Difference Between Parkinsons Disease Dementia And Dementia With Lewy Bodies
Technically, the difference between these two conditions lies in how quickly the cognitive difficulties and hallucinations develop in relation to the movement issues. In DLB, the cognitive difficulties and hallucinations develop much sooner in the disease course than in PDD, sometimes even prior to the movement difficulties. Because of the similarities between PD, PDD, and DLB, current thinking in the medical community is that they should be viewed as related diseases which fall along a continuum of Lewy body disorders.
End Point And Statistical Analysis
The main outcome variable was the initial occurrence of dementia . A study in Taiwan has previously reported that the diagnostic accuracy of dementia is approximately 90% when relying on diagnosis codes to identify dementia. To increase the validity of dementia identification, only dementia cases diagnosed with 3ambulatory visits or 1 hospitalisation were included in this study. We did not distinguish the subtypes of dementia because of data limitations due to a lack of information regarding symptoms/signs, lab data and image findings, and further outcome analyses with dementia subtype classifications, such as dementia with Lewy bodies , Alzheimers dementia, frontotemporal dementia and just Parkinsons disease dementia , were not performed. However, according to the criteria set forth by the consensus report of the Lewy Body Consortium, clinicians and researchers use the oneyear rule to help verify the diagnoses of DLB and PDD. Thus, we analysed the dementia incidence within and after 1year of PD diagnosis, respectively.
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:
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At What Stage Of Parkinsons Does Dementia Start
If people with Parkinsons develop dementia, it is usually in the later stages of the disease.
Dementia may not affect everyone who has Parkinsons. An estimated 40% of those with Parkinsons also have dementia.
A longer duration of Parkinsons, significant movement difficulties, MCI, hallucinations, and delusions may increase the risk of developing dementia with Parkinsons.
Strengths And Limitations Of This Study
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The study strengths include the fact that it is a nationwide, retrospective cohort design for 11 years with more accurate estimates of the incidence rates of dementia by using the first diagnosed PD cases rather than the prevalent cases as study subjects.
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A multivariate Cox proportional hazard regression with a competing risk analysis was used to control the confounding bias and account for the competing risk of death.
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We were unable to consider a comprehensive list of potential confounders, such as smoking, educational level, physical function and genes in the analysis because of the limited information available from the claims data.
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Another limitation is the lack of clinical symptoms and subtypes of dementia.
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When Parkinson’s And Dementia Symptoms Are Similar
Parkinson’s and dementia can also lead to similar symptoms. Although Parkinson’s is often thought of as a disease that only interferes with movement, it can also lead to thinking and memory issues. Dr Katherine Fletcher, research communications manager at Parkinson’s UK, explains:
“Parkinson’s can impact memory, thinking and concentration, with some people experiencing this more mildly than others. However, if thinking and memory problems are serious enough to affect someone’s ability to carry out everyday tasks then they may be diagnosed with dementia.”
Are There Medicines To Treat Pdd
Though there is no cure for PDD yet, there are medications that help manage the symptoms. These medications are called cholinesterase inhibitors, and they can help if a person with PDD is having memory problems. Some examples of these medicines are donepezil, rivastigmine and galantamine. Sleep problems may be managed by sleep medications such as melatonin.
Because people with PDD are usually very sensitive to medications, any new medication, even one that is not being used for the brain, needs to be reviewed with the persons provider to avoid potential contraindication.
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Patient And Public Involvement
We conducted this study by using the NHIRD. No patients or members of the public were involved in the development of the research question and outcome measures. Also, no patients or members of the public were involved in setting out the design of this study, nor were they involved in the recruitment of and conducting of the study. The study results were not disseminated to the study subjects.
Causes Of Alzheimers Disease
Alzheimers disease is the most common type of dementia.
Alzheimers disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.
Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form tangles within brain cells.
Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.
As brain cells become affected in Alzheimers, theres also a decrease in chemical messengers involved in sending messages, or signals, between brain cells.
Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimers disease.
Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.
These treatments are not a cure for Alzheimers disease, but they do help improve symptoms.
Read more about treatments for dementia.
The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.
The hippocampus is often affected early on in Alzheimers disease. This area of the brain is responsible for laying down new memories. Thats why memory problems are one of the earliest symptoms in Alzheimers.
Unusual forms of Alzheimers disease can start with problems with vision or with language.
There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms.
These conditions account for only 5% of dementia cases in the UK.
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How Are Parkinsons And Dementia Related
Parkinsons and dementia are two of the most common degenerative neurological conditions in this country, affecting many thousands of people. However, there are a lot of myths and misunderstandings about the illnesses.
If you have been told that you have either condition, the future may seem bleak and bewildering. Whether youve found this blog having been recently been diagnosed, or are worried about a loved one, then read on, hopefully, we can help you to gain some understanding.
What Happens In Pdd
People with PDD may have trouble focusing, remembering things or making sound judgments. They may develop depression, anxiety or irritability. They may also hallucinate and see people, objects or animals that are not there. Sleep disturbances are common in PDD and can include difficulties with sleep/wake cycle or REM behavior disorder, which involves acting out dreams.
PDD is a disease that changes with time. A person with PDD can live many years with the disease. Research suggests that a person with PDD may live an average of 57 years with the disease, although this can vary from person to person.
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The Pathologies Are Different But Many Of The Symptoms Can Be Similar
We do know that the pathology is quite different between Parkinsons and dementia, said Dr. Odinachi Oguh, a neurologist at the Cleveland Clinic Lou Ruvo Center for Brain Health. But the processes in which memory is impacted in both diseases is about the same.
From the pathology standpoint, both diseases are characterized by a neurodegenerative process, Oguh said. The neurodegeneration results in abnormal accumulation of protein, which builds up and becomes toxic to the brain.
Alzheimers, for example, affects memory areas of the brain, which include the temporal lobes, as well as the memory center, or hippocampus. Parkinsons, meanwhile, starts in the basal ganglia part of the brain, and as the disease progresses, it can also affect the memory center, resulting in forgetfulness, an early sign of Alzheimers or other forms of dementia.
Assessments Of Visual Function
Visual measures were all performed before mydriasis. Visual acuity was measured binocularly using a logMAR chart . Contrast sensitivity was measured binocularly using a Pelli-Robson chart . Color vision was assessed using the D15 test, and error scores log transformed.
LogMAR visual acuity chart. Adapted by permission from BMJ Publishing Group Limited. Relationship between the risk of PD dementia and visual acuity. Pelli-Robson chart for assessing contrast sensitivity. Relationship between the risk of PD dementia and contrast sensitivity. Cats-and-Dogs test of higher-order visuoperception. The task is to identify whether the animal shown is a cat or a dog, with differing amounts of skew applied to the image to determine the level of skew tolerated. Relationship between the risk of PD dementia and higher-order visuoperception, tested by skew tolerance. Biological motion. Dots are shown at the position of the major joints of the body. The dots move to give the strong percept of a person walking. Extra dots are added, and the number of dots tolerated, where the participant can still detect a person moving, is calculated. Relationship between the risk of PD dementia and higher-order visuoperception, tested with biological motion. Poorer performance in each of these measures is linked with a higher risk of PD dementia.
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See A Doctor If Youre Noticing Symptoms Beyond Parkinsons
Sometimes the mood or memory changes a person experiences cannot entirely be explained just by Parkinsons. If this is the case, the caregiver should explore other diagnoses, because if something cannot be explained by Parkinsons, theres certainly a risk of it being dementia, Oguh said.
She added that some signs to look for include increased memory and behavioral problems, like mood swings, anxiety or depression. Psychiatric behaviors, like hallucinations, delusions or paranoia, cannot just be explained by Parkinsons, and are more likely to be caused by a form of dementia like Lewy body dementia.
Oguh urged caregivers to be aware of changing symptoms like these.
I think sometimes family members are able to realize sooner than the patient, Oguh said. Often the patient might lack insight as to what is happening. I would encourage family members to seek expert opinion and treatment options.
Lewy Bodies: More Than Lbd
LBD is characterized by the presence of Lewy bodies in the nerve cells of the brain, meaning that LBD patients have Lewy bodies in the brain.2 However, Lewy bodies are also common with other conditions, such as Alzheimers and Parkinsons disease. In fact, most people with PD also have Lewy bodies in their brain. However, even if they have Lewy bodies, not all Parkinsons patients will also develop LBD.2
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The Differences Between Alzheimers And Parkinsons
16 October, 2020
Do you know the differences between Alzheimers and Parkinsons? First of all, we must say that both diseases constitute two of the causes of dementia. Now, lets be a bit more specific. According to data from the WHO , dementia due to Alzheimers disease represents 60-70% of all cases of dementia in the world.
However, its important to keep in mind that theyre very different diseases. Additionally, we must make clear that having either condition doesnt always lead to the development of dementia . In this sense, we know that between 20-60% of people with Parkinsons disease end up developing dementia.
Buter et al. conducted a study that was published in the journal Neurology. It was conducted with 233 patients with Parkinsons disease. The researchers were able to observe that about 60% of them developed Parkinsons dementia in a period of 12 years.
So whats dementia? It refers to the set of symptoms that arise as a consequence of neurological damage or disease. These symptoms involve the loss or weakening of the mental faculties and mainly affect three different areas: cognitive , behavioral , and personality .
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What Is Lewy Body Dementia Causes Symptoms And Treatments
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Lewy body dementia is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood. Lewy body dementia is one of the most common causes of dementia.
LBD affects more than 1 million individuals in the United States. People typically show symptoms at age 50 or older, although sometimes younger people have LBD. LBD appears to affect slightly more men than women.
Diagnosing LBD can be challenging. Early LBD symptoms are often confused with similar symptoms found in other brain diseases or in psychiatric disorders. Lewy body dementia can occur alone or along with other brain disorders.
It is a progressive disease, meaning symptoms start slowly and worsen over time. The disease lasts an average of five to eight years from the time of diagnosis to death, but can range from two to 20 years for some people. How quickly symptoms develop and change varies greatly from person to person, depending on overall health, age, and severity of symptoms.
In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease advances, people with LBD require more help due to a decline in thinking and movement abilities. In the later stages of the disease, they often depend entirely on others for assistance and care.
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Causes Of Dementia With Lewy Bodies
Lewy bodies are tiny clumps of a protein called alpha-synuclein that can develop inside brain cells.
These clumps damage the way the cells work and communicate with each other, and the brain cells eventually die.
Dementia with Lewy bodies is closely related to Parkinsons disease and often has some of the same symptoms, including difficulty with movement and a higher risk of falls.
How Is Age Related To Pdd
Both PD and PDD are more common with increasing age. Most people with PD start having movement symptoms between ages 50 and 85, although some people have shown signs earlier. Up to 80% of people with PD eventually develop dementia. The average time from onset of movement problems to the development of dementia is about 10 years.
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Epidemiology Of Parkinsons Disease With Dementia
Prevalence and incidence rates of PDD have varied depending upon the methodologies applied in particular surveys, imprecision in definitions of dementia and cognitive impairment, as well as pathological heterogeneity in the patient populations studied. Nevertheless a comprehensive recent systematic review of the available literature found a mean point prevalence of 31.3% of dementia in PD patients, with community prevalence of PDD in the over 65s between 0.3 and 0.5%.
As discussed in chapter 10, it is becoming increasingly recognised that cognitive impairment is present even in the earliest stages of PD for example, it was shown that between 19 and 24% of newly diagnosed PD patients had a mild degree of cognitive impairment . These deficits appear to progress over time, and it has been suggested that the mean duration from onset of PD to the development of PDD is around 10 years. A longitudinal study based in Norway suggested that the cumulative prevalence was up to 78% after 8 years of follow-up . Consistent with this are the incidence rates of PDD from longitudinal community-based cohorts which are at least four to six times that of the rate of dementia in age-matched controls with approximately 10% of PD patients developing dementia annually .
A variety of risk factors for the development of dementia in PD have been described, and these are summarised in table 1.
Table 1.
Risk factors for PDD
Symptoms Of Parkinsons Disease
- Feeling, seeing, smelling, hearing and tasting things that arent there
- Hallucinations and delusions
Parkinsons disease is usually expressed through the following five stages:
- Stage oneMild symptoms dont interfere with daily tasks, tremors occur on one side of the body, and posture, gait and facial expression changes may happen.
- Stage twoSymptoms worsen, tremors and stiffness affect the entire body and walking and standing are more difficult. At this stage, people may have some trouble performing daily activities.
- Stage threeTrouble moving quickly, and balance issues can make it hard to eat or get dresses. Patients may be more likely to fall.
- Stage four Patients may need a walker to move around. Most people are unable to live alone at this stage because they need help with daily activities.
- Stage fiveIt may be impossible to stand or walk. A wheelchair may help with mobility. A caregiver should be present at all times during this stage.
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Coping With Alzheimers And Parkinsons Disease
Living with both Alzheimers disease and Parkinsons disease is extremely challenging. The dementia of Alzheimers combined with the movement effects of Parkinsons can make self-care especially difficult.
Rivastigmine is the only medication that is specifically approved for the treatment of Parkinsons dementia. Additionally, you may need medication for the motor symptoms of Parkinsons disease and medication to help with other symptoms, such as dry skin.