What Is Alzheimer’s Disease
Alzheimer’s disease , the most common form of dementia among older adults, is an irreversible degeneration of the brain that causes disruptions in memory, cognition, personality, and other functions that eventually lead to death from complete brain failure. Genetic and environmental factors including diet, activity, smoking, traumatic brain injury, diabetes, and other medical diseases contribute to the risk of developing this form of the disease. The hallmarks of Alzheimer’s disease are the accumulation of beta-amyloid plaques between nerve cells in the brain and neurofibrillary tangles, which are twisted fibers found inside the brain’s cells). These tangles consist primarily of a protein called tau.
How Is Parkinsons Disease Diagnosed
There are currently no specific tests that diagnose PD. The diagnosis is based on:
- medical history and a neurological examination
- blood and laboratory tests, to rule out other disorders that may be causing the symptoms
- brain scans to rule out other disorders. However, computed tomography and magnetic resonance imaging brain scans of people with PD usually appear normal.
In rare cases, where people have a clearly inherited form of PD, researchers can test for known gene mutations as a way of determining an individuals risk of developing the disease. However, this genetic testing can have far-reaching implications and people should carefully consider whether they want to know the results of such tests.
What Are Hallucinations
Hallucinations are when someone sees, hears or feels something that is not actually there. They are best described as deceptions or tricks played by the brain that involve the bodys senses. Hallucinations are not dreams or nightmares. They happen when the person is awake and can occur at any time of day or night.
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Csf Biomarkers In Pdd
Many studies on CSF aimed to identify biomarkers reflecting the abnormal protein aggregates associated with PDD. In the majority of them, the level of Aß was found reduced4952 whereas the levels of total and phosphorylated tau were increased49,50,53,54 or unchanged52,55 in PDD. The use of more or less strict definition for dementia and the inclusion of more or fewer patients with AD- memory problems can partially account for the discrepancies in the tau level reported.
Based on the data from cross-sectional and longitudinal studies there is the strongest evidence that low levels of A and increased levels of tau in the CSF at baseline might predict future cognitive decline in patients with PD.5659
We performed a longitudinal study in non-demented PD patients including CSF, neuropsychological and MRI at baseline and 18 months follow-up.60 We found that a combination of lower CSF A, reduced verbal learning, semantic uency, and visuoperceptual scores, as well as cortical thinning in superior-frontal/anterior cingulate and precentral regions, were predictive for PDD. In this sense, different studies have shown that a combination of clinical, biological, and neuroimaging markers could be predictive for deterioration in cognition in PD with good accuracy.59,61,62
How Can We Support The Sleep/wake Cycle Of Pdd
For people with PDD who are confused about the day-night cycle, some daily strategies can be helpful. At night, starting a lights out routine that happens at the same hour every day, where all curtains are closed and lights are turned off, can help the person understand that it is sleep time. During the day, opening the curtains, allowing the person with PDD to spend as much time in the daylight as possible, avoiding naps, and organizing stimulating activities, can be helpful. Having lots of calendars and clocks in every room might also help a person with PDD be less confused about the time of day.
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What Are The Symptoms Of The Disease
The four primary symptoms of PD are:
- Tremor. Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. The tremor associated with PD has a characteristic rhythmic back-and-forth motion that may involve the thumb and forefinger and appear as a pill rolling. It is most obvious when the hand is at rest or when a person is under stress. This tremor usually disappears during sleep or improves with a purposeful, intended movement.
- Rigidity. Rigidity , or a resistance to movement, affects most people with PD. The muscles remain constantly tense and contracted so that the person aches or feels stiff. The rigidity becomes obvious when another person tries to move the individuals arm, which will move only in ratchet-like or short, jerky movements known as cogwheel rigidity.
- Bradykinesia. This slowing down of spontaneous and automatic movement is particularly frustrating because it may make simple tasks difficult. The person cannot rapidly perform routine movements. Activities once performed quickly and easilysuch as washing or dressingmay take much longer. There is often a decrease in facial expressions.
- Postural instability. Impaired balance and changes in posture can increase the risk of falls.
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Memory Difficulties In Parkinsons
The most common difficulty for people with PD is remembering information that has previously been learned. Memory has several different processes and types, and people with PD have trouble recalling information but their long-term memory function generally remains intact. Memory cues or choices can help people with PD to retrieve information from the brains long-term storage.3,4
Biomarkers Of Cognitive Decline
Many of the pathologies associated with cognitive impairment can be identified in vivo using a variety of imaging and blood-based or CSF-based markers. These biomarkers can be used to provide an increased understanding of the mechanisms underlying cognitive impairment in PD and, from a clinical perspective, can identify patients with an increased risk of early and rapid cognitive decline.
One of the first identified predictive markers was temporo-parietal atrophy on MRI , confirmed in many subsequent studies. In addition, basal forebrain atrophy observed using MRI is also associated with cognitive impairment in PD,. Hypometabolism in the medial frontal and parietal regions using FDG-PET is associated with a decline in executive and memory function. More recent MRI techniques, such as diffusion tensor imaging, also hold promise as biomarkers of cognitive function. For example, increased radial and axial diffusivity in the thalamus observed using diffusion tensor imaging was associated with a decline in MoCA scores.
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Symptoms Of Parkinsons Disease Dementia
Signs and symptoms of Parkinsons disease dementia include:
- Mental inflexibility
- Short-term memory issues and memory loss
- Trouble with decision making
- Executive function difficulty
- Slow processing speed
- Inattention
- Visual processing difficulty
Non-motor symptoms that can be associated with PDD include:
- Psychosis :
- Hallucinations
- Delusions
What Causes The Disease
The precise cause of PD is unknown, although some cases of PD are hereditary and can be traced to specific genetic mutations. Most cases are sporadicthat is, the disease does not typically run in families. It is thought that PD likely results from a combination of genetics and exposure to one or more unknown environmental factors that trigger the disease.
The protein alpha-synuclein. The affected brain cells of people with PD contain Lewy bodiesdeposits of the protein alpha-synuclein. Researchers do not yet know why Lewy bodies form or what role they play in the disease. Some research suggests that the cells protein disposal system may fail in people with PD, causing proteins to build up to harmful levels and trigger cell death. Additional studies have found evidence that clumps of protein that develop inside brain cells of people with PD may contribute to the death of neurons.
Genetics. Several genetic mutations are associated with PD, including the alpha-synuclein gene, and many more genes have been tentatively linked to the disorder. The same genes and proteins that are altered in inherited cases may also be altered in sporadic cases by environmental toxins or other factors.
Environment. Exposure to certain toxins has caused parkinsonian symptoms in rare circumstances . Other still-unidentified environmental factors may also cause PD in genetically susceptible individuals.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use the knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world. NINDS conducts and supports three types of research: basicscientific discoveries in the lab, clinicaldeveloping and studying therapeutic approaches to Parkinsons disease, and translationalfocused on tools and resources that speed the development of therapeutics into practice. The goals of NINDS-supported research on Parkinsons disease are to better understand and diagnose PD, develop new treatments, and ultimately, prevent PD. NINDS also supports training for the next generation of PD researchers and clinicians and serves as an important source of information for people with PD and their families.
Effects Of Memory And Cognitive Changes
While it may seem clear to you that emotional states can have a significant impact on your thinking, the reverse is also true: Your thinking can sometimes strongly influence your emotional states. You know the proverbial story of two men who see the same glass of water but one sees it as half full and the other as half empty? The same goes for thinking and emotional states.
Sometimes your assessment of a situation can influence your emotional reaction to that situation. More generally, executive cognitive functions can influence your mood states because those executive functions control all the information you have about the situations you find yourself in. Executive functions control your appraisal of those situations. If you find it difficult to recall happy memories, you may become more sad or depressed. If you find it difficult to plan a vacation, you may put off the vacation and thus influence your mood states and so forth.
Problems with executive functions can also get you into trouble over serious matters like money. If you find it difficult to balance the checkbook, you may get a bit sloppier about your finances. Consider also that the extra jolt of dopamine that comes from taking dopamine medications can sometimes make you temporarily more energized and impulsive. Now when you couple a heightened sense of impulsivity with a lowered capacity for thinking efficiently through decisions, you sometimes get impulsive respondingbad decisions.
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Impact Of Pd Treatments
The clinical choice of initial PD medication inhibitor) at disease onset does not seem to make a difference in terms of cumulative dementia rates,. However, there is strong evidence that medications with anticholinergic properties , and particularly the long-term exposure to multiple medications or medications with greater anticholinergic properties, are associated with worse long-term cognition in the general population and patients with PD,, and thus represent a target for clinical management. In patients with PDD, simplification of antiparkinsonian treatment through a stepwise withdrawal of non-levodopa PD medications starting with anticholinergic drugs, followed by amantadine, selegiline, dopamine agonists and then catechol-O-methyltransferase inhibitors, might be useful, particularly if comorbid psychosis is present.
In addition, several studies have found that DBS can worsen cognitive functioning as a result, cognitive testing is recommended as part of the pre-DBS surgery evaluation process, and patients with severe cognitive impairment should not undergo brain surgery. However, the use of model-based stimulation parameters to minimize the spread of the electrical current to non-motor portions of the subthalamic nucleus reversed the cognitive decline that occurred after DBS in one study. Encouragingly, a subsequent study of DBS in younger patients with shorter disease duration showed short-term cognitive tolerability similar to the best medical therapy.
What Are The Parkinson’s Disease Dementia Criteria
Many people with Parkinson’s disease experience cognitive changes , but not all of them develop full-blown dementia. So at what point does Parkinson’s disease cause dementia?
On average, Parkinson’s disease dementia happens about 10 years after a person first starts having movement problems.
“It happens many, many years after someone has developed Parkinson’s,”Lynda Nwabuobi, MD, assistant professor of clinical neurology at Weill Cornell Parkinson’s Disease and Movement Disorders Institute, tells Health. “It can be around 10 to 15 years.”
In fact, if someone shows signs of dementia early on in their Parkinson’s diagnosis , it could be that they were misdiagnosed out of the gate. “They might have dementia with Lewy bodies,” Dr. Nwabuobi explains.
Timing is the main factor in Lewy body dementia versus Parkinson’s disease dementia. While the two can look very similar, the dementia symptoms occur before motor symptoms in Lewy body dementia, and in Parkinson’s disease the reverse is true.
“If you look at the brain, it’s difficult to distinguish them,” Dr. Litvan says. “But clinically, they are different.”
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Many With Parkinson’s May Have Memory Problems
Brain scans revealed changes in white and gray matter
HealthDay Reporter
FRIDAY, Sept. 4, 2015 — Many people with Parkinson’s disease have memory problems, researchers report.
The study included 40 people with early stage Parkinson’s disease and 40 healthy older adults. While the disease is generally viewed as a movement disorder, about half of the Parkinson’s patients had difficulty with some aspect of memory, such as learning and retaining information, or recalling spoken information, the investigators found.
“And then half of those participants, or nearly one-quarter of all participants with Parkinson’s, were really having a difficult time consistently with their memory, enough that it would be noticeable to other people,” said study author Jared Tanner. Tanner is an assistant research professor in the department of clinical and health psychology at the University of Florida at Gainesville.
Still, there was good news: Most of the Parkinson’s patients did not have significant memory problems, according to the authors of the study published online recently in the journal PLoS One.
Because of the study’s design, the researchers could only show an association between Parkinson’s disease and memory problems they couldn’t prove a cause-and-effect relationship.
“People with Parkinson’s disease who had stronger connections between these areas of the brain did better at remembering information,” he said.
What Is Parkinsons Disease Dementia
Parkinsons disease dementia is a brain disorder that occurs in somebut not allpeople living with Parkinsons disease. The brain cell damage caused by the disease can lead to a loss of memory and other cognitive functions such as problem solving and speed of thinking. These changes in thinking and behavior can impact your daily living, independence, and relationships.
In those who do develop Parkinsons disease dementia, there is at least one yearand usually 10 to 15 yearsbetween the Parkinsons diagnosis and the onset of dementia. According to estimates by the Alzheimers Association, 50% or more of people with Parkinsons disease eventually experience dementia, although there are a number of risk factors that impact the likelihood of developing symptoms:
- Parkinsons patients who experience hallucinations, excessive daytime sleepiness, and more severe motor control problems are at higher risk for dementia.
- Dementia is more common in people who are older at onset of Parkinsons.
- Dementia is a bigger risk factor in non-tremor predominant Parkinsons.
- Overwhelming stress, cardiovascular disease, and adverse reactions to the Parkinsons disease drug levodopa can also indicate an increased risk for developing dementia.
- Dementia is relatively rare in people who develop Parkinsons before age 50, no matter how long they have had the disease.
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Patient And Public Involvement
In the past years, there has been growing attention on the need to include patients, their caregivers and families in all stages of the research process. The increasing contribution of patient and public involvement groups in defining research questions, designing and conducting clinical trials, disseminating outcomes, and shaping research roadmaps reflects the concept of research as a shared effort among all stakeholders. Although in PD research this concept is increasingly being recognized, further involvement of patients and families, also inclusive of diverse patient populations, in research focused on PD-associated cognitive impairment is needed.
Natural Remedy For Parkinsons #4 Chlorella And Borax:
If you have a neurological disease such as Parkinsons orAlzheimers, the importance of removing heavy metals from the body – especiallyfrom the brain and nervous system – cannot be overstated. Heavy metalsaccumulate in the brain and nervous system at a rapid rate and cause damage tothe neurological pathways and brain inflammation. Fluoride is one ofthe worst, however, mercury, lead, aluminium and cadmium are also extremely dangerous.Chlorella and borax not only remove these heavy metals completely, theycontinue to prevent further toxic build-ups.
Chlorella is a miracle blue-green algae and one of themost powerful detoxifiers and chelators yet discovered. Whenits combined with cilantro, its benefits are enhancedsignificantly. A Russian study found that chlorella, combined with cilantro,was able to remove all heavy metals from the body, including fluoride and mercury,with no adverse or harmful side effects. You can purchase chlorellain powdered form online or from most health food stores. Just make sure you buythe Broken Cell Wall Chlorella as this is the strongest and most bio-available.For dosage recommendations, simply follow the directions on the container.
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How Can We Manage Hallucinations
It may not be necessary to treat all hallucinations of a person with PDD. Hallucinations are often harmless, and it is okay to allow them to happen, as long as they are not disruptive or upsetting to the person or surroundings. Sometimes, recognizing the hallucination and then switching the topic might be an efficient way of handling frustrations that occur because of a hallucination. If hallucinations need medical treatment, your provider may be able to discuss and suggest some options. However, many of the medications used to treat hallucinations may make movement symptoms worse.