Wednesday, May 15, 2024
Wednesday, May 15, 2024
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How Bad Does Parkinson’s Dementia Get

Treating Movement Symptoms In Lewy Body Dementia

Coping with Dementia in Parkinson’s disease for Care Partners

LBD-related movement symptoms may be treated with medications used for Parkinson’s disease, called carbidopa-levodopa. These drugs can help make it easier to walk, get out of bed, and move around. However, they cannot stop or reverse the disease itself. Side effects of this medication can include hallucinations and other psychiatric or behavioral problems. Because of this risk, physicians may recommend not treating mild movement symptoms with medication. Other Parkinson’s medications are less commonly used in people with LBD due to a higher frequency of side effects.

People with LBD may benefit from physical therapy and exercise. Talk with your doctor about what physical activities are best.

Caring For Someone With Parkinsons

Caring for someone with Parkinsons disease or dementia can be a rewarding as well as challenging experience. It will likely involve adapting to new challenges over time as the disease progresses or new symptoms emerge.

Become informed. Learn as much as you can about Parkinsons disease and Parkinsons disease dementia and how it is likely to affect your loved one specifically, given their health history, age, and lifestyle.

Communicate openly and provide reassurance, especially in the early stages following diagnosis, that Parkinsons disease is only slowly progressive in most patients and that your loved one can still live a full life.

Modify tasks to allow for greater independence. Allow your loved one to do things for themselves even if it takes longer. If necessary, break tasks that involve fine motor skills into easier steps and focus on success, not failure.

Help your loved one find alternative means of transport if they have to give up driving. That may involve researching public transportation, ride sharing, or community shuttle services.

Exercise together. Exercising is vital for the health and state of mindof both of you. Take a class together or simply enjoy a walk outside.

Look after yourself. Take regular breaks to avoid caregiver burnout, maintain social ties, and seek out opportunities to relax and have fun. Talking to others in similar situations can be very helpful.

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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

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Related Diagnosis: Lewy Body Dementia

Current research is helping to differentiate dementia related conditions in relationship to Parkinsonâs disease. Doctorâs use a 12-month arbitrary rule to aid in diagnosis. When dementia is present before or within 1 year of Parkinsonâs motor symptoms developing, an individual is diagnosed with DLB. Those who have an existing diagnosis of Parkinsonâs for more than a year, and later develop dementia, are diagnosed with PDD.

In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. Cholinesterase inhibitors, medications originally developed for Alzheimerâs disease, are the standard treatment today for cognitive DLB and PDD symptoms. Early diagnosis is important, as DLB patients may respond differently than Alzheimerâs disease patients to certain drug, behavioral, and dementia care treatments.

This challenging, multi-system disorder involving movement, cognition, behavior, sleep, and autonomic function requires a comprehensive treatment approach to maximize the quality of life for both the care recipient and their caregiver. It is very important to pay attention to symptoms of dementia and to search for an expert clinician who can diagnose the condition accurately.

What Are The Complications Of Parkinson Disease

Parkinson

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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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.

Parkinson’s 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.

Coping With Dietary Problems

Many people with Parkinsons experience various eating and dietary problems, such as constipation, chewing and swallowing difficulties, and upset stomach. The following tips can help you minimize the symptoms.

If you suffer from constipation Drink lots of water and eat fiber-rich foods, including beans, brown rice, whole grains, and fruit.

If you have trouble chewing or swallowing food Cut foods into smaller portions to avoid choking and to encourage digestion, and remain upright for 30 minutes after eating.

If youre struggling with fatigueLimit the amount of sugar youre eating. Also avoid alcohol and caffeine, especially before bed, as they can reduce the quality of your sleep.

If you take levodopa Dont eat meat or other protein-rich foods for at least 30-60 minutes after taking levodopa, as protein blocks your bodys ability to absorb the medication.

If your medication gives you an upset stomach Take your medication with a full glass of water and a small non-protein based snack, such as a piece of toast or fruit.

Some Parkinsons disease medications need to be taken promptly at specified times before or after eating, so it can also help to establish a regular routine for meal and medication times.

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Memory And Thinking Problems

You may experience forgetfulness, slowed thinking and difficulty concentrating. You might find it harder to follow conversations, and remember some words and names. This can make communication difficult.

You may also find it increasingly difficult to make decisions, plan activities and solve problems. This can make everyday activities harder.

The Seven Stages Of Dementia

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One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

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Conceptualization Of The Diseases Needs And Interventions

Both dementia and PD are incurable and progressive diseases with often complex problems and needs, for which tailored interventions are available . For dementia, experts agree that recognizing its eventual terminal nature is the basis for anticipating future problems and an impetus to the provision of adequate palliative care . Some advocate advanced dementia to be a terminal disease to support eligibility for palliative care. However, as about half of dementia patients never reach an advanced stage , it may be a late trigger to initiate palliative care. There is no consensus, however, at which stage palliative care in dementia should start .

Table 2. Conceptualization of the disease, needs of patients and family caregivers, and interventions.

For PD there are no curative treatments either, but the success of dopaminergic replacement therapy and deep brain stimulation has enabled the majority of patients to live independently with a relatively low symptom burden for the first 10 years after diagnosis-when they live up to a decade . This may contribute to PD generally not being recognized as an illness for which a palliative approach may be helpful . A US patient and caregivers council recommends palliative care to be available from diagnosis of PD . This is also the ideal of the European Parkinson’s Disease Association although they emphasize that when to start palliative care is an individual decision.

We Compiled The Most Popular Parkinsons Questions And Answers In One Place

As your Parkinsons disease journey evolves, so do your questions about symptoms, treatment options, research and medications. Whether you live with Parkinsons or care for someone who does, you are not alone in looking for answers to your big PD questions.

The Parkinsons Foundation has recently released Frequently Asked Questions: A Guide to Parkinsons Disease, a new and improved booklet that provides answers to the most frequently asked questions our Helpline receives. Pro tip: every section in the booklet provides additional free resources you can check out to learn more. Order the free book now, read it online or check out some questions and answers below:

Q: Can Parkinsons be cured?

A: Not yet. However, many PD symptoms can be treated and researchers are making advances in understanding the disease, its causes and how to best treat it.

Q: What are the stages of Parkinsons?

A: The stages of Parkinsons correspond to the severity of movement symptoms and to how much the disease affects a persons daily activities. At all stages of Parkinsons, effective therapies are available to ease symptoms and make it possible for people with PD to live well.

Q: How can I find a doctor who can treat Parkinsons?

Q: Is it okay to drink alcohol?

A: Consult your doctor first. Generally, moderate consumption should be acceptable for people with PD, if there are no medical conditions or medications that prohibit alcohol use.

Q: Are there any new Parkinsons drugs on the horizon?

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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.

Epidemiology Of Dementia And Parkinson’s Disease

Disease Graphics, Videos &  Images on Parkinson

Dementia and PD are both diagnosed frequently and increase mortality . Perhaps dementia is perceived more so as a memory problem and a disease of old age, but the incidence of dementia and PD in younger age is similar. In the Netherlands, for dementia, the incidence per 1,000 person-years is 0.4 among those aged 6064 , and for PD, it is 0.3 . Dementia incidence patterns, however, show a much steeper increase with age mounting to 27 per 1,000 person-years for those 85 and over, compared to 4 for PD over 85. In view of similar mortality , therefore, the prevalence of dementia in the general population is much higher than prevalence of PD . However, adjusted for age and other factors, 6-year mortality in PD is higher than in Alzheimer’s dementia . Age adjustment is relevant also as it shows that comorbid disease may be equally prevalent for Alzheimer’sa main type of dementiaand PD across the same age groups .

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Diagnosis Of Parkinsons Disease

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.

A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.

Treating Parkinsons Disease Dementia

A treatment plan for PDD typically includes medications that boost the brains level of certain neurotransmitters and help improve memory and processing speed, Dr. Petrossian says. Exercise is also an important part of the treatment planDr. Petrossian recommends skill-based activities like boxing or dance to boost cognitive function as well as fitness. PDD symptoms should be monitored long-term by a neurologist, and in some cases a psychiatrist, says Dr. Okun. In many cases, physical, occupational, speech, and social work therapy can also be useful since PPD affects all aspects of life.

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Types Of Lewy Body Dementia And Diagnosis

LBD refers to either of two related diagnoses dementia with Lewy bodies and Parkinson’s disease dementia. Both diagnoses have the same underlying changes in the brain and, over time, people with either diagnosis develop similar symptoms. The difference lies largely in the timing of cognitive and movement symptoms.

In DLB, cognitive symptoms develop within a year of movement symptoms. People with DLB have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time, they also develop movement and other distinctive symptoms of LBD.

In Parkinson’s disease dementia, cognitive symptoms develop more than a year after the onset of movement symptoms . Parkinson’s disease dementia starts as a movement disorder, with symptoms such as slowed movement, muscle stiffness, tremor, and a shuffling walk. These symptoms are consistent with a diagnosis of Parkinson’s disease. Later on, cognitive symptoms of dementia and changes in mood and behavior may arise.

Not all people with Parkinson’s disease develop dementia, and it is difficult to predict who will. Many older people with Parkinson’s develop some degree of dementia.

Caregivers may be reluctant to talk about a person’s symptoms when that person is present. Ask to speak with the doctor privately if necessary. The more information a doctor has, the more accurate a diagnosis can be.

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Tracking Dementia In Parkinson’s Disease

If Dementia Occurs, Mental Abilities Can Fall Like Alzheimer’s Disease

Dec. 13, 2004 — Parkinson’s disease patients with dementia can lose their mental abilities at almost the same rate as people with Alzheimer’s disease, say Norwegian researchers.

Parkinson’s disease belongs to a group of conditions called movement disorders. Symptoms of Parkinson’s disease include tremors, rigidity, and imbalance. Symptoms vary from person to person, and not everyone is affected by all of the symptoms.

Not all people with Parkinson’s disease have dementia. However, dementia isn’t unusual with Parkinson’s disease, although it may take a decade to appear after Parkinson’s begins.

Parkinson’s disease occurs when brain cells that produce the chemical dopamine die. As a result, dopamine levels drop, garbling the brain‘s movement signals to the body.

Parkinson’s is usually diagnosed in people aged 50 or older . Advanced age is also the main risk factor for dementia. Alzheimer’s disease is the most common cause of dementia.

The latest study on Parkinson’s and dementia comes from scientists including Dag Aarsland, MD, PhD, of the geriatric psychiatry department at Norway’s Central Hospital of Roagland. Aarsland and colleagues studied 129 Parkinson’s patients who did not have dementia when they joined the study.

All participants lost at least some of their mental abilities over the years. But those with dementia had a steeper decline.

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