Dementia with Lewy bodies, the second most prevalent kind of dementia, has no known cure. Researchers at the Karolinska Institute have discovered that cholinesterase inhibitors, which are drugs used to treat Alzheimer’s disease, may help slow down cognitive impairment in patients who have dementia with Lewy bodies over five years. They also found that using cholinesterase inhibitors was associated with a lower chance of death during the first year following a diagnosis of Lewy body dementia.

With dementia with Lewy bodies accounting for 15–25% of all dementia diagnoses, it is the second most prevalent form of dementia after Alzheimer’s [1].

It is also known as Lewy body dementia and is characterized by clumps of protein in the brain known as Lewy bodies. Dementia patients with Lewy bodies have many of the same symptoms as those of Alzheimer’s and Parkinson’s diseases, including cognitive impairments like memory loss, difficulty solving problems, and trouble speaking, as well as movement problems like tremors, lack of coordination, and frequent falls.

Lewy body dementia has no known cure. Treatments and therapies, including occupational therapy, speech therapy, and psychological therapy, can all help alleviate disease symptoms.

Cholinesterase inhibitors, which are Alzheimer’s drugs, may help slow down cognitive loss in individuals with dementia with Lewy bodies over five years, according to a recent study from the Karolinska Institute in Sweden. Researchers also discovered that using cholinesterase inhibitors was associated with a lower risk of mortality in the first year after being diagnosed with Lewy body dementia.

The journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association published the research [2].

Can Cholinesterase Inhibitors Help With Lewy Body Dementia Treatment?

Researchers studied the data from more than 1,000 individuals with Lewy body dementia diagnoses from the Swedish Registry on Cognitive/Dementia Disorders.

All research participants received either no treatment at all or one of two standard Alzheimer’s disease therapies. The first medication was donepezil, a cholinesterase inhibitor, and the second was memantine. Every participant received a diagnosis, began treatment within three months, and was monitored for a maximum of ten years.

Cholinesterase inhibitors block acetylcholine breakdown in nerve cells. Acetylcholine is a neurochemical that is vital for memory and thinking skills.

Doctors prescribe memantine to treat memory loss, which is a common Alzheimer’s symptom. Alzheimer’s has a severe impact on nerve cells, causing them to produce excessive amounts of a neurotransmitter known as glutamate. Memantine protects neuronal cells by blocking the effects of excessive glutamate.

The first author of this study, Hong Xu, PhD, assistant professor in the Department of Neurobiology, Care Sciences and Society at the Karolinska Institutet in Sweden, stated in a press release that since there are currently no approved treatments for dementia with Lewy bodies, doctors frequently prescribe medications for Alzheimer’s, such as memantine and cholinesterase inhibitors, to treat its symptoms. However, the efficacy of these treatments is unknown due to inconsistent results from trials and insufficient long-term evidence [3].

Slowing Cognitive Decline in Lewy Body Dementia with Alzheimer’s Drugs

Researchers discovered that using cholinesterase inhibitors significantly delayed cognitive deterioration in patients with dementia with Lewy bodies over five years, compared to those given memantine or no treatment.

Furthermore, researchers found that using cholinesterase inhibitors lowered the probability of death in the first year after being diagnosed with Lewy body dementia. However, in people with dementia with Lewy bodies, this mortality effect did not persist after one year.

In the press release, the paper’s last author, Maria Eriksdotter, PhD, professor in the Department of Neurobiology, Care Sciences, and Society at Karolinska Institutet, said that their findings supported the need to update treatment guidelines and demonstrated the potential advantages of cholinesterase inhibitors for patients with dementia with Lewy bodies.

What are the Limitations of the Study?

The study’s observational nature makes it difficult to derive any causal conclusions. 

The researchers lacked information on patients’ lifestyle choices, frailty, blood pressure, and Alzheimer’s co-pathology, which could have affected their findings.

Another study limitation is that precisely diagnosing Lewy body dementia continues to be challenging. 

Alzheimer’s Research Association is a non-profit organization dedicated to helping caregivers of Alzheimer’s disease and dementia. We provide the latest information and news about the illness and helpful tips to help caregivers cope with their daily caregiving challenges. We realize the most important thing that a caregiver needs is financial assistance. Therefore, we provide grants to caregivers to ease their financial burden. Caregivers can apply for grants here: Alzheimer’s Grant Application. 

You can also help caregivers in their endeavor by donating as much as possible Donation To Alzheimer’s Research Associations.

References

• Kane, J.P., Surendranathan, A., Bentley, A., Barker, S.A., Taylor, J.P., Thomas, A.J., Allan, L.M., McNally, R.J., James, P.W., McKeith, I.G. and Burn, D.J., 2018. Clinical prevalence of Lewy body dementia. Alzheimer’s research & therapy, 10, pp.1-8.

• Xu, H., Habich, A., Ferreira, D., Elisabet, L., Westman, E. and Eriksdotter, M., 2024. Long‐term effects of cholinesterase inhibitors and memantine on cognitive decline, cardiovascular events, and mortality in dementia with Lewy bodies: An up to 10‐year follow‐up study. Alzheimer’s & Dementia.

• Alzheimer’s drug may slow down cognitive decline in dementia with Lewy bodies. News from Karolinska Institutet. https://news.ki.se/alzheimers-drug-may-slow-down-cognitive-decline-in-dementia-with-lewy-bodies. Published Online: 23rd August, 2024. Accessed: 29th October, 2024.

• Certain Alzheimer’s disease medications may slow cognitive decline in Lewy body dementia. Medical News Today. https://www.medicalnewstoday.com/articles/alzheimers-cholinesterase-inhibitors-slow-cognitive-decline-lewy-body-dementia. Published Online: 29th August 2024. Accessed: 29th October, 2024.

• Alzheimer’s drug may slow down cognitive decline in dementia with Lewy bodies. Science Daily. https://www.sciencedaily.com/releases/2024/08/240823120044.htm. Published Online: 23rd August, 2024. Accessed: 29th October, 2024.