Saturday, August 13, 2022

Does Parkinson’s Affect Your Speech

Seeking Help For Cognitive Changes

How Parkinson’s Patients Speak Again After Losing Their Voice

Cognitive change is a sensitive issue. In fact, the doctor is often as hesitant to address this subject as the person with PD is to ask about it. Sometimes, the doctor will delay discussing cognitive impairment out of concern for the person who is still coping with the shock of a new PD diagnosis or struggling with motor symptoms.

For this reason, the person with PD often needs to be the one to initiate the conversation. Tell your doctor if you or your loved one is experiencing problems that upset the family or cause interruptions at work.

Cognitive issues are never too mild to address with your care team. A doctor can provide ways to help, often, referring psychiatrist, neuropsychologist, speech or occupational therapist for further evaluation and assistance. The neuropsychological evaluation can be particularly useful, especially in the early stages of a cognitive problem. Having this baseline test can help the doctor determine whether future changes are related to medications, the progression of the PD itself or to other factors such as depression.

When reporting symptoms of mild cognitive impairment, the doctor will first want to rule out causes other than PD, such as Vitamin B-12 deficiency, depression, fatigue or sleep disturbances. It should be noted that PD does not cause sudden changes in mental functioning. If a sudden change occurs, the cause is likely to be something else, such as a medication side-effect.

What Are The Symptoms Of Parkinson’s Disease

The symptoms of Parkinson’s disease include tremors or trembling difficulty maintaining balance and coordination trouble standing or walking stiffness and general slowness.

Over time, a person with Parkinson’s may have trouble smiling, talking, or swallowing. Their faces may appear flat and without expression, but people with Parkinson’s continue to have feelings even though their faces don’t always show it. Sometimes people with the disease can have trouble with thinking and remembering too.

Because of problems with balance, some people with Parkinson’s fall down a lot, which can result in broken bones. Some people with Parkinson’s may also feel sad or depressed and lose interest in the things they used to do.

The symptoms of Parkinson’s disease appear gradually and get worse over time. But because Parkinson’s disease usually develops slowly, most people who have it can live a long and relatively healthy life.

Speaking Tasks And Speech Time Composition

Figure 6 shows the mean composition of the utterance for the two different speaking tasks in PD and HC speakers.

Figure 6. Mean speech time composition in PD and HC productions . PD, Parkinson’s disease HC, healthy control.

As the graph in the figure shows, no significant differences were observed between the two groups of speakers in terms of speech time composition. In the reading task, percentages are very similar in PD and HC in the case of monologs, PD productions are characterized by a slightly higher percentage of silence and of disfluency .

As expected, the most evident result is related to the effect of the speaking task on the composition of the utterance: the mean increase of the percentage of disfluency in the monologs of both groups of speakers in comparison with the reading tasks and the subsequent reduction of the fluent speech percentage.

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How Are Cognitive Changes In Pd Different Than Alzheimers Disease

Overall, dementia produces a greater impact on social and occupational functioning in PD than with Alzheimers due to the combination of motor and cognitive impairments.

  • There is some overlap between symptoms and biological changes seen in Alzheimers and PD. However, it is less likely for both disorders to occur at the same time.
  • Development of dementia in people with PD represents progression of the disease, usually after several years of motor impairment.
  • Dementia may or may not occur in people with PD. According to recent research, 30 percent of people with Parkinsons do not develop dementia as part of the disease progression
  • See 10 Signs of Alzheimers.

Tips For Managing Drooling In Parkinsons

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Sailorrhea, or drooling, refers to pooling of saliva in the mouth. It occurs in around 50-80% of all Parkinsons patients, particularly men. This blog post explains the cause, risk of aspiration, anxiety, and social embarrassment, with 10 helpful tips & treatment options to help with this pesky problem.

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Language Impairment In Parkinson’s Disease

In this 1-hour webinar, speech language pathologist Jamie Russell discusses communication and swallowing challenges common in people with Parkinson’s, general interventions and self-management strategies for patients and caregivers, strategies for working through difficulties such as following complex commands, word retrieval, and organizing thought in conversation, as well as general swallowing strategies.

Other Mental Health Problems Linked To Parkinson’s

Some mental health issues are side effects of Parkinson’s treatments, like hallucinations, paranoia, and delusions.

A hallucination happens when you think something is present when it isn’t. For example, you may hear a voice but no one is there. An example of paranoia is when you think someone is following you when they are not. A delusion is when you are convinced something is true, despite clear evidence that proves it’s not.

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How Do You Treat Depression In Parkinson’s Disease

Your depression can be treated with psychological therapy and medication. People seem to do better when they get both types of treatment.

There are many antidepressant medications, and each has pros and cons. Which one your doctor suggests depends on your overall condition and specific needs.

Most people should not take amoxapine because it could temporarily make Parkinson’s symptoms worse.

Psychological therapy can help you rebuild your sense of self-worth. It also can help you keep up good relationships with your caregivers and family members.

Reduced Blinking And Eye Movement Disturbances

What to Know About Parkinson’s and Voice

Other eye movement disturbances have been described in Parkinson’s disease patients. These include an impaired ability to pursue a moving target with the eyes, difficulty initiating gaze shifts or taking the eyes off a face. Also, the ability to maintain eccentric gaze is impaired, and the blink frequency tends to be reduced. Of these abnormalities, only the latter tends to show significant symptoms, as reduced blinking can cause a feeling of dry eyes. This may be further enhanced by reduction in tear secretion, which is also common in Parkinson’s disease. Management of dry eyes usually involves the use of artificial tears. It is rare that you’ll need any additional treatment to combat symptoms of dry eyes.

Patients with Parkinson’s disease are also susceptible to visual hallucinations. These can be related to the underlying neurological illness or medications used for treatment. PD patients who have visual hallucinations respond well to antipsychotic medications such as quetiapine. Hallucinations should always be reported to the physician.

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How Are Speech Problems Treated

There are many options to help improve your speech. A speech-language pathologist can help you pick the right approaches for you. Speech-language pathologists are trained health care professionals who specialize in evaluating and treating people with speech, swallowing, voice, and language problems.

Ask your doctor for a referral to a speech-language pathologist. It is also important to contact your health insurance company to find out what therapy and procedures are eligible for reimbursement and to find a list of SLPs covered by your plan. Finally, visit a SLP who has experience treating people with PD.

A Swallowing And Medication

As previously mentioned, levadopa treatment tends to have the most predictable effects on limb symptoms in PD. Nonetheless, certain aspects of eating and swallowing may be enhanced by medication. It therefore is recommended that patients time their meals and medication in such a way that they receive maximum medication effect during meals so as to facilitate upper extremity control and possibly oral and pharyngeal function. Similarly, some patients may show improvement in swallowing when medication is changed. Thus, in patients who have changed medication, the clinician may opt to wait several weeks to begin swallow therapy especially in the form of active range of motion exercises to determine whether the medication benefits the patients swallow. Some patients experience xerostomia as a side effect of pharmacologic treatment for PD. Depending on the existence of other swallowing and eating difficulties, taking frequent sips of water, throat lozenges or lemon drops, as well as synthetic saliva may prove helpful.

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If I Have Parkinsons Disease What Kind Of Speech And Voice Problems May I Experience

If you have Parkinsons disease, some of the voice and speech difficulties seen include:

  • Softened voice. Reduced volume to your voice.
  • Speaking in an unchanging pitch .
  • Having a hoarse or strained quality to your voice.
  • Having a breathiness to your voice. Breathiness in the quality of your voice that is easily heard by your listeners. It takes more effort and energy to speak. You run out of gas as you speak.
  • Trouble clearly and easily pronouncing letters and words.
  • Tremor in your voice.
  • Using short rushes of speech.
  • Loss of your facial expression.

If you have Parkinsons disease, you may not be aware of the problems with your spoken communication. Changes in the quality of your voice may be the first sign of speech problems followed by the inability to have fluid speech and clear and distinct speech sounds. Speech problems that are severe enough to reduce your ability to be easily understood usually do not occur until later in the course of Parkinsons disease.

How Is Parkinson’s Disease Treated

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If a doctor thinks a person has Parkinson’s disease, there’s reason for hope. Medicine can be used to eliminate or improve the symptoms, like the body tremors. And some experts think that a cure may be found soon.

For now, a medicine called levodopa is often given to people who have Parkinson’s disease. Called “L-dopa,” this medicine increases the amount of dopamine in the body and has been shown to improve a person’s ability to walk and move around. Other drugs also help decrease and manage the symptoms by affecting dopamine levels. In some cases, surgery may be needed to treat it. The person would get anesthesia, a special kind of medicine to prevent pain during the operation.

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How Can Listeners Help People Who Have Difficulty Speaking And Communicating

Here are some ways friends and family of people with Parkinsons disease can ease speaking and communication difficulties:

  • Talk to the person with Parkinsons disease face-to-face only, and look at the person as he or she is speaking.
  • Ask questions that require a simple “yes” or “no” answer.
  • Repeat the part of the sentence that you understood.
  • Ask the person to repeat what he or she said, to speak more slowly or spell out the words you did not understand.

How Do I Know If I Have A Speech Or Voice Problem

  • My voice makes it difficult for people to hear me.
  • People have difficulty understanding me in a noisy room.
  • My voice issues limit my personal and social life.
  • I feel left out of conversations because of my voice.
  • My voice problem causes me to lose income.
  • I have to strain to produce voice.
  • My voice clarity is unpredictable.
  • My voice problem upsets me.
  • My voice makes me feel handicapped.
  • People ask, “What’s wrong with your voice?”

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Who Gets Parkinson’s Disease

About 1 million people in the United States have Parkinson’s disease, and both men and women can get it. Symptoms usually appear when someone is older than 50 and it becomes more common as people get older.

Many people wonder if you’re more likely to get Parkinson’s disease if you have a relative who has it. Although the role that heredity plays isn’t completely understood, we do know that if a close relative like a parent, brother, or sister has Parkinson’s, there is a greater chance of developing the disease. But Parkinson’s disease is not contagious. You can’t get it by simply being around someone who has it.

How Are Cognitive Problems Treated

Parkinsons and stutter – Pacing, rate control to improve speech

Much remains to be learned about the basic biology that underlies cognitive changes in PD. Researchers work towards the development of diagnostic tests to identify people who seem to be at greatest risk for cognitive changes and to differentiate cognitive problems in people with PD from those that occur in another disorder related but different known as dementia with Lewy bodies.

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If I Have Speech And Voice Problems How Can I Maintain And Improve My Communication

Some tips to improve communication include:

  • Choose a quiet, low-noise space. Turn off televisions, radios and other devices that create noise.
  • Speak slowly.
  • Make sure your listener can see your face. Look at the person while you are talking. A well-lit room improves face-to-face conversation, increasing the ability to be understood.
  • Use short phrases. Say one or two words or syllables per breath.
  • Plan periods of vocal rest before planned conversations or phone calls. Know that fatigue significantly affects your ability to speak. Techniques that work in the morning might not work later in the day.
  • Keep your throat hydrated. Drink plenty of water. Dont drink caffeinated or alcoholic beverages. Use a humidifier if the air in your home is dry.
  • Keep an upright posture, straight chin, slightly lifted neck to improve airflow from lungs to your vocal cords.
  • If you are soft spoken and your voice has become low, consider using an amplifier.

If some people have difficulty understanding you, these additional strategies might help:

The Effects Of Parkinsons On Speech

Parkinsons disease is a nervous system disorder that slowly progresses over time. The first signs of the disease can be small, and unnoticeable at first. It may be a small tremor in your hand or a loss of expression in your face. As the disease progresses many of the people affected begin to notice an effect on their speech. Some may notice their voice gets softer and monotone, slower and slurred, and can have a hard time finding the words they want to say. The cause of this disease is usually genetic, but in some cases, it can occur because of exposure to certain toxins. The symptoms start to occur at an older age, usually when people are in their sixties.

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Support Groups And Networking

There are many different types of support groups. But they can broadly be defined as a group of people who have something in common – in this context Parkinsons – who meet to discuss and exchange ideas and information, or voice concerns. The group may also include partners, family and/or carers.

Each group will be individual with varying activities, meeting places, opportunities and capabilities. Sometimes there is a trained leader, such as a counsellor or social worker, although many Parkinsons groups are run by people with the condition as well as experienced volunteers. Groups often meet once a month, but many meet more regularly.

Most members find participating in a group supportive and a good way to interact with others in a similar position. Many Parkinsons organisations have support groups. To find out about how groups operate in your own country contact your national Parkinsons association.

For Family Friends And Carers

Managing the Side Effects of Parkinsonâs Disease

Communication difficulties also affect family, friends and carers. Problems can be frustrating to deal with and misunderstandings may arise. The following suggestions may help when communicating with someone who has Parkinsons:

  • Be patient and give them plenty of time to collect their thoughts and communicate. Dont walk away while they do this.
  • Dont interrupt and finish their sentences for them.
  • Talk normally, without shouting or sounding stressed or impatient.
  • Make sure you are both in the same room and can see each other.
  • Listen carefully and turn off any distractions such as the radio or television.
  • If you dont understand something, ask them to repeat it louder and slower. Dont pretend that you have understood if you havent.
  • Encourage them to engage in a conversation but without putting them under pressure.
  • Reassure them if they have difficulty communicating. A simple squeeze of the hand can be very calming and encouraging.

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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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What Alternative Communication Devices And Tips Can Help With My Voice And Speech Problems

If you have difficulty speaking, are frustrated and stressed by your inability to communicate or tire from the efforts to speak, consider the following devices and methods to be better understood:

  • Amplification: This could be a portable personal amplifier or a telephone amplifier that can be used to increase vocal loudness in soft-spoken people. The amplifier also decreases voice fatigue.
  • TTY telephone relay system: This is a telephone equipped with a keyboard so speech can be typed and read by a relay operator to the listener. Either the whole message can be typed or just the words that are not understood.
  • Low-technology devices: Paper-based books and boards, alphabet boards and typing devices are examples of low technology assistive methods.
  • High-technology electronic speech enhancers, communication devices: Computers with voice synthesizers and speech generating devices are available. Talk to a speech-language pathologist about the available high technology devices best suitable for your needs.

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