Understanding Lewy Body Dementia and Its Symptoms
Lewy body dementia (LBD) is a progressive neurological condition caused by abnormal protein deposits called Lewy bodies in areas of the brain involved in thinking, memory, movement, and behavior.
Symptoms can include changes in attention and alertness, muscle stiffness, slowed movement, poor balance, visual hallucinations, sleep disturbances, and increasing difficulty with everyday activities.
Movement problems can appear early, making it harder to walk safely, get out of a chair, climb stairs, or move around the home. As these activities become more challenging, people often become less active. Over time, reduced activity can lead to muscle loss and weakness, making everyday movement even more difficult and increasing dependence on caregivers.
How Lewy Body Dementia Affects Movement and Mobility
Unlike many other forms of dementia, Lewy body dementia often causes movement problems early in the disease, including muscle stiffness, slowed movement, poor balance, shuffling, and falls.
One of the defining characteristics of Lewy body dementia is that symptoms can fluctuate dramatically from day to day - or even hour to hour. A person may walk through the house independently one day and need significantly more help standing or moving the next.
Although exercise cannot stop the progression of Lewy body dementia or prevent these fluctuations, ongoing strength training can help preserve the physical abilities needed for everyday life. When leg strength is maintained, the lows may not be as low, and everyday function may be more consistent - even when symptoms fluctuate. Stronger legs support standing, walking, and transfers, helping people remain as mobile and independent as possible.
How Strength Training Supports Everyday Activities
Progressive strength training works to maintain the muscle strength needed for everyday movement. When combined with balance and functional exercises, it can help people continue performing familiar activities as their abilities change.
Supporting Balance and Safer Movement
Lewy body dementia can affect balance, coordination, and the ability to control movement, increasing the risk of falls. Shuffling steps and difficulty adjusting to changes in direction can make walking through the home more challenging.
Strengthening the legs and practicing balance can help support the movements needed to stand, walk, and change direction. Repeating these movements regularly helps make movement a familiar part of everyday life, reinforcing the physical abilities needed to keep moving. The goal is to help maintain safer mobility and reduce the physical limitations that can make everyday movement more difficult.
Maintaining Walking Ability and Reducing Reliance on Assistance
For someone living with Lewy body dementia, being able to walk to the bathroom, move through the kitchen, or get around the home can make a meaningful difference in daily life. As leg strength declines, a person may begin relying more on a walker or another person's assistance to get around.
Stronger legs help support the ability to stand, walk, and move from one position to another. Maintaining leg strength can help a person continue walking and performing everyday activities with less physical assistance, when safe and appropriate.
The goal is to preserve as much mobility and independence as possible, while helping each person remain active in their own home.
Supporting Movement Despite Stiffness and Slowed Movement
Muscle stiffness and slowed movement are common in Lewy body dementia. Getting started, taking steps, and moving from one position to another can become more difficult.
Strength training does not eliminate stiffness or restore normal movement. However, maintaining leg strength can help support the physical effort needed to stand, walk, and transfer. When a person has more strength to draw on, everyday movement may be easier to manage despite these challenges.
Supporting Overall Well-Being
Staying physically active can help people with Lewy body dementia maintain strength, mobility, and participation in everyday life. Continuing to move and take part in familiar activities can also support quality of life.
Exercise may benefit some aspects of thinking and attention, but research specific to Lewy body dementia remains limited.
What Does Research Say About Exercise for Lewy Body Dementia?
Research on exercise specifically for Lewy body dementia is still developing, but early findings are encouraging.
The PRIDE study examined a structured exercise program for people living with Lewy body dementia. The program included resistance training, balance exercises, and functional activities. Researchers reported improvements in areas such as physical function and mobility, highlighting the potential value of structured exercise.
The findings support the importance of maintaining physical activity and strength, while recognizing that exercise cannot stop the progression of the disease.
How Strength Training Supports Mobility on Difficult Days
One of the most challenging aspects of Lewy body dementia is the unpredictable fluctuation in physical and cognitive function.
Families may notice that their loved one can walk independently one day but needs help standing from a chair the next. Balance, coordination, stiffness, alertness, and endurance can change throughout the day.
Strength training cannot prevent these fluctuations. However, maintaining leg strength helps preserve physical capacity, which may make it easier to manage everyday movement when symptoms become more pronounced. When a person has a stronger physical foundation, the difference between a better day and a more difficult day may be less pronounced, and everyday function may be more consistent.
Think of leg strength as a reserve. During more difficult periods, stronger muscles provide additional physical capacity to help with standing, walking, and transfers.
Why Exercise Needs to Change as Lewy Body Dementia Progresses
Lewy body dementia is progressive, so exercise programs need to adapt as a person's strength, balance, and mobility change.
Exercises should continue to provide an appropriate challenge while matching the person's current abilities. On stronger days, the program may safely increase in difficulty. On more difficult days, exercises may need to be modified while still working toward maintaining strength.
The goal is to keep building or preserving the strength needed for everyday activities without making exercise unnecessarily difficult or unsafe.
How Does Tandem Strength & Balance Support People Living with Lewy Body Dementia?
Tandem Strength & Balance provides private-pay, in-home strength and balance training for older adults who need continued exercise beyond traditional rehabilitation. Our physical therapists bring everything needed to the client's home and create individualized programs focused on building and maintaining leg strength, improving balance, and supporting everyday mobility.
Working in a familiar environment allows us to practice meaningful activities, such as standing from a favorite chair, getting in and out of bed, and walking through the home. As Lewy body dementia changes over time, we adapt each program to the person's abilities, safely increasing the challenge on stronger days and modifying exercises on more difficult days.
When Medicare-covered physical therapy ends, the need to maintain strength and mobility doesn't. Without continued strengthening, leg muscles can become weaker, walking may become more difficult, and everyday activities may require more assistance. Tandem provides ongoing, private-pay training that adapts as each person's needs change.
Our goal is to help each person maintain strength, move with greater confidence, and remain as mobile and independent as possible for as long as possible.
Why Families Choose Tandem Strength & Balance
Families choose Tandem Strength & Balance for ongoing, individualized strength training that can continue as Lewy body dementia progresses.
Our proprietary in-home program focuses on building and maintaining leg strength where it matters most - at home. We work on the movements that support everyday activities and adjust the program as physical abilities change.
The goal is to help clients maintain strength, move with greater confidence, and continue participating in daily life for as long as possible.
Frequently Asked Questions
Can strength training help someone with Lewy body dementia?
Strength training cannot cure Lewy body dementia or stop its progression. However, maintaining leg strength and practicing functional movements can help support mobility, balance, and everyday activities.
How does leg strength support everyday movement?
Strong legs help with standing, walking, climbing stairs, getting in and out of bed, and transferring safely. Maintaining leg strength supports the physical abilities needed to remain mobile and independent.
Why is ongoing exercise important with Lewy body dementia?
Lewy body dementia is progressive, and physical abilities can fluctuate from day to day. Ongoing exercise helps maintain strength and allows the program to change as a person's needs change.
Is walking enough exercise?
Walking is important for cardiovascular health and endurance, but it does not provide the resistance needed to build and maintain leg strength. Progressive strength training works the muscles needed for standing, climbing stairs, and transferring safely.
What happens after Medicare physical therapy ends?
Many people continue to need exercise after Medicare-covered therapy ends. Tandem Strength & Balance provides ongoing, private-pay, in-home strength and balance training that adapts as each person's abilities change, helping support mobility and independence.
References
1. Inskip MJ, Mavros Y, Sachdev PS, et al. Promoting independence in Lewy body dementia through exercise: The PRIDE study. BMC Geriatrics. 2022;22:650.
2. Inskip M, Mavros Y, Sachdev PS, Fiatarone Singh MA. Exercise for Individuals with Lewy Body Dementia: A Systematic Review. PLOS ONE. 2016;11(6):e0156520.
3. Systematic review of the efficacy of non-pharmacological interventions in people with Lewy body dementia.