When a parent, spouse, or loved one begins showing memory changes, movement challenges, hallucinations, or sudden shifts in alertness, it can be hard to know what is happening.
You may wonder whether it is Alzheimer’s disease, Parkinson’s disease, Lewy body dementia, or another condition.
Understanding the key differences can help you prepare for medical appointments, describe symptoms clearly, and seek the right support with more confidence.
Watch: Understanding Lewy Body Dementia, Alzheimer’s, and Parkinson’s
This educational conversation can help families better understand why changes in memory, movement, sleep, and behavior may appear together.
What Is Lewy Body Dementia?
Lewy body dementia, often called LBD, is a progressive brain disorder linked to abnormal deposits of a protein called alpha-synuclein. These deposits are called Lewy bodies.
Lewy bodies can affect areas of the brain involved in:
- Thinking
- Memory
- Movement
- Sleep
- Mood
- Behavior
- Alertness
- Automatic body functions, such as blood pressure and digestion
The National Institute on Aging describes Lewy body dementia as a complex brain disorder and one of the more common causes of dementia.
For families, one of the hardest parts of LBD is that symptoms may change throughout the day. A loved one may seem clear and engaged in the morning, then confused or withdrawn later.
Lewy Body Dementia vs. Alzheimer’s vs. Parkinson’s
Lewy body dementia can be difficult to recognize because it shares symptoms with both Alzheimer’s disease and Parkinson’s disease.
The conditions are different, but their symptoms can overlap.
| Condition | Often Noticed First | Common Symptoms | Key Difference |
| Alzheimer’s disease | Memory loss | Forgetfulness, confusion, trouble with familiar tasks, difficulty recalling recent conversations | Memory changes often appear early |
| Parkinson’s disease | Movement changes | Tremor, stiffness, slowed movement, balance concerns, changes in walking | Movement symptoms often appear before cognitive changes |
| Lewy body dementia | Thinking changes, alertness shifts, hallucinations, sleep changes, or movement symptoms | Visual hallucinations, fluctuating attention, Parkinson’s-like movement, REM sleep behavior disorder, confusion | Symptoms often overlap and may fluctuate |
Mayo Clinic notes that Lewy body dementia can involve cognitive symptoms and Parkinson’s-like movement symptoms, including rigid muscles, slow movement, walking difficulty, and tremors.
Why the Overlap Matters
Families may first notice forgetfulness and think of Alzheimer’s disease.
Then they may see stiffness, shuffling steps, or tremors and think of Parkinson’s disease.
If visual hallucinations, dream enactment, or sudden changes in attention also appear, a physician may consider Lewy body dementia.
Families do not need to diagnose the condition on their own. The most helpful step is to notice patterns and share them with a qualified medical professional.
Early Signs of Lewy Body Dementia Families May Notice
Lewy body dementia does not always begin with memory loss. Some early signs involve sleep, alertness, movement, mood, or visual changes.
Families may notice:
- Vivid visual hallucinations, such as seeing people, animals, or objects that are not there
- Acting out dreams, including talking, kicking, moving, or yelling during sleep
- Sudden changes in attention, where a loved one seems focused one moment and confused the next
- Slowed movement, stiffness, tremors, or shuffling steps
- Balance changes or falls
- New anxiety, depression, paranoia, or delusions
- Trouble planning, solving problems, or following steps
- Difficulty judging distances or navigating familiar spaces
- Sensitivity to certain medications
How to Respond to Hallucinations
Hallucinations can be frightening for a loved one and for family members.
Arguing may increase fear or confusion. A calmer response often helps.
Try saying:
- “That sounds upsetting.”
- “You are safe here with me.”
- “Let’s move to another room together.”
- “I’ll stay with you.”
The goal is comfort, not correction.
Why Lewy Body Dementia Can Be Hard to Diagnose
Lewy body dementia can resemble several other conditions, including:
- Alzheimer’s disease
- Parkinson’s disease
- Parkinson’s disease dementia
- Depression
- Sleep disorders
- Medication side effects
- Other types of dementia
The timing of symptoms can help guide a medical evaluation.
If cognitive symptoms and movement changes appear close together, a physician may consider dementia with Lewy bodies.
If Parkinson’s movement symptoms are present for a longer time before dementia symptoms appear, a physician may consider Parkinson’s disease dementia.
This distinction is complex. Families should speak with a neurologist, geriatrician, or another qualified medical professional who understands dementia.
What to Bring to a Medical Appointment
A symptom journal can help your loved one’s physician see patterns that may not appear during a brief visit.
Track:
- Memory changes
- Falls or balance concerns
- Hallucinations
- Sleep behaviors
- Tremors or stiffness
- Sudden confusion
- Medication changes or reactions
- Changes in appetite or swallowing
- Mood or behavior changes
Bring your notes to appointments. Clear details can help the care team understand what daily life looks like at home.
Treatment, Therapies, and Daily Support Strategies
There is no cure for Lewy body dementia, but thoughtful dementia care can support comfort, safety, and quality of life.
Treatment should always be guided by a physician. This is especially important because some people with Lewy body dementia may be sensitive to certain medications.
A care plan may include:
- Medication review with a physician
- Evaluation by a neurologist or geriatric specialist
- Sleep assessment
- Support for mood or behavior changes
- Physical therapy for balance, strength, walking, and fall prevention
- Occupational therapy for dressing, bathing, eating, and daily routines
- Speech therapy for communication or swallowing changes
- Structured cognitive support through familiar routines and meaningful activities
Daily Routine Support
A calm, predictable environment can reduce confusion and support dignity.
Try:
- Keeping rooms well lit
- Removing clutter and loose rugs
- Using nightlights
- Keeping a consistent routine
- Reducing background noise
- Offering one instruction at a time
- Labeling drawers or doors
- Keeping frequently used items visible
- Allowing extra time for transitions
Small changes can make the day feel safer and more manageable.
Caregiving Challenges Families May Face
Lewy body dementia can be especially difficult because symptoms may feel unpredictable.
A loved one may have a good morning, then become confused by the afternoon. They may sleep poorly, see things that are not there, or need more help walking safely.
This can leave families feeling exhausted, worried, and unsure. It can also bring grief as daily life and familiar roles begin to change.
Caregiver Tips That May Help
Try these practical steps:
- Keep a symptom journal.
- Share changes with the physician.
- Avoid arguing about hallucinations.
- Use a calm voice and simple words.
- Ask family members for specific help.
- Prepare questions before appointments.
- Keep emergency contacts easy to find.
- Seek support before burnout becomes severe.
Caring for someone with dementia is an act of love. Love still needs support.
When Memory Care May Help
Families often wonder when it is time to consider memory care. There is no single answer. Every loved one and family situation is different.
Memory care may be worth exploring when:
- Falls become more frequent
- Hallucinations or delusions create safety concerns
- Sleep disruptions affect the household
- A loved one needs more help with bathing, dressing, eating, or mobility
- Medication management becomes difficult
- Wandering or unsafe movement becomes a concern
- Swallowing or nutrition changes appear
- Caregiver stress becomes unsustainable
- The home environment no longer feels safe
Choosing memory care does not mean giving up. It means widening the circle of support around your loved one.
Dementia Care at The Kensington Sierra Madre
At The Kensington Sierra Madre, we understand how emotional it can be to watch a loved one change. Families often come to us after months, or even years, of trying to manage symptoms at home.
The Kensington Sierra Madre offers assisted living and memory care in a warm, family-centered community.
We are proud to be a Positive Approach to Care Designated Community. Positive Approach to Care, created by Teepa Snow, supports connection, dignity, and a deeper understanding of brain change.
Three Memory Care Neighborhoods
Our memory care neighborhoods are designed to support different stages of cognitive change.
The Kensington Club
The Kensington Club is for new and current assisted living residents experiencing mild cognitive changes.
This neighborhood supports residents who may benefit from added structure, social connection, and early memory care support while remaining part of assisted living.
Connections
Connections is for mid-stage memory loss.
This neighborhood supports residents who may need more daily guidance, cueing, and a secure, engaging environment.
Haven
Haven is for later-stage memory loss.
This neighborhood supports residents who need more advanced care, comfort, and personalized assistance throughout the day.
Talk With Our Team
If your loved one is experiencing symptoms that feel confusing, unpredictable, or difficult to manage at home, The Kensington Sierra Madre team members are here to help you explore next steps with compassion and clarity.
Our community is located near Pasadena, Arcadia, and other San Gabriel Valley communities.
Contact us to discuss your options or schedule a tour.
FAQs: Lewy Body Dementia, Alzheimer’s, and Parkinson’s
No. Lewy body dementia and Alzheimer’s disease are different types of dementia. Alzheimer’s disease often begins with memory loss. Lewy body dementia may involve visual hallucinations, changes in alertness, sleep disturbances, and Parkinson’s-like movement symptoms earlier in the condition.
Yes. Both conditions can involve Lewy bodies in the brain and may cause movement symptoms such as stiffness, tremors, or slowed movement. The timing of cognitive and movement symptoms helps physicians distinguish dementia with Lewy bodies from Parkinson’s disease dementia.
The first sign is not always memory loss. Some families first notice visual hallucinations, acting out dreams during sleep, sudden changes in attention, balance changes, or slowed movement.
There is no cure for Lewy body dementia, but symptoms may be managed with physician-guided care, medication review, therapy support, structured routines, sleep support, and safety planning.
Families may consider memory care when symptoms begin to affect safety, daily routines, or caregiver well-being. This may include frequent falls, hallucinations, wandering, sleep disruption, medication complexity, swallowing changes, or caregiver burnout.