior.
However, there are currently no approved treatments specifically for DLB, and doctors often prescribe medications originally developed for Alzheimer’s disease, such as cholinesterase inhibitors (ChEIs) and memantine, to help manage symptoms.
A new study from Karolinska Institutet in Sweden, published in Alzheimer’s & Dementia, provides long-term evidencesuggesting that cholinesterase inhibitors may help slow cognitive decline in DLB patients.
Researchers tracked 1,095 patients with DLB for up to ten years and found that those treated with cholinesterase inhibitors had better cognitive function over five years compared to those taking memantine or receiving no treatment at all.
Additionally, the study showed that patients who used cholinesterase inhibitors had a lower risk of death within the first year after diagnosis. This suggests that these medications may not only help with symptoms but could also improve overall survival in the early stages of DLB.
Why This Study Matters
DLB is the second most common neurodegenerative disorder after Alzheimer’s disease, yet research on long-term treatments is limited.
Patients with DLB often struggle with a mix of symptoms, including memory problems, hallucinations, movement difficulties, and disruptions in automatic bodily functions like blood pressure regulation. Because of this wide range of symptoms, finding an effective treatment has been challenging.
According to Hong Xu, the study’s lead researcher, previous trials on cholinesterase inhibitors and memantine for DLB have produced inconsistent results, making it unclear whether these treatments truly help. This study provides new insights by looking at long-term data, which could help guide future treatment recommendations.
Caution and Limitations
Although the findings suggest that cholinesterase inhibitors may be beneficial for DLB patients, the study was observational, meaning it cannot prove a direct cause-and-effect relationship.
Other factors, such as lifestyle habits, frailty, blood pressure, and the presence of Alzheimer’s disease-related changes in the brain, were not included in the analysis, which could have influenced the results.
Another challenge in studying DLB is that diagnosing the condition can be difficult, as its symptoms overlap with both Alzheimer’s and Parkinson’s diseases. This makes it hard to ensure that all patients in the study had a definitive DLB diagnosis.
What’s Next?
The researchers believe their findings support updating treatment guidelines for DLB to include cholinesterase inhibitors as a standard option for managing symptoms. However, they emphasize the need for more controlled clinical trials to confirm these benefits and better understand which patients respond best to these medications.
In the future, studies may also explore how DLB interacts with other conditions, such as Alzheimer’s disease and vascular dementia, and whether targeted treatments could offer more effective symptom relief.
For now, this study provides hope for patients and doctors by suggesting that cholinesterase inhibitors could offer meaningful benefits for those living with DLB.
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The research findings can be found in Alzheimer s & Dementia.
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