What is the ‘Lewy lean’? The odd sign of a type of dementia that progresses faster than Alzheimer’s

Stand at attention for an off-kilter sign of this particular kind of dementia.

Nearly 7 million Americans have been diagnosed with dementia, which gradually destroys memory, thinking skills, and the capacity to perform basic tasks. 

While Alzheimer’s disease remains the most common form of dementia, another prevalent type of cognitive decline includes a singular symptom.

4

Lewy body dementia (LBD) is the third-most common form of dementia. Unlike Alzheimer’s, in which sufferers have issues forming new memories, people with Lewy body dementia can create new memories but have a hard time retrieving them.

“LBD has many core clinical features that distinguish this form of dementia from Alzheimer’s disease,” Dr. Jonathan Fellows from the Michigan Institute for Neurological Disorders (MIND) told The Post.

“Patients can experience fluctuations in their cognition, alertness and attention, which can vary from day to day or even from hour to hour.”

Fellows noted that there is one troubling, telltale sign of LBD — and it made seem familiar if you’ve noticed a loved one always seems to be leaning forward when they stand.

“The ‘Lewy lean’ is a term used to describe gait and balance problems associated with LBD,” he said. 

“Patients can have several different variations, including a persistent lean to one side when sitting, standing, or walking; difficulty standing upright; difficulty walking straight; and increased falls associated with loss of balance.”

4

He notes that the so-called Lewy lean typically expresses itself in the disease’s later stages.

According to Fellows, LBD progresses more rapidly than Alzheimer’s, averaging 5 to 8 years from diagnosis to death compared to 8 to 10 years for Alzheimer’s disease.

For those who notice the ‘Lewy lean’ in a friend or family member, Fellows encourages them to seek care from a medical professional, as it could be a sign of LBD or other neurological issues.

“This type of imbalance certainly can be seen with a degenerative brain condition such as LBD, but also can be seen with other neurologic problems, including Parkinson’s disease, stroke, neuropathy, or multiple sclerosis.”

Recent research from the University of Michigan found that millions of Americans likely have dementia symptoms but no formal diagnosis, in part because patients misunderstand their symptoms as normal aging.

4

Fellows shared that LBD patients can also present with detailed visual hallucinations and sleep disturbances that often appear early in the disease process.

“A common early feature of LBD includes REM sleep behavior disorder, where patients have vivid dreams and act out their dreams with yelling, kicking, or punching during sleep. This sleep disorder often precedes the cognitive symptoms by many years.”

As there is no cure for LBD, treatment focuses on symptom management.

Because the disease shares features with both Alzheimer’s and Parkinson’s disease, therapies are used interchangeably.

“Cholinesterase inhibitors, such as rivastigmine or donepezil, although not FDA approved for this condition, can be used to help with cognition, attention, and hallucinations,” the doc said.

4

“Symptoms similar to those of patients with Parkinson’s disease can sometimes be managed with levodopa therapy, such as Sinemet.”

Atypical antipsychotic medication is used to treat symptoms like hallucinations, delusions, and agitation. However, Fellows emphasized that traditional antipsychotics should be avoided as they can exacerbate LBD symptoms.

LBD patients who are suffering from REM sleep behavior disorder can utilize melatonin or clonazepam.

“All of these medications used to treat symptoms of LBD can be discussed with your neurology provider.”

The autopsy of Robin Williams revealed the beloved actor and comedian was suffering from LBD before his death by suicide in 2014.

diabetes, excess alcohol intake, traumatic brain injury, sleep issues.