How Common Is Cognitive Decline In Parkinsons
A new study finds that cognitive impairment is a frequent and rapidly progressing symptom of Parkinsons disease . About half of the participants who had PD for an average of five years and had normal cognition at the beginning of the study developed mild cognitive impairment within six years about 11 years after PD diagnosis. Those few who developed MCI progressed to dementia within five more years. The results appear in the September 11 online edition of Neurology.
With a diagnosis of PD, most people and their physicians focus on treating and coping with movement symptoms. Yet even early in the course of disease, people with PD may have difficulty multitasking, or feel that their thinking abilities are just not the same.
To better understand the rate at which cognitive impairment develops, and identify risk factors for the development of cognitive impairment, researchers led by Daniel Weintraub, M.D., recruited 141 people with PD to participate in the study. All were receiving treatment at the University of Pennsylvanias Udall Center for Parkinsons Disease Research. On average they were 69 years old and had been living with PD for five years 63 percent were men. All participants had normal cognition based on a battery of standard tests for people with PD. The researchers re-evaluated study participants cognition each year for up to six years.
Results
What Does It Mean?
Reference
Medicines For Parkinson’s Disease
Medicines prescribed for Parkinson’s include:
- Drugs that increase the level of dopamine in the brain
- Drugs that affect other brain chemicals in the body
- Drugs that help control nonmotor symptoms
The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapysuch as nausea, vomiting, low blood pressure, and restlessnessand reduces the amount of levodopa needed to improve symptoms.
People with Parkinson’s should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.
Other medicines used to treat Parkinsons symptoms include:
- Dopamine agonists to mimic the role of dopamine in the brain
- MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
- COMT inhibitors to help break down dopamine
- Amantadine, an old antiviral drug, to reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
You May Like: Parkinson’s Double Vision
What Are The Primary Motor Symptoms Of Parkinsons Disease
There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.
It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.
Tremors
Rigidity
Bradykinesia
Postural Instability
Walking or Gait Difficulties
Dystonia
Vocal Symptoms
Want To Learn More About The Latest Research In Parkinsons Disease Ask Your Questions In Our Research Forum
3. Loss of SmellMany people temporarily lose their sense of smell due to colds or the flu, but if the loss is sustained over a length of time without any noticeable congestion, then it could be an early sign of Parkinsons disease.
4. Sleeping DisordersTrouble sleeping can be attributed to many illnesses and Parkinsons disease is one of them. Waking due to sudden body movements, or thrashing your legs in your sleep could be a warning sign of the condition.
5. Stiffness in Walking and MovingGeneral stiffness that cant be attributed to exercise aches and pains and doesnt ease up when moving around could be an early warning sign of Parkinsons disease. Many patients complain that it feels like their feet are literally stuck to the floor.
MORE: Did you know that Parkinsons disease patients may benefit from dancing?
6. ConstipationUnable to move your bowels is also a common early sign of Parkinsons disease. Although this is a common enough problem in healthy people, Parkinsons patients are more susceptible to constipation. If you suddenly find youre constipated and consider your diet normal then you should have a doctor check you out.
7. Low or Soft VoiceA sore throat or a cold can change the way you speak, but if you have been experiencing a sudden softness to the tone of your voice and are now speaking in a quieter or hoarser tone, this could be an early symptom of Parkinsons disease.
MORE: Check some seated exercises for patients with Parkinsons disease
Read Also: Prayers For Parkinson’s Disease
How Is Constipation An Early Warning Sign Of Parkinson’s It’s Such A Common Problem
A: It’s not as specific as other prodromal symptoms, like anosmia. The rate at which people with chronic and unexplained problems with constipation develop Parkinson’s disease is not as easy to pin down. But if someone has unexplained, persistent constipation, it should at least be noted, as it could be considered prodromal.
Parkinsons Early Signs And Symptoms
The early signs of Parkinsons can be difficult to spot at first, and not all Parkinsons early signs are directly related to movement, Hammel added.
You might have small tremors, but you also might notice you have smaller handwriting, he said. Some also have a softer or lower voice, and you might have trouble hearing them.
The Parkinsons Foundation lists the following as the 10 most common early signs of Parkinsons disease:
- Tremors
- Dry, flaking skin on the face and scalp
Also Check: What Foods Should Be Avoided When Taking Levodopa
Do People Actually Lose Their Sense Of Smell With Parkinson’s
A: Yes. It’s a condition called anosmia, and if you have it with no other disease , you have at least a 50 percent chance of developing Parkinson’s disease in the next five to 10 years. What happens is that alpha-synuclein, the protein that clumps in the part of the brain that regulates dopamine and leads to Parkinson’s disease, also aggregates in the olfactory bulb, the part of the brain responsible for your sense of smell. This happens well before the protein accumulations cause motor symptoms.
Discuss With Your Physician
Non-motor symptoms can sometimes be difficult to recognize. Therefore, it is important to make your doctor aware of them.
One useful resource is the PD NMS Questionnaire. You can use this to record your symptoms and discuss them with your doctor.
Dr. Ron Postuma, whose research was funded by donations to the Parkinson Canada Research Program, has also developed tools to help people with Parkinsons and their physicians identify and manage non-motor symptoms.
Recommended Reading: Pfnca Wellness Programs
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
How Is Parkinsons Treated
While there currently is no cure for Parkinsons, there are medications that can help slow the progression of the disease. A combination of the prescription drugs Levopoda and Carbidopa are often prescribed to those living with Parkinsons. These can help reduce tremors and rigidity.
Hammel said any combinations of medications prescribed should be accompanied by an exercise program.
There are two things that 110% dictate the progression of the disease: the medications your neurologist recommends and physical activity, he said. Its like they say, if you dont use it you lose it. Thats true with movement.
Research indicates that regular exercise can slow the decline in those with Parkinsons. Exercise can also save dopamine, Hammel added. Loss of dopamine is what causes the disease in the first place, so, exercise is huge, he said.
There are several Parkinsons exercise programs out there. Check with your doctor to see which one is right for you.
Read Also: Does Sam Waterston Have Parkinsons
Why Is There A Delay
Parkinsons disease is a slow, progressive condition, said Simonet. We do not expect all symptoms to start at once from one day to another.
According to Simonet, there is a pre-diagnostic phase when the motor symptoms and non-motor symptoms of Parkinson’s emerge over time.
The researchers did suggest one possible reason for the delay in diagnosis.
Even if patients have classic signs of Parkinsons like tremors and memory problems, providers may have a harder time evaluating symptoms in patients from traditionally under-represented groups.
Symptoms Of Parkinsons Disease
Parkinson’s disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Other symptoms may include depression and other emotional changes difficulty swallowing, chewing, and speaking urinary problems or constipation skin problems and sleep disruptions.
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
Recommended Reading: On-off Phenomenon
What Are The Stages Of Parkinsons
Every case of Parkinsons is different and so is the progression of the disease. The disease is typically diagnosed in those who are 60 or older, but there are instances where a diagnosis is made much earlier. The Parkinsons Foundation recognizes five stages of the disease based on the severity of symptoms.
How Can Inpatient Rehabilitation Help
As a senior physical therapist at Encompass Health Fayetteville, Hammel works with Parkinsons patients at various stages of the disease. He said inpatient rehabilitation for Parkinsons can benefit even those who are only experiencing Parkinsons early signs and symptoms.
Honestly, I would say the moment you are diagnosed, rehabilitation can help, he said. Once youre diagnosed, one of the best things you can do is therapy. We can help with education and trying to regain independence or modify how you used to do things.
At an inpatient rehabilitation hospital such as Encompass Health, you will receive three hours of therapy five days a week, along with frequent visits from a rehabilitation physician. Occupational therapy can help you with activities of daily living, such as eating and grooming, physical therapy can help you build strength and balance, and speech therapy can help with speech and swallowing, as well as cognitive issues.
The goal of rehabilitation for Parkinsons patients, Hammel added, is to allow you to remain independent at home for as long as possible. If you or a loved one was recently diagnosed with Parkinsons disease or is experiencing more progressed symptoms, find an Encompass Health location near you, and talk to a rehabilitation specialist to see if inpatient rehabilitation could benefit you.
Also Check: Yopd Life Expectancy
Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.
Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.
What Is Parkinson’s Disease
Named after an English Doctor, James Parkinson, Parkinson’s disease is a life-limiting disorder of the central nervous system .
This degenerative disorder can greatly impact a person’s ability to move around or do basic things on his/her own. It occurs when the nerve cells in the brain are unable to produce a particular chemical known as dopamine. Moreover, this is a progressive malady, which will only get worse over time, instead of getting better.
Still, specialists all over the world believe that early detection could play a key role in the treatment of this disease. Hence, today at Boldsky, we have compiled a list of early warning signs of Parkinson’s disease that one should know about and never take it lightly .
Studies point out that the symptoms differ from person to person. While they might strike as vague and harmless, they should not be taken lightly.
Take a look at some of the most common early warning signs of this motor system disorder.
Read Also: Parkinson’s Bike Therapy
Parkinson’s Disease: The Signs And Symptoms
When you subscribe we will use the information you provide to send you these newsletters. Sometimes theyll include recommendations for other related newsletters or services we offer. Our Privacy Notice explains more about how we use your data, and your rights. You can unsubscribe at any time.
Parkinsons disease is a condition that causes the brain to become more and more damaged over a long period of time. But the symptoms can take a long time to develop, and its not always noticeable at first.
The condition itself is caused by a loss of nerve cells in a specific part of the brain.
These nerve cells are used by the body to send messages to the nervous system.
But seeing as this damage takes place over a long period of time, symptoms can take a long time to reveal themselves.
There are, however, 10 key warning signs that you should be looking out for.
Early Symptoms Of Parkinsons Disease
Michael J. Fox was a 29-year-old actor who woke up one morning and noticed his little finger shaking. What he thought was a side effect of a hangover actually was an early symptom of Parkinsons disease.
Parkinsons disease is a chronic and progressive movement disorder that has no known cause. Nearly a million people in the United States live with the disease.
Some symptoms of the disease are easy to see, while others are hard even for a trained healthcare professional to detect.The National Parkinson Foundation offers these 10 early warning signs of Parkinsons disease:
No one symptom necessarily means that you have the disease the symptom may be caused by another condition. However, if you feel you are experiencing symptoms, dont hesitate to visit your physician.
Don’t Miss: Cleveland Clinic Parkinson’s Bicycle Study 2017
Social Engagement And Parkinsons Disease
See the groundbreaking work of Dr Stephen Porges to understand more about this aspect of our Nervous System and its role in wellness and disease, based on the fact that mammals have a more evolved part of the Nervous System specifically designed for purposes of Social Engagement and Social Co-operation.
Social Engagement involves mainly the Cranial Nerves and their use in social functions such as making sounds and vocal calls for communication, and in facial expressiveness for transmitting emotional states to each other. Dysregulation of this Social Engagement part of our NS seems now to be a principal underlying cause in many chronic conditions, especially in PD, where loss of voice and loss of facial expression are major symptoms. See