Cognitive Loss Associated With Parkinsons Disease
Parkinsons disease is first and foremost associated with mobility issues. However, as the disease progresses, brain function can decline which is called cognitive impairment associated with Parkinsons. Cognitive loss is very frequent in the diseases late stages. Factors that increase the odds of developing cognitive impairment from Parkinsons include: being older, longer duration of disease, and more severe symptoms. Up to 30% of people with Parkinsons have significant cognitive impairment.
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.
Effects Of Memory And Cognitive Changes
While it may seem clear to you that emotional states can have a significant impact on your thinking, the reverse is also true: Your thinking can sometimes strongly influence your emotional states. You know the proverbial story of two men who see the same glass of water but one sees it as half full and the other as half empty? The same goes for thinking and emotional states.
Sometimes your assessment of a situation can influence your emotional reaction to that situation. More generally, executive cognitive functions can influence your mood states because those executive functions control all the information you have about the situations you find yourself in. Executive functions control your appraisal of those situations. If you find it difficult to recall happy memories, you may become more sad or depressed. If you find it difficult to plan a vacation, you may put off the vacation and thus influence your mood states and so forth.
Problems with executive functions can also get you into trouble over serious matters like money. If you find it difficult to balance the checkbook, you may get a bit sloppier about your finances. Consider also that the extra jolt of dopamine that comes from taking dopamine medications can sometimes make you temporarily more energized and impulsive. Now when you couple a heightened sense of impulsivity with a lowered capacity for thinking efficiently through decisions, you sometimes get impulsive respondingbad decisions.
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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.
Clinical Value Of The Present Findings
Our PD participants had problems in WM updating that were unrelated to their other cognitive difficulties, such as prolonged response latencies, difficulties in maintaining attention and inhibiting irrelevant information, and episodic memory deficits. As compared to other WM subdomains, updating was the only subdomain that clearly discriminated PD patients from healthy controls even when no other problems were considered. Altogether, these findings suggest that the WM subdomain of updating should receive particular attention when surveying onset cognitive deficits in PD patients. However, further test development is needed to utilize this knowledge in practice, as standardized, readily available measures of WM updating are lacking.
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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.
How Is Parkinson Disease Diagnosed
Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinson’s disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.
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What Is Parkinsons Disease
Parkinsons is a neurological illness caused by degeneration or breaking down of cells in the nervous system, explained Dr. Shprecher. The nature of Parkinsons Disease is progressive, meaning that it gets worse over time. To comprehend the natural progression of the disease, we should understand its five stages, as explained by the Parkinsons Foundation.
Stage One
Individuals experience mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. They may also experience changes in posture, walking and facial expressions.
Stage Two
Symptoms worsen, including tremor, rigidity and other movement symptoms on both sides of the body. The person is still able to live alone, but daily tasks are more difficult and lengthier.
Stage Three
This is considered mid-stage. Individuals experience loss of balance and slowness of movements. While still fully independent, these symptoms significantly impair activities such as dressing and eating. Falls are also more common by stage three.
Stage Four
Symptoms are severe and limiting. Individuals may stand without help, but movement likely requires a walker. People in stage four require help with daily activities and are unable to live alone.
Stage Five
Background Characteristics And Group Comparisons For Single Measures
The groups were comparable on all demographic characteristics, as well as on motivation and alertness evaluations throughout the test sessions . The age of the PD group ranged from 45 to 72 years and they had an average education of 14.8 years . The mean age at disease onset had been 59.5 years , while the average disease duration had been 5.6 years . The age of the control group ranged from 50 to 73 years and they had an average education of 14.2 years .
There were some differences between the groups in cognitive performance, global cognitive abilities, self-reported everyday cognition, and self-reported affective symptoms . As shown in Table 2, the PD patients performed significantly worse than the healthy controls on SRT , CPT , and the Wordlist recall task . Sentence recall was the only non-WM task that systematically correlated with the WM tasks within the PD group .
Table 2. Group differences for computerized tasks between the PD patients and the healthy controls.
The PD patients exhibited also general cognitive impairment , and reported more everyday cognitive difficulties as well as depressive symptoms as compared to the controls. The PD patients did not, however, differ from the controls on the other global cognitive ability measure or on the self-reported apathy rating .
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Differential Effects Of Parkinson’s Disease And Dopamine Replacement On Memory Encoding And Retrieval
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Affiliation The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada
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Affiliation The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada
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Affiliations The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada, Department of Psychology, University of Western Ontario, London, Ontario, Canada
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Affiliation Faculty of Law, University of Ottawa, Ottawa, Ontario, Canada
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Affiliations Functional Neuroimaging Unit, Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada, Department of Radiology, University of Montreal, Montreal, Quebec, Canada
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Affiliation Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
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* E-mail:
Affiliations The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada, Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
Comparison With Other Dementias
Dementia is the result of physical changes in the brain that can lead to memory loss and an inability to think clearly.
Several types of dementia exist, including:
PD dementia has different symptoms to other types.
Alzheimers dementia, for example, impairs memory and language. PD dementiam on the other hand, affects problem-solving, the speed at which thoughts occur, memory, and mood, alongside other important cognitive functions.
Dementia with Lewy bodies and Parkinsons disease dementia are similar in that the Lewy Bodies might be present in both forms.
However, whether the disease causes Lewy bodies or if Lewy bodies cause the disease symptoms is unclear. Researchers also believe that the way the Lewy bodies form in Parkinsons disease dementia is different from those in Lewy body dementia.
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Associations Between Cognitive Deficits And Psychiatric Symptoms
Neither everyday cognition nor psychiatric symptoms were correlated with WM performance in the PD group. These findings support the existence of subjective cognitive decline in PD , suggesting that objectively measured cognitive performance, subjectively experienced cognitive problems, and affective symptoms arise from distinct underlying factors. This is the case in WM as well. Lack of correlation between subjective cognitive complaints and task performance has also been observed in some previous studies with other cognitive measures . Our study further indicates that both everyday cognitive difficulties and affective symptoms are linked to PD symptoms, indicating that the various types of difficulties in daily living could have a common origin that perhaps relates to psychiatric well-being. Cognitive difficulties directly related to PD and those associated with a decline in global cognitive abilities could, in turn, have different underlying mechanisms. As noted above, our findings suggest a direct link between PD and WM updating, while more widespread WM deficits may occur in parallel with global cognitive decline.
Language Dysfunction In Parkinsons
There are several functions within language, including naming objects, generating words, comprehension, and verbal concepts. PD most often affects a persons ability to find a word, although as PD progresses, additional language difficulties may develop, including difficulty naming, difficulty comprehending information, and the use of more simplified and less spontaneous speech.3,4
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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 don’t 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 Happens In Pdd
People with PDD may have trouble focusing, remembering things or making sound judgments. They may develop depression, anxiety or irritability. They may also hallucinate and see people, objects or animals that are not there. Sleep disturbances are common in PDD and can include difficulties with sleep/wake cycle or REM behavior disorder, which involves acting out dreams.
PDD is a disease that changes with time. A person with PDD can live many years with the disease. Research suggests that a person with PDD may live an average of 57 years with the disease, although this can vary from person to person.
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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
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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What Causes Parkinsons Disease Dementia
A chemical messenger in the brain called dopamine helps control and coordinate muscle movement. Over time, Parkinsons disease destroys the nerve cells that make dopamine.
Without this chemical messenger, the nerve cells cant properly relay instructions to the body. This causes a loss of muscle function and coordination. Researchers dont know why these brain cells disappear.
Parkinsons disease also causes dramatic changes in a part of your brain that controls movement.
Those with Parkinsons disease often experience motor symptoms as a preliminary sign of the condition. Tremors are one of the most common first symptoms of Parkinsons disease.
As the disease progresses and spreads in your brain, it can affect the parts of your brain responsible for mental functions, memory, and judgment.
Over time, your brain may not be able to use these areas as efficiently as it once did. As a result, you may begin experiencing symptoms of Parkinsons disease dementia.
You have an increased risk of developing Parkinsons disease dementia if:
- youre a person with a penis
- youre older
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.
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Are Cognitive Impairments Due To Parkinsons Disease The Same As Those From Alzheimers Disease
Parkinsons disease and Alzheimers disease are both neurodegenerative diseases. However, their effect on the brain differ: Alzheimers primarily affects cognitive functions whereas Parkinsons primarily affects motor functions and then, secondarily, cognitive functions. And among cognitive functions, Parkinsons does not impair memory and language functions as much as Alzheimers disease. To learn more about the different functions of the brain, you can read: Our Brain: It Does More than Just Remember.
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Mild Memory And Thinking Problems
Mild memory and thinking problems can be a normal part of getting older. But sometimes, these symptoms are caused by Parkinsons.
This is when you have symptoms such as forgetfulness, problems concentrating and difficulty making decisions, but you can still manage your day-to-day life.
Mild memory and thinking problems are common in Parkinsons and can happen at any stage of the condition, but not everyone with Parkinson’s has these symptoms.
If you do experience these symptoms, your doctor may describe it as mild cognitive impairment .
Its normal to worry if youre experiencing memory and thinking problems, but it doesnt necessarily mean you have dementia, or that you will develop it in the future.
Dementia in Parkinsons is diagnosed when thinking and memory problems are steadily getting worse over time and affect everyday life and daily tasks such as cooking, cleaning and dressing.
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