Theres A Spectrum Of Pathologies
Scientists have been examining this linkand how the two diseases often overlapfor some time, but still arent completely certain how they contribute to one another. As a result, physicians sometimes group the diseases into different combinations when making diagnoses.
Dementia in Parkinsons patients can present itself in varying forms. In some cases, the Parkinsons pathology can trigger the dementia pathologya situation that results in whats known as Parkinsons disease dementia, says Dr. Aaron Ritter, Director of the Clinical Research Program at the Cleveland Clinic Lou Ruvo Center for Brain Health.
A substantial subset of folks with Parkinsons who live long enough, will develop dementia, Ritter said.Its separate from Alzheimers, but its likely related to Parkinsons pathology, a sort of spreading of Parkinsons.
In other cases, patients may develop a form of dementia like Alzheimers separately from their Parkinsons disease, though this isnt visible until after death, through an autopsy.
Many people with Parkinsons may also develop Lewy body dementia shortly after their diagnosis. When you have Parkinsons, and see cognitive declineor things like hallucinations and delusionsup to a year after your Parkinsons diagnosis, you may have Lewy body dementia, Oguh said.
How Does Parkinsons Affect The Brain
When the disease occurs, some nerve cells might break down or die gradually.
Though due to this the dopamine level of your brain decreases, & if the dopamine decreases, the brain will start behaving in an abnormal way.
Albeit, people often get confused over the two terms Alzheimers & Parkinsons well both the disease are caused by damaged brain cells..but there are huge differences.
Dementia With Lewy Bodies And Parkinson Disease Dementia
, MD, PhD, Department of Neurology, University of Mississippi Medical Center
Dementia with Lewy bodiesParkinson disease dementia
Dementia is chronic, global, usually irreversible deterioration of cognition.
Dementia with Lewy bodies is the 3rd most common dementia. Age of onset is typically > 60.
Lewy bodies are spherical, eosinophilic, neuronal cytoplasmic inclusions composed of aggregates of alpha-synuclein, a synaptic protein. They occur in the cortex of some patients who have dementia with Lewy bodies. Neurotransmitter levels and neuronal pathways between the striatum and the neocortex are abnormal.
Lewy bodies also occur in the substantia nigra of patients with Parkinson disease Parkinson Disease Parkinson disease is a slowly progressive, degenerative disorder characterized by resting tremor, stiffness , slow and decreased movement , and eventually gait and/or read more , and dementia may develop late in the disease. About 40% of patients with Parkinson disease develop Parkinson disease dementia, usually after age 70 and about 10 to 15 years after Parkinson disease has been diagnosed.
Both dementia with Lewy bodies and Parkinson disease dementia have a progressive course with a poor prognosis.
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Parkinsons Disease Dementia And Dementia With Lewy Bodies
The key pathological hallmark found in brains of Parkinsons disease and Parkinsons disease dementia patients are abnormal microscopic deposits composed of -synuclein. This protein is found widely in the brain and its normal function is not yet well understood. The deposits are called Lewy bodies. Lewy bodies are also found in several other neurodegenerative brain disorders, including dementia with Lewy bodies . Evidence suggests that Parkinsons disease and Parkinsons disease dementia, and dementia with Lewy bodies, may be linked to the same underlying abnormalities in caused by the deposition of -synuclein.
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Medications For Other Symptoms Of Dementia
People with LBD may often experience a sleep disorder called rapid eye movement sleep behavior disorder. This can sometimes be treated with sedatives like clonazepam or with melatonin . Other more severe symptoms of LBD including fluctuating levels of alertness , hallucinations, agitation, severe confusion, and delirium can be challenging to treat. Doctors must first rule out underlying causes like infection or other medications that can be triggering these symptoms. If unable to find a treatable cause, doctors may use a low dose of the atypical antipsychotic medication quetiapine to treat these symptoms. However, people with LBD must not be given typical antipsychotics or high-potency atypical antipsychotics , as people with LBD are very sensitive to these medications and may develop neuroleptic malignant syndrome if they take them. This is a life-threatening condition that causes fever, muscle stiffness, and racing heart, and can lead to heart and kidney failure. Talk with your doctor about medication options.
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Parkinsons Disease: Symptoms Stages And Treatment
Parkinson’s disease usually begins after age 60, gradually progressing over the years. Some people can have early-onset Parkinson’s disease, starting in their 30s or 40s. It is primarily a movement disorder characterized by resting tremors and slowness and stiffness of movement.
In the late stages of the disease, Parkinson’s dementia can develop. But most people who have Parkinson’s disease do not develop dementia as a part of the condition.
Lifespan In Parkinsons Nearly Identical To General Population
A new study finds that, overall, lifespan for those living with Parkinsons disease is nearly identical to those in the general population. The study looked at a group of diseases called synucleinopathies, including Parkinsons. The results appear in the May 15 online edition of JAMA Neurology.
Lewy bodies clumps of alpha-synuclein protein that accumulate in certain brain cells are the hallmark of PD. The clumps also occur in less common diseases such as multiple system atrophy , dementia with Lewy bodies , and PD dementia in which symptoms can be similar to those of typical Parkinsons.
Researchers led by Rodolfo Savica, M.D., Ph.D., at the Mayo Clinic in Rochester, MN, compared lifespan and cause of death among people with synucleinopathies compared to the general population. They examined the medical records of all 461 people diagnosed with synucleinopathies in Olmsted County, MN, between 1991 and 2010. The scientists also analyzed records from individuals closely matched for age and sex who did not have these diagnoses.
Results
What Does It Mean?
Overall, the study reminds us that people with Parkinsons can live many years with the disease. With that in mind, people living with these diseases, their care partners and their families can take steps to plan for their health care and make important financial decisions.
Reference
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What Causes Lewy Body Dementia
The causes of LBD are not yet well understood, but research is ongoing in this area. There are probably multiple factors involved, including genetic and environmental risk factors that combine with natural aging processes to make someone susceptible to LBD.
For more information, visit www.lbda.org.
Modified with permission from the Lewy Body Dementia Association
To learn more about motor symptoms related to Parkinsons, visit here.
To learn more about non-motor symptoms related to Parkinsons, visit here.
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What Is Vascular Dementia
Vascular dementia is the second most common type of dementia in the UK after Alzheimers disease. It occurs when the brain is damaged due to a lack of blood flow.
Sometimes people have both vascular dementia and Alzheimers, giving them a diagnosis of mixed dementia.
If the vascular system within the brain becomes damaged so that the blood vessels leak or become blocked then blood cannot reach the brain cells and they will eventually die.
This death of brain cells can cause problems with memory, thinking or reasoning, and when these cognitive problems are bad enough to impact on daily life, it is known as vascular dementia.
Dementia symptoms specific to vascular dementia include stroke-like symptoms, suchas as muscle weakness, movement and thinking problems and mood changes, such as depression.
There are several different types of vascular dementia, due to the varying levels of damage on the affected part of the brain.
They include stroke-related dementia, single-infarct and multi-infarct dementia and subcortical vascular dementia.
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What Causes Alzheimer’s New Study Reveals Shocking Detail
It is estimated that about 44 million people worldwide are currently living with Alzheimer’s disease. One of the most influential research articles on Alzheimers states that the disease is caused by the buildup of amyloid plaques in the brain. However, new research has discovered that the disorder is caused by a decline in levels of a soluble protein called amyloid beta. The investigation by Science Magazine is published in the Journal of Alzheimer’s Disease.
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Serious Infections Linked To Early Alzheimers Parkinsons Disease
Batya Swift Yasgur MA, LSW
Patients in early- and mid-life who contract with infections that require hospitalization appear to be at increased risk for neurodegenerative diseases, including Alzheimers disease and Parkinsons disease at a relatively young age, new research suggests.
Investigators in Sweden analyzed data from several large national registries, and compared individuals diagnosed with AD, PD, and amyotrophic lateral sclerosis to randomly selected age- and sex-matched controls from the general population.
They found that those who had a hospital-treated infection 5 or more years earlier were at a 16% increased risk for AD and a .04% increased risk for PD. Multiple infections before age 30 years conferred more than a 2.5-fold increased risk for AD and a 1.5-fold increased risk for PD before age 60 years.
Increased risks for AD and PD were associated with bacterial, viral, other infections and different sites of infection, including gastrointestinal, and genitourinary infections.
Our study suggested that individuals with hospital-treated infections, especially in those occurring in early- and mid-life, had an increased risk of developing AD and PD, attributable to cases diagnosed before 60 years, the investigators, led by Jiangwei Sun, PhD, a postdoctoral researcher in the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, write.
The study was published online September 15 in PLOS Medicine.
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How Is Lbd Different From Parkinsons Or Alzheimers
These diseases are similar in a lot of ways. But there are some key differences in the symptoms that affect people with LBD and when those symptoms happen.
LBD may not cause short-term memory loss like Alzheimerâs. People with both conditions have trouble with thinking, alertness, and paying attention. But in LBD, those problems come and go. The disease can also cause hallucinations, often in the first few years someone has LBD. People with Alzheimerâs usually donât have hallucinations until the later stages.
People with LBD also often act out their dreams and make violent movements when theyâre asleep. Itâs called REM sleep behavior disorder. Sometimes, itâs the first sign that someone has LBD.
LBD and Parkinsonâs disease both cause movement problems, like stiff muscles and tremors. But most people with Parkinsonâs donât have problems with their thinking and memory until the very later stages of their disease. Sometimes, they donât have it at all. In the type of LBD known as Parkinsonâs disease with dementia, these problems begin much sooner.
People with LBD also need different drugs for their condition than the ones that treat Parkinsonâs or Alzheimerâs.
Protein And Not Plaque Is The Key To Alzheimers Disease
The original research was in 2006 and has been cited in over 2,000 articles since then. The study suggested that the formation of amyloid plaques in the human brain is the main cause of senile dementia. Amyloid plaques are clumps of a sticky protein called amyloid-beta that form in the spaces between nerve cells. Experts have believed that these abnormally configured proteins play a key role in Alzheimer’s disease. They are thought to first develop in the areas of the brain related to memory and other cognitive functions.
In the current study, scientists from the University of Cincinnati and Karolinska Institute analyzed the concentration of amyloid plaques and amyloid-beta proteins in two groups. The first group consisted of people that had a very high risk of Alzheimers according to the 2006 study. The researchers found mutations signaling the development of amyloid plaques in the future. The second group was comprised of healthy individuals.
The researchers observed that, in both cases, individuals with low concentrations of soluble amyloid-beta protein were at a bigger risk of dementia. In contrast, those more likely to have amyloid plaques in their brain in the future but also high concentrations of amyloid-beta protein demonstrated normal brain activity.
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Medicines For Parkinsons Disease
Medicines can help treat the symptoms of Parkinsons by:
- Increasing the level of dopamine in the brain
- Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells
- Helping control non-movement symptoms
The main therapy for Parkinsons is levodopa. Nerve cells use levodopa to make dopamine to replenish the brains dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy such as nausea, vomiting, low blood pressure, and restlessness and reduces the amount of levodopa needed to improve symptoms.
People living with Parkinsons disease should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, like being unable to move or having difficulty breathing.
The doctor may prescribe other medicines to treat Parkinsons symptoms, including:
- Dopamine agonists to stimulate the production of dopamine in the brain
- Enzyme inhibitors to increase the amount of dopamine by slowing down the enzymes that break down dopamine in the brain
- Amantadine to help reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
Symptoms Related To Brain Function Are Different
There is some overlap, but in general, the overall cognitive symptoms that people experience with Parkinson’s disease, dementia, and Alzheimer’s are different. Alzheimer’s mainly affects language and memory at the outset, whereas Parkinson’s affects problem-solving, speed of thinking, memory, and mood.6
Unlike Alzheimer’s disease, people with Parkinson’s-related dementia often experience hallucinations, delusions, and paranoid thoughts. Both conditions can lead to depression, anxiety, and sleep disturbances.4,6
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What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
Parkinsons Disease: Causes Symptoms And Treatments
Parkinsons disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination.
Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
While virtually anyone could be at risk for developing Parkinsons, some research studies suggest this disease affects more men than women. Its unclear why, but studies are underway to understand factors that may increase a persons risk. One clear risk is age: Although most people with Parkinsons first develop the disease after age 60, about 5% to 10% experience onset before the age of 50. Early-onset forms of Parkinsons are often, but not always, inherited, and some forms have been linked to specific gene mutations.
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What Is The Self
Protein in the diet may affect the absorption of levodopa, the major medication used to treat Parkinsons disease. Fluctuations in the level of levodopa may worsen some behavioral and cognitive symptoms. A low-protein diet may reduce fluctuations in dopamine levels. In some patients with these fluctuations, dietary changes can improve symptoms. However, it is important to ensure that the person is getting adequate calories and other nutrients.
People with Parkinsons disease should remain as active as possible. Physical therapy helps the person maintain mobility.
In general, people with Parkinsons disease plus dementia should no longer drive vehicles. Movement problems may prevent quick reactions in hazardous driving situations. Certain medications, especially those given to treat symptoms of dementia, may make them less alert. However, this should be determined on an individual basis and in compliance with the laws of the state.
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How Many Americans Have Alzheimers Disease
Estimates vary, but experts suggest that more than 6 million Americans age 65 and older may have Alzheimers. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimers disease.
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How Is Parkinson Disease Diagnosed
Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinson’s disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.
What Is Parkinsons Disease
Parkinsons disease was described by James Parkinson nearly 100 years before Dr. Alois Alzheimer described the dementia later named Alzheimers disease . Called the shaking palsy by Parkinson, PD is diagnosed when a person shows at least two of these three symptoms: slowed movements , muscle rigidity, and tremor . We recognize many other associated signs of PD, including expressionless face, quiet speech, cramped handwriting, shuffling gait, trouble getting out of a chair, and difficulty swallowing. Many of the symptoms of idiopathic Parkinson’s disease result when certain nerve cells that produce dopamine in the brain begin to malfunction and die.
Most cases are called idiopathic, meaning the cause remains unknown, although a small number of cases are linked with poisoning , head trauma, more complex PD-like neurological disorders , or reversible toxic medication effects ,
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