Its Not Necessarily Alzheimers
More than 50 conditions can cause or mimic the symptoms of dementia, and a small percentage of dementias are reversible. Two common examples are dementia caused by vitamin B12 deficiency or an underactive thyroid . Getting the right diagnosis is important so that you know what options you have, because symptoms subside when the underlying problem is treated.
Things You Should Know About The Link Between Parkinsons And Dementia
Both Parkinsons disease and dementia were ravaging the brain and behavior of actor Robin Williams before his death, but at the time, he didnt realize he had the latter.
Despite the fact that the signs of this combination can be confusing, the double diagnosis of Parkinsons and dementia impacts a large number of people. Of the one million people who have Parkinsons in the U.S., 50 to 80 percent may have dementiaeither as a result of Parkinsons pathology, or separately.
Robin Williams widow, Susan, wrote an editorial published in Neurology that was addressed to neurologists after his death. In it, she shared what it was like seeing her husband experience both Parkinsons disease and Lewy body dementia firsthand.
My hope is that it will help you understand your patients along with their spouses and caregivers a little more, Susan wrote.
Williams was first diagnosed with Parkinsons disease, which at first seemed to provide some answers for his out-of-character symptoms.
But it wasnt until after his death that an autopsy revealed he had been in the later stages of Lewy body dementiaa common form of dementia characterized by deposits of Lewy body proteins in the brain, which can impact physical movement, mood, memory and behavior.
I will never know the true depth of his suffering, nor just how hard he was fighting, Susan wrote. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
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Other Types Of Impulsive And Compulsive Behaviours
Punding
This is when someone does things such as continually handling and sorting objects. They may be fascinated with taking technical equipment apart or collecting a type of object.
This behaviour can mean people dont get enough sleep. It can also cause social problems with family or at work. If someone collects objects or takes machinery apart without knowing how to put it back together, it can also have a big financial impact, as theyll need to spend money to buy new objects or getting equipment repaired.
Some people also experience other behaviours such as compulsive singing, writing, smoking, reckless driving or doing crafts
Hoarding
This happens when someone feels that they must continue to keep items that they dont need. The thought of getting rid of the items may make someone feel upset.
Addiction to Parkinsons medication Some people with Parkinsons have a compulsion to take more medication than they need to control their symptoms because they are addicted to the way it makes them feel.
If a person is taking too much medication and their healthcare professional attempts to reduce it to the levels theyre supposed to take, this may cause unpleasant feelings, anxiety and cravings. It may also cause reduced mobility. A person may refuse to accept this, sometimes resulting in aggression, secret hoarding or requests for repeat prescriptions.
The number of people who may experience impulsive and compulsive behaviours may vary in research because of:
Mild Memory And Cognitive Problems
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Mild memory loss and thinking problems are known as mild cognitive impairment, or MCI. Many people experience some form of thinking or memory problems at some point in life, perhaps due to factors such as grief or stress. But when people experience greater difficulties with memory, language, thinking or judgment than might be expected at their age, they may have MCI.
The terms memory problems and ‘memory loss’ can be misleading because far more than just memory may be affected. If you have mild cognitive problems, you may experience:
- Slowed thought processes. You may find it hard to follow a number of steps to complete a task or have problems multi-tasking
- Difficulties with planning, problem-solving or making decisions
- Difficulties following and taking part in conversations
- Difficulty finding the right word
- Poor concentration
- Lack of motivation
- Short-term memory loss difficulty remembering names or the sequence of recent events
- Problems with judging distances or direction. Describing how to get from one place to another may become hard.
Visual hallucinations or delusions may accompany cognitive problems in some people. Sometimes these are drug induced or they may be related to Lewy body dementia so you should let your doctor know if you experience these symptoms.
People with cognitive difficulties may be unaware of the problems they are experiencing, and friends and family may notice first.
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What Causes Parkinsons Disease Dementia
A chemical messenger in the brain called dopamine helps control and coordinate muscle movement. Over time, Parkinsons disease destroys the nerve cells that make dopamine.
Without this chemical messenger, the nerve cells cant properly relay instructions to the body. This causes a loss of muscle function and coordination. Researchers dont know why these brain cells disappear.
Parkinsons disease also causes dramatic changes in a part of your brain that controls movement.
Those with Parkinsons disease often experience motor symptoms as a preliminary sign of the condition. Tremors are one of the most common first symptoms of Parkinsons disease.
As the disease progresses and spreads in your brain, it can affect the parts of your brain responsible for mental functions, memory, and judgment.
Over time, your brain may not be able to use these areas as efficiently as it once did. As a result, you may begin experiencing symptoms of Parkinsons disease dementia.
You have an increased risk of developing Parkinsons disease dementia if:
- youre a person with a penis
- youre older
What Is The Prognosis And Life Expectancy For Parkinson’s Disease
The severity of Parkinson’s disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinson’s disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
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Condition Causing Slurred Speech
Slurring of one’s speech could be from substance intoxication or from a stroke. A doctor needs to make this distinction. You should see one immediately.
Rarity: Uncommon
Top Symptoms: slurred speech, arm weakness, hearing voices or seeing things that aren’t there, odd walking gait, hard testicle lump
Urgency: Emergency medical service
Other Reasons For Cognitive Symptoms
Besides PD, there are other important causes of cognitive dysfunction to keep in mind. Medical illnesses such as thyroid disease or vitamin B12 deficiency can cause cognitive symptoms. Urinary tract infections or pneumonia can acutely cause confusion or hallucinations. In these settings, the cognitive symptoms are generally reversible after the infection or medical condition is treated. One should be aware that some medications for pain or bladder problems may cause sedation/sleepiness or confusion, and, thereby, impair cognitive function.
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Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
Causes And Risk Factors
PD is idiopathic, meaning that a doctor does not know why a person has the condition. However, according to Johns Hopkins Medicine, early-onset Parkinsons disease has links to genetic inheritance from a parent.
Researchers have identified several risk factors that may make a person with Parkinsons disease more likely to experience dementia.
These risk factors include:
- advanced age at time of diagnosis
- experiencing excessive daytime sleepiness
- hallucinations before the onset of other dementia symptoms
- having a specific Parkinsons symptom that causes a person to have difficulty starting to take a step or to halt mid-step while walking
- a history of mild thought impairment
- more severe movement impairment symptoms than most people with Parkinsons disease
However, researchers do not know why some people with Parkinsons disease develop cognitive difficulties as well as movement problems.
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Drug Therapy And Research
If the disease progresses beyond minor symptoms, drug treatment may be indicated. Drug therapy for Parkinsonâs typically provides relief for 10â15 years or more. The most commonly prescribed medication is L-dopa , and this helps replenish some of the depleted dopamine in the brain. Sinemet, a combination of levodopa and carbidopa, is the drug most doctors use to treat Parkinsonâs disease. Recent clinical studies have suggested, in the younger person, the class of drugs called âdopamine agonistsâ should be used prior to levodopa-carpidopa except in patients with cognitive problems or hallucinations. In those older than 75, dopamine agonists should be used cautiously because of an added risk of hallucinations.
Other drugs are also used, and new drugs are continually being tested. It is common for multiple drugs to be prescribed because many of them work well together to control symptoms and reduce side effects. Contrary to past beliefs, starting Sinemet in newly diagnosed people does not lead to early symptoms of dyskinesia . Current knowledge is that the disease progression causes dyskinesias, not a âresistanceâ to the drug.
Quality of life studies show that early treatment with dopaminergic medications improves daily functioning, prevents falls, and improves a personâs sense of well-being.
If Youre Experiencing Forgetfulness Or Confusion Check Your Medicine Cabinet
by Dr. Armon B. Neel, Jr., February 9, 2016| 0
For a long time doctors dismissed forgetfulness and mental confusion as a normal part of aging. But scientists now know that memory loss as you get older is by no means inevitable. Indeed, the brain can grow new brain cells and reshape their connections throughout life.Most people are familiar with at least some of the things that can impair memory, including alcohol and drug abuse, heavy cigarette smoking, head injuries, stroke, sleep deprivation, severe stress, vitamin B12 deficiency, and illnesses such as Alzheimer’s disease and depression.
But what many people don’t realize is that many commonly prescribed drugs also can interfere with memory. Here are 10 of the top types of offenders.
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Parkinsons Dementia Vs Alzheimers Dementia
According to experts, Parkinsons dementia can cause impaired physical activity and impacts motor skills. Two neurotransmitters called dopamine and serotonin tend to be damaged by Parkinsons.
In addition to causing issues with movement and coordination, this form of dementia can also cause a slower thought process and memory problems. This is usually less pronounced however, until the later stages of the disease.
With Alzheimers, two types of proteins in the brain, tangles and plaques , accumulate and kill brain cells. This Alzheimers-induced dementia affects memory, clear thinking, language skills, and orientation. It reduces comprehension, learning capacity, and judgement. Storing new information and memory retrieval are impacted more than motor skills.
Distinguishing between these neurodegenerative conditions is important to determine the best treatment approach. Medications for one of condition might create problems when given to a patient with the other condition.
Managing Cognitive Impairments In Parkinsons
After a thorough evaluation to rule out other causes of cognitive impairment, patients with PD may be treated with medication, occupational therapy, and/or speech therapy. The medications used to treat cognitive impairments in people with PD are based on treatments used for Alzheimers disease. Occupational therapy can help a person with PD by providing adaptive strategies for daily activities. Speech therapy can help with language functions, as well as information processing. 3,4
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Who Gets Parkinsons Disease
Parkinsonâs disease, documented in 1817 by physician James Parkinson, is the second most common neurodegenerative disease after Alzheimerâs disease. Estimates regarding the number of people in the United States with Parkinsonâs range from 500,000 to 1,500,000, with 50,000 to 60,000 new cases reported annually. No objective test for Parkinsonâs disease exists, so the misdiagnosis rate can be high, especially when a professional who doesnât regularly work with the disease makes the diagnosis.
Living With Parkinsons Disease
Depending on severity, life can look very different for a person coping with Parkinsons Disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the diseases progression. Besides movement issues Parkinsons Disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinsons are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in your other medications can affect your Parkinsons symptoms, you should remind each member of your healthcare team to send a copy of your clinic note after every appointment.
Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.
Also Check: How Much Does Parkinson’s Medication Cost
Foster A Good Relationship
Lastly, maintaining your relationship and communication with the person with Parkinsonâs can be the most challenging and rewarding aspect of caregiving. As Parkinsonâs disease progresses, the roles change and the person with Parkinsonâs may go from being an independent head of the household to a very dependent person requiring a significant level of care. However, research shows that despite high levels of strain, caregivers with good quality relationships have reduced depression and better physical health. Remember, as a caregiver your service to your loved one is beyond measure in terms of love, depth of care, and concern.
How Are These Mental Health Problems Treated
Your doctor will first want to check if your hallucinations, delusions, or paranoia are caused by other medical conditions. They’ll check for imbalances in chemicals in your blood that help send nerve signals.
They may also check to see how well your kidney, liver, or lungs are working, as well as test for certain infections. All of these issues could cause mental health problems.
Other medications that you may be using, including over-the-counter drugs, could also play a role in your mental health. Tell your doctor about all the medicines you take, including herbs and supplements.
Often the medications used to treat Parkinson’s disease can cause mental health problems. Your doctor may suggest you switch to a different drug or change your dose. If changing your Parkinson’s medication causes your Parkinson’s symptoms to get worse, your doctor may recommend you stick with it but take antipsychotic drugs at the same time.
There’s a chance that an antipsychotic medicine you take is making your Parkinson’s worse. If that happens, you have alternatives. The medication pimavanserin was approved by the FDA to specifically treat psychosis that goes along with Parkinson’s disease. Other drugs, such as olanzapine , quetiapine , and clozapine can control hallucinations at low doses without making your Parkinson’s symptoms worse.
If you feel depressed or notice any mental health problems, talk to your doctor right away. There’s likely a remedy that will make you feel better.
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One Of The Most Difficult Neurological Disorder Symptoms Of Parkinsons
Why might this be important to families challenged by PD? Because the biggest source of conflict in families occurs when loved ones fail to recognize that a person with brain changes is not the same person who existed at an earlier time in life. Human beings greatly value continuity in personality but by expecting the person to be the same as they once were, loved ones are unfair to the person with brain insult. This person could no more return to an earlier personality state than he or she can will away tremors or rigidity. Energy expended in any way other than coming to terms with this new person is fruitless. There is actually some fascinating research in this area and it is likely to be a topic for a great deal more discussion in future blogs.
Because of the greater likelihood for executive dysfunction and dementia, personality change is easier to see among individuals with more advanced PD. Motivation is frequently affected, resulting in apathy that diminishes how actively an individual interacts with other people and with the world . Thinking or cognition changes can cause the person to process information more slowly and with less focus and concentration . A previously methodical, consistent individual often becomes increasingly chaotic in their response to their environment . One easily becomes less interested and hopeful about the future .
Who Gets Parkinson’s Disease Dementia
No two cases of Parkinson’s are exactly alike, so it’s hard to say for sure who will develop Parkinson’s disease dementia and who will not. However, researchers have identified several factors that may increase a person’s risk for Parkinson’s disease dementia, including:
- Older age, especially at the time Parkinson’s symptoms began
- Being a man
- Advancing to late-stage Parkinson’s disease
- Experiencing visual hallucinations
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