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Understanding Visual Hallucinations and Dementia With Lewy Bodies
It can be unsettling if you or a loved one start to see things that aren’t really there. These experiences are called visual hallucinations, and while they can have several causes, in older adults they are often an early warning sign of dementia with Lewy bodies (DLB).
Recognising hallucinations as more than “just ageing” is important. They can be a vital clue that specialist assessment is needed, leading to a faster and more accurate diagnosis — and better treatment and support.
What are visual hallucinations?
Visual hallucinations mean seeing objects, people, or animals that aren’t actually present. People often describe them as:
- Vivid and detailed (for example, children, animals, or figures in the room)
- Recurrent, sometimes happening at similar times of day
- Distressing, or occasionally strangely comforting
They are different from illusions (misinterpreting something real, like a coat on a chair looking like a person).
Why do visual hallucinations happen in dementia with Lewy bodies?
In DLB, changes in brain chemistry and networks affect how the brain processes vision. Hallucinations are therefore a core feature of the disease, and they often appear early — sometimes even before memory problems are obvious.
This makes hallucinations a red flag symptom that specialists use to help distinguish DLB from other causes of dementia, such as Alzheimer’s disease.
Other possible causes of hallucinations
Not all hallucinations mean dementia. They can also be linked to:
- Eye disease (Charles Bonnet syndrome)
- Medication side-effects
- Delirium from infection or illness
- Parkinson’s disease itself, particularly with certain treatments
That’s why it’s essential to have a thorough assessment, so the right cause — and treatment — can be identified.
Why specialist diagnosis matters
Dementia with Lewy bodies requires a different management approach to other types of dementia. Some medications used in Alzheimer’s can make symptoms worse in DLB, while tailored treatments — like Rivastigmine patches — can improve both hallucinations and thinking.
At the Memory and Brain Clinic London, you will be seen by Dr Soumit Singhai, Consultant Geriatrician, with special expertise in cognitive movement disorders and Lewy body dementia. This rare expertise means families receive accurate diagnosis, safe treatment, and holistic support.
Frequently Asked Questions
Are visual hallucinations always a sign of dementia?
No. They can also be caused by eye conditions, medication, or delirium. However, in older adults — particularly when hallucinations are vivid and recurrent — they should always prompt an assessment for Lewy body dementia.
What type of dementia causes hallucinations?
Visual hallucinations are especially common in dementia with Lewy bodies. They can also occur in Parkinson’s disease dementia and, less often, in Alzheimer’s disease.
Do hallucinations mean the dementia is advanced?
Not necessarily. In Lewy body dementia, hallucinations often appear early in the illness, sometimes even before memory problems are obvious.
How are hallucinations treated in Lewy body dementia?
Treatment usually includes:
- Cholinesterase inhibitors (such as Rivastigmine patches), which can reduce hallucinations and confusion
- Careful adjustment of other medications
- Support for sleep, movement, and daily living activities
Should families be worried about safety?
Hallucinations can sometimes cause distress or confusion, but with the right treatment many people remain safe and supported at home. If hallucinations are frequent or frightening, it’s important to seek specialist help promptly.
Next steps
Visual hallucinations can be unsettling, but they are also a valuable clue. With the right expertise, they can lead to an earlier and more accurate diagnosis — and better treatment options.
Download our free checklist: 5 Signs Visual Hallucinations Could Point to Dementia With Lewy Bodies
Contact the Memory and Brain Clinic London
If you or a loved one are experiencing visual hallucinations, don’t delay seeking specialist help. Our clinic provides expert, same-day diagnostic pathways for clarity and peace of mind.
Address: Memory and Brain Clinic London, 10 Harley Street, London, W1G 9PF
Telephone: 0207 062 7248
Email: drsinghaisecretary@outlook.com
Consultations are led by Dr Soumit Singhai, Consultant Geriatrician, with special expertise in cognitive movement disorders and Lewy body dementia.
