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.
Identification Of Common Molecular Mechanisms
Common molecular mechanisms between AD and PD were identified with the help of a systematic literature mining approach with post-hoc manual curation. More specifically, the text mining engine SCAIView was used to construct cause-effect relationships between molecules, pathways, biological processes and imaging features in both, AD and PD, see Domingo-Fernandez et al. and Kodamullil et al. for details, for details. After manual curation, two computable disease maps, one for AD and one PD were created. Finally, we have also made them interactively usable via a dedicated web application .
Calculation of the intersection of cause-effect relationships described in the AD and PD disease maps resulted into 27 genes grouped into 15 cause-effect relationship sub-graphs, called mechanisms from now on . While some of these mechanisms describe only posttranslational modifications of a single protein, others reflect more complex proteinprotein interactions and signaling cascades . Key proteins described in both diseases include e.g. APOE, TAU, SNCA and TOMM40. These proteins are involved into several known disease relevant processes that we have made computationally accessible via our earlier developed NeuroMMSig database.
We mapped 148 genetic variants measured in ADNI1, ADNI2/GO as well as PPMI to the 27 common AD/PD disease genes via a combination of two strategies: a) proximity ; and b) eQTL mapping, see details in Supplements on page 2.
Key Brain Changes Are Different
The key brain changes linked to Parkinsons disease and Parkinsons-related dementia are abnormal deposits of common brain proteins, called alpha-synuclein. These deposits are known as Lewy bodies, named after the doctor who discovered them. As more of these proteins clump in the brain, normal brain cells begin to die off.1
In Alzheimers disease, the key brain changes include the buildup of different brain proteins, called amyloid and tau. When amyloid proteins clump together, they form abnormal structures known as plaques. Abnormal groups of tau proteins form tangles.3 Over time, the buildup of these proteins causes normal brain cells to die, and affected parts of the brain may shrink.5
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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.
Symptoms Of Parkinsons Disease
Unlike Alzheimers, Parkinsons disease specifically affects movement. Early signs of the disease can be easy to miss or ignore, but the most common manifestation is a tremor. This is characterized by involuntary shaking that usually begins in your hands or fingers, though it can potentially affect any part of your body. Your hand may tremble when you are at rest, or you may unconsciously rub your thumb and index finger together .
Parkinsons disease can also result in bradykinesia, or slowed movement. This can create the feeling of having your feet stuck to the floor. Your gait may change to shorter steps when you walk, and you may have difficulty with general movements, like trying to get out of a chair.
You may also experience muscle rigidity or stiffness. This can further limit your range of motion and make movement painful.
This can also extend to any automatic or unconscious movements. You may have trouble blinking, emoting, or swinging your arms when you walk. In fact, many people experience a masked face where they constantly have a mad, sad, or serious look even when they are in perfectly good moods.;
Along with its effects on movement, Parkinsons disease can affect other things involving your motor function, including:
- Changes to your handwriting
- Slurring or speaking softer, lower, or without your usual inflections
- Poor posture
- Constipation
- Poor sleep
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The Differences Between Alzheimer’s And Parkinson’s
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 .
What Is Parkinson Disease
Parkinson;disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinsons disease also have tremors and may develop cognitive problems, including memory loss and dementia.
Parkinson;disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, it’s called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. It’s also much more common in men than in women.
Parkinson disease is a chronic and progressive disease.; It doesn’t go away and continues to get worse over time.
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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.
What Causes Lewy Body Dementia
The causes of LBD are not yet well understood, but research is ongoing in this area. There are probably multiple factors involved, including genetic and environmental risk factors that combine with natural aging processes to make someone susceptible to LBD.
For more information, visit www.lbda.org.
Modified with permission from the Lewy Body Dementia Association
To learn more about motor symptoms related to Parkinsons, visit here.
To learn more about non-motor symptoms related to Parkinsons, visit here.
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Psychotic Symptoms And Others
In addition to the symptoms we already mentioned, other symptoms may appear in both diseases. For example, in Alzheimers disease, delirium appears occasionally, while it rarely ever does in Parkinsons. Its vital to remember that delirium is an organic disorder that mainly affects consciousness and attention.
Regarding psychotic symptoms, visual hallucinations can appear in both diseases, more or less in the same proportion. Delusions may also arise. They occur often in Alzheimers and occasionally in Parkinsons.
Dementia With Lewy Bodies
DLB is second only to Alzheimers as the most common cause of dementia in the elderly. It causes progressive intellectual and functional deterioration. In addition to the signs and symptoms of Parkinsons disease, people with DLB tend to have frequent changes in thinking ability, level of attention or alertness and visual hallucinations. They usually do not have a tremor or have only a slight tremor. The parkinsonian symptoms may or may not respond to levodopa.
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Caring For Someone With Parkinsons
Practice patience and understanding when dealing with Parkinsons. You may be very frustrated and challenged as a caregiver, but those with Parkinsons are just as frustrated. Their physical and mental conditions can be debilitating, depressing, and humiliating.
Diet and nutrition can have a huge impact on the health and comfort of a Parkinson patient. Eating well, getting more rest, sleeping well, fresh air, and exercise can make a difference. Getting the right medication and complementary therapies is also important.
As Parkinsons impacts a patients motor skills, modifications to the living environment may have to be made to accommodate wheelchairs and limited mobility issues. Professional in-home assistance for Parkinsons can allow Parkinson patients to remain independent and can enhance quality of life.
Most importantly, seek help and support from family, friends, and caregiving support groups. Take advantage of the resources in your community. Shouldering all the burden can take a toll on a caregiver.
Take care of yourself or you wont be able to take care of your loved one. Follow the preventive advice provided above for yourself as well, and take deep breaths!
Resources
What Is Lewy Body Dementia
LBD is a chronic, neurodegenerative cognitive disorder, and is the 3rd most common form of dementia.3 Unlike most other forms of dementia, people with LBD have Lewy bodies in the brain. Lewy bodies are abnormally-folded proteins found in the nerve cells of the brain.2 Patients with LBD may experience memory/cognitive problems, visual hallucinations, and Parkinsonism symptoms.4
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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.
How Is Parkinson Disease Treated
Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
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The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to 90 percent of the time.
The symptoms of Alzheimers and dementia can overlap, but there can be some differences.
Both conditions can cause:
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
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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Signs And Symptoms Of Pdd
Common signs and symptoms of Parkinsons disease dementia include:
- Poor memory and concentration
- Depression
- Visual hallucinations
If youve noticed some of the above signs and symptoms in yourself or a loved one, its important to get them checked out. But dont jump to conclusions. People with Parkinsons often experience cognitive changes such as anxiety, lack of motivation, and slowed thinking. These symptoms do not automatically mean dementia.
More Differences Found Between Alzheimer’s And Parkinson’s
Pauline Anderson
Although some research points to the possibility of a pathologic overlap between Alzheimer’s disease and Parkinson’s disease , 2 recent studies highlight the differences between these age-related neurodegenerative diseases.
One study found no significant evidence supporting the presence of loci that increase the risk for both PD and AD, while another study concluded that cognitively impaired patients with PD don’t exhibit the same pattern of -amyloid deposition in the brain as those with AD.
Although patients with AD and PD can share common clinical symptoms and neuropathology, the gene study, August 5 in JAMA Neurology, did not find any evidence for overlap of the genetic risk factors that underpin the 2 diseases.
“Our study does not support the hypothesis that AD and PD form a biological continuum, but instead suggests that the diseases are innately distinct,” said lead author Valentina Moskvina, PhD, Medical Research Council Center for Neuropsychiatric Genetic and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, United Kingdom.
A meta-analysis of combined AD and PD GWA studies used a previously published mathematical approach to adjust for lack of independence caused by controls being used in both studies. This analysis revealed no significant evidence for the presence of alleles that increase the risk for both diseases.
Polygenic Score
Amyloid Study
Clinical Applicability
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Validation Of Patient Subtypes Via Independent Studies
Figure; gives an overview of our overall validation strategy, which consists of two parts: In the first part we re-clustered patients in our merged AD/PD validation cohort using the same workflow that we had established for our discovery cohort, which re-confirmed the possible existence of 4 clusters in AD and PD .
Figure 7
After classifier development, we were able to assign patients from independent studies to the clusters discovered in our discovery cohort . The in-group proportion measure proposed by Kapp and Tibshirani then measured the proportion of patients in the validation study, whose nearest neighbors in the discovery cohort had the same cluster label. An IGP closer to 1 indicates a stronger coherence of the statistical distribution of data in the validation cohort with the clustering of the discovery cohort. An IGP closer to zero indicates disagreement.
To further assess the statistical significance of observed IGP values we performed a permutation test, in which we randomly permuted the cluster assignment of patients and re-calculated the IGP. This was done for 1000 times. None of the randomly permuted cluster assignments exceeded the IGP of the original clustering, i.e. our obtained results were highly significant.