Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia, often with a worse prognosis than Alzheimer’s disease, including faster cognitive decline, shorter lifespan, and higher rates of institutionalization. Currently, no specific pharmacological or non-pharmacological treatments available due to limited research. A 78-year-old man presented with bradykinesia, vivid visual hallucinations, muscle stiffness, gait difficulties, REM sleep behavior disorder, and cognitive decline. He was diagnosed with DLB and prescribed prescribed Circadin, Rivotril, Aricept, Quetiapine, Pitavastatin, and Mardopa. His initial scores were MMSE 27/30, MoCA 22/30, and Timed Up and Go (TUG ) 47 seconds. He participated in a structured rehabilitation program, including strength training (focusing on quadriceps, hamstrings, hip adductors/abductors, and core) five days per week and cognitive stimulation therapy twice weekly. After three years, his TUG improved to 17.8 seconds, MMSE score remained relatively stable at 25/30, MoCA score was 20/30, with no new neuropsychiatric symptoms appearing. However, six months after reducing exercise to once weekly, his functional decline accelerated despite an increased Mardopa dose, ultimately leading to an inability to walk. This case underscores the potential advantages of structured physical exercise and cognitive stimulation therapy in enhancing motor function and preserving cognitive stability in individuals with DLB. A multidisciplinary approach may improve long-term outcomes. Many studies have demonstrated the positive impact of exercise and weight training on Alzheimer’s dementia, similar strategies may be valuable for other dementias.

Authors:
Manita Kittileadworakul, Institute of Medicine, Thailand
Bootsakorn Loharjun, Institute of Geriatric Medicine, Thailand
Yindee Boontra, Institute of Geriatric Medicine, Thailand
Keiko Mehra, Japan International Cooperation Agency, Japan
Penpicha Opasawat, Institute of Geriatric Medicine, Thailand
Natthanun Roongruangsahapan, Institute of Geriatric Medicine, Thailand

About the Presenter(s)
Miss Manita Kittileadworakul is currently a geriatrician at Institute of Geriatric Medicine, department of medical services, Thailand.

See this presentation on the full schedule – Friday Schedule

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