In Spain, there are more than 100,000 people with Lewy body dementia, the third most common type of dementia.

In Spain, more than 100,000 people live with Lewy body dementia, a neurodegenerative disease that ranks as the third leading cause of dementia in the country, surpassed only by Alzheimer’s and vascular dementia. For the past two years, January 28 has been commemorated as World Lewy Body Dementia Day, aiming to raise awareness about this condition that, unfortunately, often remains in the shadows.

The Spanish Society of Neurology (SEN) estimates that between 10% and 20% of dementia cases in Spain correspond to this disease, highlighting the magnitude of the problem. Dr. Raquel Sánchez-Valle, Coordinator of the SEN's Behavioral and Dementia Study Group, emphasizes that Lewy body dementia shares both clinical and biological characteristics with Alzheimer’s and Parkinson’s diseases, which can complicate its identification. However, accurate diagnosis is crucial to ensure appropriate clinical management.

One of the main challenges associated with Lewy body dementia is its variability in symptom presentation. The early signs of this disease are often confused with other disorders, including psychiatric conditions, contributing to its underdiagnosis. In fact, it is common for patients to experience a delay in diagnosis, which worsens their situation. Dr. Sánchez-Valle underscores the importance of early diagnosis to improve the quality of life for those affected.

The onset of cognitive decline is one of the distinguishing features of this dementia, with a particular focus on attentional and visuospatial disturbances, as well as psychomotor slowing. Neuropsychiatric manifestations, such as illusions or visual hallucinations, can also occur, affecting a significant percentage of patients. These symptoms, along with motor and sleep disorders, should raise suspicion of the disease and facilitate timely diagnosis.

The course of Lewy body dementia tends to be aggressive, with a life expectancy of approximately five to six years after diagnosis. As the disease progresses, patients face increasing disability and dependence, resulting in higher care costs. It is essential for both healthcare professionals and family members to be informed about the nature of this disease to assist those who suffer from it.

The accumulation of Lewy bodies in the brain, characterized by abnormal deposits of the protein alpha-synuclein, defines this disease. Although the causes of this accumulation are not fully understood, several risk factors have been identified, including age, sex, and family history. These characteristics demonstrate that Lewy body dementia does not discriminate among individuals but disproportionately affects men and older adults.

One of the most alarming aspects is the time it can take to obtain an appropriate diagnosis. In one-third of cases, the process can extend for more than two years. This delay not only affects treatment but can also impact the quality of life of the patient and their loved ones. Dr. Sánchez-Valle emphasizes the need for reliable diagnostic tests that allow for the identification of the disease during the patient's lifetime, which is key for effective medical intervention.

Although only symptomatic treatments currently exist, the personalization of pharmacotherapy is essential, considering the hypersensitivity to neuroleptics in many patients. Individualizing treatment, which must take into account all symptoms presented by the patient, poses a significant challenge for physicians. However, efforts in clinical research are vital for the development of new therapies that can improve quality of life and delay dependence.

As awareness of Lewy body dementia grows, so does the hope that more people will be diagnosed and treated appropriately. Education and awareness are essential tools in addressing this disease. With the collaboration of healthcare professionals, researchers, and families, we can move towards a future where Lewy body dementia is recognized and treated with the seriousness it deserves.