Friday, July 29, 2022

Do Parkinson’s Patients Get Mean

The Relationship Between Parkinsons Disease And Sleep

Why do people get Parkinson’s?

Its unclear whether poor sleep causes parkinsonian symptoms to worsen or whether worsening parkinsonian symptoms cause poor sleep. In many cases its likely a case of bidirectionality, with each one exacerbating the other.

Fragmented sleep and sleep deprivation appear to leave the brain more vulnerable to oxidative stress, which has been tied to the development of Parkinsons disease. Parkinsons disease is not usually diagnosed until individuals have developed sufficient motor symptoms, by which time a significant portion of brain cells have already been damaged. If poor sleep quality or having sleep disorders foreshadows the development of parkinsonian symptoms, these could be useful in early diagnosis of the disease.

More research is needed to clarify the multifaceted relationship between Parkinsons disease and sleep. A better understanding of this connection may offer medical experts the unique opportunity to screen at-risk individuals and perhaps delay the onset of the disease.

What Are The Five Stages Of Parkinson’s Disease

Researchers may disagree on the number of stages of Parkinsons disease . However, they all agree the disease is a progressive disease with symptoms that usually occur in one stage may overlap or occur in another stage. The stage increase in number value for all stage naming systems reflect the increasing severity of the disease. The five stages used by the Parkinsons Foundation are:

  • Stage 1: mild symptoms do not interfere with daily activities and occur on one side of the body.
  • Stage 2: Symptoms worsen with walking problems and both sides of the body affected.
  • Stage 3: Main symptoms worsen with loss of balance and slowness of movement.
  • Stage 4: Severity of symptoms require help usually person cannot live alone.
  • Stage 5:Caregiver needed for all activities patient may not be able to stand or walk and may be bedridden and may also experience hallucinations and delusions.

    A neurologist who specializes in movement disorders will be able to make the most accurate diagnosis. An initial assessment is made based on medical history, a neurological exam, and the symptoms present. For the medical history, it is important to know whether other family members have Parkinson’s disease, what types of medication have been or are being taken, and whether there was exposure to toxins or repeated head trauma previously. A neurological exam may include an evaluation of coordination, walking, and fine motor tasks involving the hands.

    The diagnosis of Parkinson’s disease is more likely if:

    Parkinson’s Disease Diet And Nutrition

    Maintaining Your Weight With Parkinson’s Disease

    Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.

    • Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
    • If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
    • Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.

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    What Is The Outlook For Persons With Parkinsons Disease

    Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.

    Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.

    The future is hopeful. Some of the research underway includes:

    • Using stem cells to produce new neurons, which would produce dopamine.
    • Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
    • Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.

    Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.

    What Are The Different Stages Of Parkinsons Disease

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    Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.

    In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:

    Early stage

    Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.

    Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.

    Mid stage

    Mid-late stage

    Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.

    Advanced stage

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    Increased Feelings Of Anxiety Or Depression

    Anxiety and depression have been linked to Parkinsons. In addition to movement problems, the disease can also have an impact on your mental health. Its possible that changes in your emotional well-being can be a sign of changing physical health as well.

    If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.

    Possible Risk Reduction Factors

    While age, genetics, and being a man make it more likely you’ll develop Parkinson’s disease, some factors make it less likely. It is generally believed that Asian-Americans and African-Americans seem to have a lower risk of developing Parkinson’s as compared to Caucasians. Drinking coffee may lower risk, as a 30-year study of Japanese-American men found the greater amount of coffee they drank, the lower their risk of Parkinson’s disease became.

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    What You Can Expect

    Parkinson does follow a broad pattern. While it moves at different paces for different people, changes tend to come on slowly. Symptoms usually get worse over time, and new ones probably will pop up along the way.

    Parkinsonâs doesnât always affect how long you live. But it can change your quality of life in a major way. After about 10 years, most people will have at least one major issue, like dementia or a physical disability.

    Mental Health Concerns In Advanced Parkinsons Disease

    Tremor Disorder or Parkinson’s?

    Today we continue Parkinsons Disease: Planning for the What Ifs, a special series of posts to address both motor and non-motor issues of people with advanced Parkinsons disease . We are defining advanced PD as those who are no longer independent of their activities of daily living, and require help for their self-care such as eating, bathing, dressing and toileting. Additional background and the full introduction to the series is still available if you missed it.

    I receive a lot of questions through our Ask a Doctor feature on our website concerning advanced PD, specifically around mental health issues.

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    Some Parkinson’s Treatment Options

    Parkinson’s disease has no cure, but there are treatment options to control your symptoms and improve your quality of life which include:

    • Medication. Levodopa and other medications, which are trying to boost dopamine . There are number of those medications which can be used alone or in combination. Although many of those medications can help you significantly control your motor symptoms , you might also experience side effects and diminished efficacy over time.
    • Physical, occupational, and speech therapy are usually part of your treatment plan and can improve your balance, mobility, ability to do daily tasks, and speech.
    • Deep brain stimulation is a surgery performed by a neurosurgeon, and in indicated patients can help with motor symptoms, though non-motor symptoms, such as falls, constipation, low blood pressure and incontinence do not improve.
    • Tai Chi is a Chinese martial art that may help sufferers regain some of their balance and strength, as well as decrease the risk of falling. Dance, such as a Zumba, may also help, as can using a stationary bicycle and rock steady boxing.

    Many treatment options for Parkinson’s are most effective when used in conjunction with others such as taking medication and doing physical therapy.

    Other Medicines Used For Pd

    • Catechol-O-methyltransferase inhibitors are relatively new medicines. They include tolcapone, entacapone and opicapone. These help to stop the breakdown of levodopa by the body, so more of each dose of levodopa can get into the brain to work. A COMT inhibitor is sometimes advised in addition to levodopa when symptoms are not well controlled by levodopa alone.
    • Other medicines are sometimes used to help relieve symptoms. They have various effects which try to correct the chemical imbalance in the brain. They include beta-blockers, amantadine and anticholinergic medicines. One of these may be tried when symptoms are mild. However, you are likely to need levodopa or a dopamine agonist at some point.

    Various things may influence which medicine is advised. For example, your age, severity of symptoms, how well your symptoms respond to treatment, if side-effects develop, other medicines that you may take, etc. Your specialist will advise on the best medicine for you to take. Whatever medicine or medicines you are prescribed, read the leaflet in the medicine packet for a full list of possible side-effects. Mention to your doctor if you develop a troublesome side-effect. A modification of the dose, dose schedule, or the type of medication, may be possible to help keep side-effects to a minimum.

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    Can Parkinsons Dementia Be Reversed

    No specific cure has been identified for Parkinsons Disease Dementia. Rather, treatments have been aimed at reducing the symptoms of dementia and helping the patient maintain a high quality of life. Doctors treating patients of PD Dementia generally prescribe medications such as:

    • Antidepressants
    • Cholinesterase inhibitors
    • Clonazepam and L-dopa

    Serotonin reuptake inhibitors are known to reduce depression symptoms. The ones widely prescribed by doctors include:

    • Prozac
    • Zoloft and
    • Lexapro

    Cholinesterase inhibitors help reduce the effects of cognitive decline in people with dementia whereas Clonazepam helps enhance sleep quality. L-dopa helps reduce movement issues caused by PD but runs the risk of making confusion and dementia symptoms worse.

    Doctors treating PD Dementia patients may also prescribe antipsychotic drugs but generally do so with caution, the reason being these reduce psychotic episodes but increase Parkinsons symptoms. The use of these drugs may also cause increased confusion and change in consciousness. For the record, Pimavanserin and Nuplazid have been identified as effective antipsychotic drugs.

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    Parkinsonâs disease: mobility and balance

    I am a very active person, but deep fatigue must be addressed with rest. Taking a day to rest is not in my nature. It makes me feel like a sloth. Yet, when deep fatigue hits me, the best remedy is to do just that take the day off! I limit myself to one day of physical rest, very rarely two days . I also find that the mind must rest with the body. Getting the mind to a quiet place is the practice of meditation, in whatever form suits the moment. At the height of deep fatigue, meditation can be very difficult, but not impossible. At times, it has taken me four hours to quiet my mind and body to get rejuvenating rest.

    But there is a caution here: Be wary of using rest as an excuse to procrastinate. In another column, Ill address the link of scenario looping to set-shifting issues and difficulty initiating new tasks. Basically, getting off the sofa can be problematic if I stay there too long. Perhaps this seems contradictory to my history as a highly active person, but that is the nature of PDs nonmotor effects. Once off the sofa, I make myself shift into a physical task, followed by a short rest and then some type of mental task. There is always some resistance to overcome to do this to get off the sofa but the rest is absolutely necessary to stop the deep fatigue.

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    Can Parkinsons Disease Make You Aggressive

    Parkinsons disease Dementia or PD Dementia can make a patient very aggressive. Parkinsons Dementia Aggression germinating from Parkinsons disease Dementia can lead patients to behave erratically, experience sudden anger outbursts, feel constantly irritated, and always be in a state of restlessness. Outbursts are generally in the form of:

    • Shouting
    • Falling

    What To Expect In The Late Stages

    The late stages of PD are medically classified as stage four and stage five by the Hoehn and Yahr scale:

    • Stage Four of Parkinsons Disease In stage four, PD has progressed to a severely disabling disease. Patients with stage four PD may be able to walk and stand unassisted, but they are noticeably incapacitated. Many use a walker to help them. At this stage, the patient is unable to live an independent life and needs assistance with some activities of daily living. The necessity for help with daily living defines this stage. If the patient is still able to live alone, it is still defined as Stage Three.
    • Stage Five of Parkinsons Disease Stage five is the most advanced and is characterized by an inability to arise from a chair or get out of bed without help. They may have a tendency to fall when standing or turning, and they may freeze or stumble when walking. Around-the-clock assistance is required at this stage to reduce the risk of falling and help the patient with all daily activities. At stage five, the patient may also experience hallucinations or delusions.1,2

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    What Causes Parkinsons Disease

    Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.

    People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.

    Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.

    Diagnosis Of Parkinsons Disease

    Understanding Parkinson’s 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.

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    Does Parkinson’s Disease Cause Dementia

    The cells in the brain affected in PD are not in the ‘thinking’ parts of the brain and dementia is not a typical early feature of PD. However, if you have PD you have an increased risk of developing dementia. About half of people with PD develop dementia at some stage. If dementia occurs, it tends to develop in older people with PD . Early dementia in younger people with PD virtually never develops. It is thought that PD alone does not cause dementia however, other age-related factors in addition to PD may increase the risk of dementia developing.

    Parkinsons Sleep Problems: Diagnosis And Treatment

    Parkinsons disease is chronic and progressive, meaning it tends to get worse over time. However, there are treatment options that can help manage symptoms and allow patients to get more restful sleep.

    The simplest way to start sleeping better with Parkinsons disease is by adopting healthy sleep habits. Sleep hygiene tips for Parkinsons disease sufferers include:

    • Sticking to regular bedtimes
    • Following a consistent bedtime routine with soothing activities such as listening to music or reading a calming book
    • Getting regular exercise, preferably early in the day
    • Getting adequate exposure to light, whether outdoors or through light therapy
    • Avoiding long naps and naps late in the day
    • Creating a cool, dark, and comfortable sleeping environment
    • Restricting bedtime activities to sex and sleep only
    • Turning off screens an hour before bedtime
    • Reducing liquid intake before bedtime
    • Avoiding caffeine, alcohol, and tobacco
    • Eating a healthy diet and avoiding large meals at night

    Light therapy, exercise, and deep brain stimulation have been successfully used to improve overall sleep quality and to treat specific conditions, such as REM sleep behavior disorder, in patients with Parkinsons disease. Cognitive behavioral therapy for insomnia has proven effective at reducing insomnia in healthy adults, although further research is needed on the effects of CBT in patients with Parkinsons disease.

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