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.
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.
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.
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What Is The Difference Between Dementia And Vascular Dementia
Vascular dementia is simply one type of dementia. The term dementia actually refers to several progressive brain diseases and is used as an umbrella term. The most common types of dementia are Alzheimers disease, Parkinsons disease, and vascular dementia. Vascular dementia is caused when individuals suffer from impaired blood flow. This type of dementia is more common among those who have high blood pressure, high cholesterol, or diabetes.
Dementia Caused By Huntingtons Disease
Huntingtons disease is an inherited degenerative brain disease that affects the mind and body. It usually appears between the ages of 30 and 50, and is characterised by intellectual decline and irregular involuntary movement of the limbs or facial muscles. Other symptoms include personality change, memory disturbance, slurred speech, impaired judgement and psychiatric problems.There is no treatment available to stop the progression of this disease, but medication can control movement disorders and psychiatric symptoms. Dementia occurs in the majority of people with Huntingtons disease.
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What Medications Are Available To Manage Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, include:
- Cholinesterase inhibitors, including donepezil , rivastigmine and galantamine .
- NMDA receptor antagonist memantine .
- Anti-amyloid antibody aducanumab .
Healthcare providers use these drugs to treat people with some of the other forms of dementia.
Cholinesterase inhibitors and the NMDA receptor antagonist affect different chemical processes in your brain. Both drug classes have been shown to provide some benefit in improving or stabilizing memory function in some people with dementia.
Cholinesterase inhibitors manage the chemicals in your brain that allow messages to be sent between brain cells, which is needed for proper brain function. Memantine works similarly to cholinesterase inhibitors except it works on a different chemical messenger and helps the nerve cells survive longer.
Aducanumab targets amyloid proteins, which build up into the plaques seen in the brains of people with Alzheimers disease.
Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, healthcare providers prescribe the appropriate drugs used to treat those specific conditions. These other conditions include sleeping problems, depression, hallucinations and agitation.
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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.
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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.
Epidemiology Of Dementia And Parkinsons Disease
Dementia and PD are both diagnosed frequently and increase mortality . Perhaps dementia is perceived more so as a memory problem and a disease of old age, but the incidence of dementia and PD in younger age is similar. In the Netherlands, for dementia, the incidence per 1,000 person-years is 0.4 among those aged 6064 , and for PD, it is 0.3 . Dementia incidence patterns, however, show a much steeper increase with age mounting to 27 per 1,000 person-years for those 85 and over, compared to 4 for PD over 85. In view of similar mortality , therefore, the prevalence of dementia in the general population is much higher than prevalence of PD . However, adjusted for age and other factors, 6-year mortality in PD is higher than in Alzheimers dementia . Age adjustment is relevant also as it shows that comorbid disease may be equally prevalent for Alzheimersa main type of dementiaand PD across the same age groups .
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What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts dont know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
What Is Parkinsons Disease
Parkinsons disease was described by James Parkinson nearly 100 years before Dr. Alois Alzheimer described the dementia later named Alzheimers disease . Called the shaking palsy by Parkinson, PD is diagnosed when a person shows at least two of these three symptoms: slowed movements , muscle rigidity, and tremor . We recognize many other associated signs of PD, including expressionless face, quiet speech, cramped handwriting, shuffling gait, trouble getting out of a chair, and difficulty swallowing. Many of the symptoms of idiopathic Parkinson’s disease result when certain nerve cells that produce dopamine in the brain begin to malfunction and die.
Most cases are called idiopathic, meaning the cause remains unknown, although a small number of cases are linked with poisoning , head trauma, more complex PD-like neurological disorders , or reversible toxic medication effects ,
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The Difference Between Parkinsons & Vascular Dementia
The biggest difference between vascular dementia and Parkinsons disease is that Parkinsons doesnt always lead to dementia. Parkinsons affects mobility, similar to vascular dementia, and both are brain disorders that may stem from vascular problems. Parkinsons disease may also affect memory like vascular dementia but not in every case.
Vascular dementia symptoms include memory loss, reduced ability to organize thoughts or actions, confusion and trouble concentrating, trouble paying attention.
Parkinsons disease symptoms include slowed movement, muscle rigidity, shuffled walking, quiet speech, issues with swallowing.
During the end-stage of all types of dementia, the symptoms tend to be the same across the board.
Parkinsons Doesnt Always Cause Dementia
While cognitive decline is common in both Alzheimers and Parkinsons, it is less likely to occur in Parkinsons patients. According to studies, only half of those with Parkinsons develop cognitive difficulties. This can range from mild forgetfulness to full-blown dementia.
When dementia does manifest itself with Parkinson, it occurs in the subcortical area of the brain. Alzheimers dementia occurs in the cortical area of the brain. As a result of this, the clinical symptoms of these two dementias can be somewhat different.
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More Differences Found Between Alzheimers And Parkinsons
Pauline Anderson
Although some research points to the possibility of a pathologic overlap between Alzheimers disease and Parkinsons 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 dont 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
Clinical Applicability
Symptoms Of Parkinsons Disease
Some symptoms of Parkinsons affect a persons ability to move. These symptoms are often called motor symptoms, and they include:
- Stiffness of muscles
- Tremor of an arm or leg while at rest
- Unstable posture
Other symptoms of Parkinsons dont affect a persons movement. These nonmotor symptoms may include:
- Digestive problems, such as constipation
- Cognitive changes, such as loss of attention, difficulty solving problems, memory loss, and trouble with language
Parkinsons symptoms may take several years to appear. A majority of people with Parkinsons live for many years with the condition.
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Alzheimers Disease Vs Parkinson Disease
The main difference between Alzheimers disease and Parkinsons disease is that a deficiency of acetylcholine is linked to Alzheimers disease and usually induces the symptoms of Alzheimers patients whereas Parkinsons disease is mainly caused by a drop in dopamine levels in the brain. Both the diseases are brain disabilities with neurological malfunctioning along with reversed psychological tendencies.
Alzheimers disease is a neurodegenerative condition that causes the central nervous system to shrink and the death of brain cells.
Alzheimers disease is by far the most prevalent degenerative brain disease, which is defined as a progressive loss of cognitive, behavioral, and social abilities that impairs a persons capacity to operate alone
Treatment Of Pdd And Dlb
Unfortunately, since both types of Lewy Body Dementia often display similar symptoms, patients suffering from either PDD of DLB can get misdiagnosed and subsequently prescribed the incorrect medication and method of treatment. Caregivers and medical professionals alike can increase their understanding of symptoms for each disease to help them more quickly and accurately diagnose and treat each one.
The Lewy Body Dementia Resource Center provides literature, support groups, and help for caregivers grappling with care and treatment of a loved one who has Lewy Body Dementia. Our helpline is available 12 hours a day, 7 days a week for caregivers who have questions or are in need of support. Our online resource center seeks to bring awareness and support to caregivers of those suffering with Lewy Body Dementia. Please dont hesitate to reach out to us.
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Main Differences Between Alzheimers Disease And Parkinson Disease
Potential For Therapeutic Targets
The researchers add that their findings have the potential to provide new therapeutic targets for both Alzheimers and Parkinsons disease.
Until now, nobody has really understood what the overlap between Alzheimers and Parkinsons disease was, or if it were important, says Jada Lewis, associate professor of neuroscience at the Centre for Translational Research in Neurodegenerative Disease at the University of Florida. Our study ties these diseases together in a unique way.
The researchers conclude that their findings show that LRRK2 genetic studies in human tauopathies may be warranted.
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The Effects Of Alzheimers On The Brain
In people with Alzheimers disease, brain cells die and connections between brain cells may break down. One of the hallmark symptoms is abnormal protein deposits in the brain called plaques and tangles.
Plaques are dense clusters of protein that can block communication between neurons. Tangles are proteins that twist together that lead to the death of healthy brain cells.
In advanced Alzheimers, the brain shows significant shrinkage. Changes in the brain may occur a or more before symptoms start.
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 can 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.
Things You Should Know About The Link Between Parkinsons And Dementia
Both Parkinsons disease and dementia were ravaging the brain and behavior of actor Robin Williams before his death, but at the time, he didnt realize he had the latter.
Despite the fact that the signs of this combination can be confusing, the double diagnosis of Parkinsons and dementia impacts a large number of people. Of the one million people who have Parkinsons in the U.S., 50 to 80 percent may have dementiaeither as a result of Parkinsons pathology, or separately.
Robin Williams widow, Susan, wrote an editorial published in Neurology that was addressed to neurologists after his death. In it, she shared what it was like seeing her husband experience both Parkinsons disease and Lewy body dementia firsthand.
My hope is that it will help you understand your patients along with their spouses and caregivers a little more, Susan wrote.
Williams was first diagnosed with Parkinsons disease, which at first seemed to provide some answers for his out-of-character symptoms.
But it wasnt until after his death that an autopsy revealed he had been in the later stages of Lewy body dementiaa common form of dementia characterized by deposits of Lewy body proteins in the brain, which can impact physical movement, mood, memory and behavior.
I will never know the true depth of his suffering, nor just how hard he was fighting, Susan wrote. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.
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Dementia With Lewy Bodies
Dementia with Lewy bodies is the second most common contributor to dementia in older people. People with DLB may also experience the typical symptoms of Parkinsons, which makes the condition especially difficult to distinguish from Parkinsons. However, several characteristics make DLB stand out.
Among them, dementia is the first sign of DLB, which can include inattentiveness, decreased alertness, memory loss, and visual hallucinations. People with DLB usually start to experience dementia and movement issues around the same time or less than one year apart. People with DLB generally dont experience tremor, and if they do, its slight.
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.
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