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What is Lewy body dementia? About the condition Patrick Stewart had

Patrick Stewart, cast member in the Paramount+ television series "Star Trek: Picard."
Patrick Stewart, who died Wednesday, had Alzheimer’s and Lewy body dementia, which one expert explains often co-occur.
(Willy Sanjuan / Associated Press)
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British actor Patrick Stewart died Wednesday at 86. His spokesperson said Thursday that he died from Alzheimer’s disease and Lewy body dementia.

The two conditions often occur together, said UCLA neurology professor Dr. Keith Vossel, and when that happens, the individual’s decline may be faster.

Lewy body dementia is the second-most-common form of degenerative dementia, behind Alzheimer’s disease, Vossel said. It occurs when a protein called alpha-synuclein aggregates in clumps inside the brain. The condition is under-recognized and under-diagnosed in part because its symptoms can overlap with those of Alzheimer’s.

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Patrick Stewart, the British actor known for ‘Star Trek: The Next Generation’ and the ‘X-Men’ franchise, has died at age 86.

Other celebrities who suffered from the condition include Robin Williams, who took his own life at 63, and Casey Kasem.

The condition is named after Friedrich H. Lewy, the neurologist who discovered the brain abnormalities in the early 1900s, according to the Alzheimer’s Assn. website.

“Essentially the only way to really diagnose these conditions together is after an autopsy and to see the hallmark features of the diseases under the microscope,” Vossel said.

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Lewy body dementia symptoms tend to start with rapid eye movement sleep behavior disorder, such as screaming or kicking during sleep. A sufferer may have rigidity or tremors in one of their arms or legs. And they may experience slowness of movement.

A patient may be diagnosed with Lewy body dementia after also experiencing cognitive symptoms within one year of motor symptoms. Cognitive symptoms could include illusions or hallucinations — some patients report sensing a shadowy figure nearby — and difficulties with problem solving and navigation. The condition is also marked by dramatic fluctuations in alertness that occur within hours of the same day.

Another early feature of Lewy body dementia is anxiety, Vossel said.

By contrast, Alzheimer’s disease typically is associated with memory and language loss, and is more associated with apathy and depression than with anxiety. The course of Alzheimer’s disease is slightly slower than that of Lewy body dementia, according to Vossel.

Lewy body dementia is more common in men than in women. Anyone over the age of 60 is at higher risk of having a degenerative condition. Lewy body dementia is most common in people in their 70s to 80s, he said.

There is currently no cure for Lewy body dementia, which is terminal and progressive. After a diagnosis, people can typically expect to live six to eight years before they need 24-hour care, Vossel said.

But medication can help manage symptoms. Clinical studies have found that cardiovascular fitness can slow the rate of decline, Vossel said.

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Those who suspect they have Lewy body dementia symptoms should contact a neurologist or a clinician trained in either geriatric medicine or geriatric psychiatry for an evaluation, Vossel said.

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