Comparison Of Clinical Outcome Measures Between Clusters
Our next steps focused on the question whether our identified patient clusters were disease associated or just reflecting general genetic differences in the population. For this purpose, we used clinical, imaging, transcriptome and methylome data.
We first investigated differences in clinical outcome measures of AD and PD patients across clusters. This was done separately on the basis of each of the individual study used in this paper , because available clinical data differs between studies , and differences in inclusion/exclusion criteria may bias a combined analysis: Despite the fact that all patients had a time till initial diagnosis of at most 2;years there were significant differences of baseline UPDRS scores between PD studies , and in all cases UPDRS total in PPMI and DIGPD were lower than in AETIONOMY PD and ICEBERG . Similarly, AD cohorts differed significantly by age , level of education and MMSE baseline scores .
Table 1 Demographic and clinical variable summary of AD discovery and validation cohorts.Figure 4
Examples of significant differences between clusters with respect to clinical baseline features in PD patients after correction for confounding effects . MDS-UPDRS I score ; MDS-UPDRS III on treatment score ; HADS anxiety score ; Schwab-England Scale in % . The Figures shows statistical distributions as violin plots , and individual data points are shown as superimposed dots.
Differences Between Delirium Dementia Alzheimer’s And Parkinson’s
Your brain doesnt;finish developing;until your mid-to-late 20s. Is it all downhill from there? Neuroscientists are discovering that you can continue to;rewire your brain;to encourage growth and prevent your brain cells from dying, but everyone experiences age-related cognitive decline.
Its often lumped into an umbrella category of mental slowdown that happens as you get older.
However, there are a few different brain diseases that affect aging adults. Heres how to understand the difference between delirium, dementia, Alzheimers and Parkinsons.
What Makes Them Different
MS and Parkinsonâs have different causes. They usually start to affect you at different ages, too.
MS often affects people between ages 20 and 50, but children get it, too. Parkinsonâs usually starts at age 60 or older, but some younger adults get it.
MS is an autoimmune disease. That means your bodyâs immune system goes haywire for some reason. It attacks and destroys myelin. As myelin breaks down, your nerves and nerve fibers get frayed.
Some genes may put you at risk for Parkinsonâs, especially as you age. Thereâs a small chance that people who are exposed to toxic chemicals like pesticides or weed killers can get it, too.
These symptoms are more common if you have MS. They not usually found in Parkinsonâs:
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Wait So What Is Parkinsonism
Parkinsonism refers to the motor symptoms that are typically associated with PD, such as tremors, stiffness, and walking/balance problems. Both PD and LBD are forms of Parkinsonism, meaning that PD patients and LBD patients may experience these motor symptoms.2 Because the Parkinsonism motor symptoms of PD and LBD can be very similar, it can be difficult to differentiate between the two conditions.
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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How Is Parkinsons Disease Dementia Diagnosed
No single test can diagnose Parkinsons disease dementia. Instead, doctors rely on a series or combination of tests and indicators.
Your neurologist will likely diagnose you with Parkinsons and then track your progression. They may monitor you for signs of dementia. As you get older, your risk for Parkinsons dementia increases.
Your doctor is more likely to conduct regular testing to monitor your cognitive functions, memory recall, and mental health.
Depression With Huntingtons Disease
Due to the nature and lower life expectancy of Huntingtons disease, it is common for a diagnosis to lead to depression. Patients with Huntingtons are at a higher risk of suicide.
If you are struggling with your Huntingtons diagnosis or prognosis, contact the Substance Abuse and Mental Health Services Administration National Helpline online or call 1-800-662-4357 to seek help.
For more mental health resources, including a helpful list of links and hotline numbers, see our National Helpline Database.
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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.
How Are They Alike
These diseases both affect your nerves. MS can break down the coating, called myelin, that surrounds and protects your nerves. In Parkinsonâs, nerve cells in a part of your brain slowly die off.
Both can start out with mild symptoms, but they get worse over time.
Common symptoms of both diseases include:
- Shaky fingers, hands, lips, or limbs
- Slurred speech thatâs hard for others to understand
- Numb or weak limbs that make your walk unsteady
- Loss of muscle control that often affects one side of your body at first, then later both
- Spastic limb movements that are hard to control
- Loss of bladder or bowel control
- Poor balance
Depression is another symptom common to both conditions.
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.
Data Extraction And Literature Quality Evaluation
The authors N.-N. Hou and X. Zuo completed literature retrieval and selection independently. When there was a disagreement, L. Cui and H.-M. Wu participated to reach a consensus. Extracted from the studies were author name, publication year, gender, age range, study design, response rate, diagnostic criteria, case number, study location, urban/rural, education, and sample size. All eligible studies were systematically evaluated for quality based on their sample size, study design, response rate and diagnostic assessment. The detailed scoring criteria were performed as previously described by Prince et al. .
Don’t Smoke Lessen Alcohol Intake & Do Not Take Drugs
Even if you don’t drink a lot, alcohol has a cumulative effect on your brain. One blackout after a drinking binge can induce life long memory loss. Over time, smaller amounts of alcohol will lead to blackouts and soon you’ll have a ton of lost time even though you barely drank one bottle of beer.
Smoking negatively affects memory by reducing the amount of oxygen that reaches the brain while repeated drug use kills your neurons and the rushes of dopamine reinforce drug dependence.
Will The Research Lead To A Breakthrough
Experts in these fields told Healthline this particular research does provide some encouragement.
James Hendrix, director of global science initiatives at the Alzheimers Association, said although the three diseases involve different proteins and have different effects on the brain, there is still some commonality.
He likened it to studying the motors of cars, airplanes, and boats. Although theyre different modes of transport, they still have similar engines.
Its valuable to have this cross talk. You dont want to work in a silo, Hendrix told Healthline. A discovery in one area can revolutionize another field.
George Yohrling, PhD, the senior director of mission and scientific affairs at the Huntingtons Disease Society of America, agrees.
Theyre looking at whats going on at the cellular level. What cellular machinery is being disrupted, he told Healthline.
It gets down to the cellular level, added Hendrix. If you can understand whats going wrong, you might be able to prevent that mechanism from happening.
A breakthrough is sorely needed for all these diseases.
Late last month, the Centers for Disease Control and Prevention announced that the death rate from Alzheimers in the United States increased 55 percent between 1999 and 2014.
In addition, about 50,000 people in the United States are diagnosed with Parkinsons every year. An estimated 500,000 Americans are living with the disease.
That would be wonderful, said Yohrling.
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Lewy Body Dementia Vs Parkinsons Disease Dementia
Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.
Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.
The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.
This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.
The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.
Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.
Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.
Parkinsons disease itself isnt fatal, but complications can be.
Research has shown a median survival rate of about
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.
Read Also: Can Parkinson’s Run In The Family
Can You Have Both Parkinsons And Alzheimers
People who already have Parkinsons disease and later develop signs of dementia are diagnosed with Parkinsons dementia.6 However, if you first have Alzheimers disease and develop signs of movement difficulties, you can also have a diagnosis of Parkinsons disease.
Tell us about your experience in the comments below, or with the community.
Mechanism Burden Scores Allow For Reproducible Subtyping Of Ad And Pd Patients
Using the data of 148 SNPs mapping to 15 common AD/PD disease mechanisms in 486 AD and 358 PD patients within our discovery cohorts, we developed an unsupervised machine learning approach to discover subgroups . This approach consisted of two basic steps: sparse autoencoding of the SNPs mapping to each of the 15 mechanisms, resulting into a profile of genetic burden scores; consensus sparse non-negative matrix factorization to cluster patients and for identifying most discriminative mechanisms. Our method resulted in 4 subgroups in ADNI, PPMI as well as in a merger of ADNI and PPMI patients that were statistically stable and better discriminated than expected by pure chance ; details are described in the section and in the Supplementary Text . Interestingly, clusters found in the merged AD/PD cohort were all composed of a mixture of AD and PD patients . They were not identical to the ones identified in each disease individually, but showed a highly significant overlap in both cases -test). That means our clustering suggests the existence of certain commonalities between AD and PD patients on the level of SNP burden on specific mechanisms. We will discuss the question of disease relevance later.
Cluster 2 isamong other featuresstrongly associated with the genetic burden on IL1B, NLRP3, TP53,,,. Activation of IL1B by NLRP3 and TP53 play a role in the response of the immune system. Neuroinflammation is a common feature of AD and PD.
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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.
Theres A Spectrum Of Pathologies
Scientists have been examining this linkand how the two diseases often overlapfor some time, but still arent completely certain how they contribute to one another. As a result, physicians sometimes group the diseases into different combinations when making diagnoses.
Dementia in Parkinsons patients can present itself in varying forms. In some cases, the Parkinsons pathology can trigger the dementia pathologya situation that results in whats known as Parkinsons disease dementia, says Dr. Aaron Ritter, Director of the Clinical Research Program at the Cleveland Clinic Lou Ruvo Center for Brain Health.
A substantial subset of folks with Parkinsons who live long enough, will develop dementia, Ritter said.Its separate from Alzheimers, but its likely related to Parkinsons pathology, a sort of spreading of Parkinsons.
In other cases, patients may develop a form of dementia like Alzheimers separately from their Parkinsons disease, though this isnt visible until after death, through an autopsy.
Many people with Parkinsons may also develop Lewy body dementia shortly after their diagnosis. When you have Parkinsons, and see cognitive declineor things like hallucinations and delusionsup to a year after your Parkinsons diagnosis, you may have Lewy body dementia, Oguh said.
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Possible Link To Alzheimers
Though Alzheimers, Huntingtons, and Parkinsons are distinctly different diseases, some evidence has emerged that shows a common link between the three.
All three diseases have proteins within the cells that do not assemble properly. Though the molecular and cellular changes that occur in each disease vary greatly, this protein degradation has been shown to precede early clinical signs in each disease. This is promising news, as more studies are being done to determine whether this can either predict or prevent these neurodegenerative diseases.
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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