Is The Dementia Caused By Parkinsons Or Something Else
Indications that dementia may be caused by something other than Parkinsons disease include agitation, delusions , and language difficulties. If the onset of cognitive symptoms is sudden, theyre more likely due to something other than Parkinsons diseaseeven reversible causes such as infection, a vitamin B12 deficiency, or an underactive thyroid gland.
Depression can mimic dementia by causing similar symptoms such as apathy, memory problems, and concentration difficulties. Since depression is very common in Parkinsons patients, its important to recognize the signs and symptoms of depression in older adults.
Parkinsons disease dementia vs. other dementias
Other types of dementia that can be commonly mistaken for Parkinsons disease dementia include:
Lewy Body Dementia is characterized by fluctuations in alertness and attention, recurrent visual hallucinations, and Parkinsonian motor symptoms like rigidity and the loss of spontaneous movement. In this disorder, cognitive problems such as hallucinations tend to occur much earlier in the course of the disease and often precede difficulties with walking and motor control.
Alzheimers disease and Parkinsons disease are both common in the elderly, especially in those over 85. Patients with Parkinsons who develop dementia may even develop Alzheimers dementia as well. Therefore, its important to be aware of the signs of Alzheimers Disease and how its treated.
What Is Parkinson’s Disease Dementia
Parkinson’s disease is an age-related degenerative disorder of certain brain cells. It mainly affects movements of the body, but other problems, including dementia, may occur. It is not considered a hereditary disease, although a genetic link has been identified in a small number of families.
- The most common symptoms of Parkinson’s disease are tremor of the hands, arms, jaw, and face rigidity of the trunk and limbs slowness of movement and loss of balance and coordination.
- Other symptoms include shuffling, speaking difficulties, , facial masking , swallowing problems, and stooped posture.
- The symptoms worsen gradually over years.
Depression, anxiety, personality and behavior changes, sleep disturbances, and sexual problems are commonly associated with Parkinson’s disease. In many cases, Parkinson’s disease does not affect a person’s ability to think, reason, learn, or remember .
About 500,000 people in the United States have Parkinson’s disease, and about 50,000 new cases are diagnosed each year. The number of those who have some cognitive symptoms is difficult to pinpoint because accurate data are lacking for the following reasons:
Most people have the first symptoms of Parkinson’s disease after the age of 60 years, but Parkinson’s disease also affects younger people. Early-onset Parkinson’s disease strikes people around the age of 40 years, or even earlier.
Diagnosis: Parkinson’s Dementia Or Dementia With Lewy Bodies
During assessment, a specialist may look at when the dementia symptoms first appeared before reaching a diagnosis of Parkinson’s dementia or dementia with Lewy bodies.
If there have been motor symptoms for at least one year before dementia symptoms occur, specialists will often give a diagnosis of Parkinson’s dementia.
If dementia symptoms occur before or at the same time as motor symptoms, specialists will usually give a diagnosis of dementia with Lewy bodies.
However, it should be noted that in some cases of dementia with Lewy bodies, no motor symptoms develop at all.
Theres no single test – diagnosis is made through several different assessments, usually starting with an appointment with your GP or Parkinson’s nurse.
Some people find it helps to go to the appointment with someone who knows them well, who can give the GP or Parkinson’s nurse information about changes they’ve noticed.
Your GP can discuss your symptoms with you and carry out a physical examination, including blood and urine tests, to rule out other potential causes of the symptoms .
Your GP may also review your medication, in case your symptoms are side effects.
If your GP thinks you have dementia, they can refer you to a specialist, such as a neurologist, psychiatrist or geriatrician.
You might be referred to a memory clinic or memory service. In some areas of the country, you can refer yourself to these services.
But if you feel you need to see the specialist again, you can ask to be referred back.
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What Are The Symptoms Of Lewy Body Dementia
LBD is a progressive disease. This means that the symptoms start slowly and get worse over time. The most common symptoms include changes in cognition, movement, sleep, and behavior:
- Dementia, which is a loss of mental functions that is severe enough to affect your daily life and activities
- Changes in concentration, attention, alertness, and wakefulness. These changes usually happen from day to day. But sometimes they can also happen throughout the same day.
- Visual hallucinations, which means seeing things that are not there
- Problems with movement and posture, including slowness of movement, difficulty walking, and muscle stiffness. These are called parkinsonian motor symptoms.
- REM sleep behavior disorder, a condition in which a person seems to act out dreams. It may include vivid dreaming, talking in one’s sleep, violent movements, or falling out of bed. This may be the earliest symptom of LBD in some people. It can appear several years before any other LBD symptoms.
- Changes in behavior and mood, such as depression, anxiety, and apathy
In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease gets worse, people with LBD need more help due to problems with thinking and movement. In the later stages of the disease, they often cannot care for themselves.
What Is The Best Way To Communicate With A Person With Pdd
- It is not usually helpful to try to reason or argue with someone experiencing a hallucination or delusion. Stay calm and be patient. If the person is frightened by the hallucination or delusion, try to redirect their attention to something else.
- You may find acknowledging what the person is seeing, even if you do not see it, can reduce stress.
- Speak slowly and at eye level. Communicate in simple sentences.
- Ask one question at a time and wait for an answer.
- Limit distractions. Turn off the TV or radio before asking a person with PDD to do something.
- Consider causes behind disruptive behavior: the person may be hungry, thirsty, tired, in pain, frustrated, lonely or bored.
- If the person is stuck on an idea, try agreeing with them, then changing the subject.
- Its OK to use humor to diffuse stressful situations but avoid negative humor or sarcasm these can be misunderstood.
Page reviewed by Dr. Jori Fleisher, MSCE, Assistant Professor, Department of Neurological Sciences at Rush University Medical Center, a Parkinsons Foundation Center of Excellence.
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Managing The Effects Of Parkinsons Disease
Currently there is no cure for Parkinsons disease but UK and international research is ongoing.
With Parkinsons disease the interventions are focused on support, management of the changes, working with the person and their family to ensure they can live as well as possible with the condition. The physical effects of Parkinsons disease can be managed by:
- adapting the home environment so any trip hazards are removed and risks minimised
- a referral to Speech and Language Therapy if there are speech or swallowing problems
- a referral to a physiotherapist if there are movement issues
- a referral to an occupational therapist for aids and devices that may help around the house
If the person with Parkinsons has significant communication or cognitive issues they can be reduced by:
- reviewing the medication given for Parkinsons as this may be worsening the cognitive symptoms
- speaking slowly and clearly if understanding and thought processes are slowed
- reducing distractions
- giving time for communication it may take longer to respond
- asking questions to narrow down the answer, give choices or use yes/no cards or picture cards the person may have word finding difficulties as well as needing longer to respond
- using a mobile phone, tablet or electronic communication aid
- avoid unfamiliar or noisy places as they can cause distress
- providing a routine and activities that the person enjoys and feels comfortable with
Relationship Between Alzheimers And Parkinsons
People with PD and AD can develop behavioral problems. In addition, depression is very common in both illnesses and it is difficult to distinguish between the syndromes.
However, the treatment is different and the symptoms need to be clarified. However, antidepressant treatment responds better to PD than AD.
Note: Distinguish between treatments well you need to decide on the best treatment approach, but Dr. Vivek Pratap Singh is known as the Best Psychiatrist in Patna.
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Not Everyone With Parkinsons Will Develop Dementia
Despite the fact that the pathology of Parkinsons disease can trigger the development of different types of dementia, not everyone with Parkinsons will develop dementia. About 30 percent of people with Parkinsons will actually not develop dementia at all, as stated by the National Parkinson Foundation.
However, the vast majority of people with Parkinsons may experience some form of cognitive impairment over time, the foundation says.
What Causes Parkinson’s Disease Dementia
Doctors don’t yet know the exact cause of Parkinson’s disease dementia, but they think it has to do with an accumulation of a protein called alpha-synuclein. When it builds up in the brain, it can create clumps called “Lewy bodies” in nerve cells, causing them to die.
The death of those cells usually results in the motor symptoms typically associated with Parkinson’s disease. As Parkinson’s disease progresses, those Lewy bodies may eventually damage the brain and cause problems with memory and thinking.
While many people with Parkinson’s disease experience cognitive changes, not all of them will go on to develop dementia. It’s estimated that between 50% and 80% of individuals with the disease eventually develop Parkinson’s disease dementia, usually in the later stages of the disease.
What Are Possible Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may start later. As the disease gets worse over time, about 4 in 5 people develop dementia. This can cause profound memory loss and make it hard to maintain relationships. This often happens later in the course of the disease.
Parkinson disease dementia can cause problems with:
Speaking and communicating with others
If you have Parkinson disease and dementia, you likely won’t be able to live by yourself at some point. Dementia affects your ability to care for yourself, even if you can still physically do daily tasks.
Experts don’t understand how or why dementia often occurs with Parkinson disease. But its clear that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells breakdown, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer disease, another type of dementia.
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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What You Can Do To Avoid Pesticide Exposure
- Use organic lawn sprays, or wear PPE when applying pesticides. Most people will use pesticides like RoundUp, Ready-to-Spray lawn insect killers , or yard fog, without wearing gloves or a mask. While these pesticides work well for ants and mosquitos, they can harm pets and children. Use an organic pesticide https://www.amazon.com/gp/product/B084TQFJYB/ref=as_li_tl?ie=UTF8& camp=1789& creative=9325& creativeASIN=B084TQFJYB& linkCode=as2& tag=blog-post05-20& linkId=dc179b6ba063b4cf7f882032331d26dd instead of brands like Cutter, Off, Ortho, Spectricide, etc.
- Eat a healthy ORGANIC diet. One study has shown that eating a strictly organic diet has reduced the amount of specific pesticides in their urine within 1 week. Organic foods have less chemicals applied, however to go completely pesticide-free you need your own garden!
- Grow your own fruits and vegetables. Studies have shown that those who garden live on average 4.2 years longer than those who dont. The lifestyle changes with starting a garden are 100% beneficial! Other recent studies have shown that young children that grow up gardening have better overall health, more diversified gut microbiome , improved nutrient intake, and increased physical activity. They are also more likely to try nutritious foods when helping in the garden, when compared to store-bought foods.
What Are The Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.
Parkinson disease dementia can cause problems with:
- Speaking and communicating with others
- Problem solving
- Paying attention
If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.
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Treatment Of Parkinsons Disease Dementia
Currently, statistics on cognitive change and dementia in PD come from studying patients who were first diagnosed ten or twenty years ago, prior to widespread recommendations about physical activity and exercise.
While no treatments have been proven to prevent development of Parkinsons and dementia, there is strong reason to believe that physical and cognitive activity could play a powerful role in slowing disease progression in the early stages of Parkinsons disease and throughout the course of disease.
Treatment of PDD involves the use of rivastigmine, an oral or transdermal medication that boosts the brains acetylcholine .
Rivastigmine is the only medication FDA approved for PDD but other medications sometimes used off label include donepezil , also an acetyhlcholine boosting drug, and memantine , an NMDA receptor antagonist.
Medications for dementia help somewhat, and other treatments may play a role for behavior issues in PDD.
Research, including clinical trials, is ongoing to find disease-modifying treatments for PDD.
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IF YOU OR SOMEONE YOU KNOW HAS THOUGHTS ABOUT SUICIDE
Advice For Carers Family And Friends
Living with or caring for someone with Parkinsons disease dementia can be challenging. Sometimes help and support will be relied on heavily but there will be times when it will be better to step back and allow the person with dementia to do things for themselves. This balance will be difficult to judge at first, but with time and patience new routines and approaches to day-to-day living can be established.
It is important to encourage, stimulate and help the person with dementia, but remember too that rest is important.
Dementia Progresses At Different Rates For Different People
Dementia is, unfortunately, progressive but, like the motor features of MD, progresses at very different rates in different people. It not only causes poor memory and thinking, but also is frequently associated with depression, sleep disorders, loss of motivation, loss of interest and pleasure in activities that had previously enriched or even defined their life. Patients with dementia are often apathetic, showing reduced happiness and unhappiness. They are more likely to develop problems with sleeping too much or developing challenging sleep habits brings with it an increased sensitivity to the side effects of all the drugs used in treating Parkinsons Disease itself. People with dementia are more likely to develop hallucinations or confusion. Therefore the motor problems of Parkinsons Disease cannot be treated as aggressively in a patient with dementia as compared to the patient without dementia.
Dementia does not kill people. It is not a death sentence. It is true that dementia is associated with a reduced life expectancy, but this is likely due to the greater difficulty involved in treating the motor problems of PD. As noted above, this is because of the increased likelihood of drug side effects in patients with dementia. Unfortunately, more bad things happen to people with dementia. They may forget to use their cane or walker, increasing the risk of falls. They may take their medications unreliably or incorrectly or ignore warning signs of other medical problems.
Tip : Make It A Priority To Be Socially Engaged
The more socially active you are, the more you connect face-to-face with others, the stronger your memory and cognition is likely to be. You dont need to be a social butterfly or the life of the party, but you do need to regularly connect with people who care about you.
Connecting with others is the most effective means of relieving stress which left unchecked can exacerbate symptoms of Parkinsons disease. Staying socially engaged also stimulates immune function that may slow the progress of disease. While many of us become more isolated as we get older, its never too late to meet others and develop new friendships.
Tips for meeting new people
Hotlines and support
UK: Call the helpline at 0808 800 0303 or visit Parkinsons UK to find support
Australia: Call the info line at 1800 644 189 or visit Parkinsons Australia for links to state organizations that provide support and services.
Canada: Call 1 800 565-3000 for information or referrals or visit Parkinson Society of Canada for regional resources and support.
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