What Are Pd Dementia Safety Concerns
Safety issues should be considered and monitored from the time of diagnosis. As PDD progresses, ensure that your loved one is not left alone.
- Evaluate driving privileges before safety is a concern. Your doctor can make a driving evaluation referral.
- Work out legal and financial issues and safeguard finances. People with dementia are at greater risk of falling victim to scams and fraud.
- Minimize prescription risks. Confirm with the doctor the medication names and doses of the person with PD. If the person is in dementias early stages and capable, fill up their weekly pill box together and monitor use.
- Medical alert systems can be critical in case your loved one falls or wanders outside of the home. Many types of systems are available, from bracelets and pendants to smart watches with fall detection and one-button connections to 911.
- Evaluate gun safety. If your loved one owns a firearm or has one in the home, consider speaking with their doctor about the subject and taking appropriate safety precautions.
What Are The Symptoms Of Parkinsons Disease Dementia
Cognitive impairment in Parkinsons disease may range from a single isolated symptom to severe dementia.
- The appearance of a single cognitive symptom does not mean that dementia will develop.
- Cognitive symptoms in Parkinsons disease usually appear years after physical symptoms are noted.
- Cognitive symptoms early in the disease suggest dementia with Parkinsonian features, a somewhat different condition.
Cognitive symptoms in Parkinsons disease include the following:
- Loss of decision-making ability
- Loss of short- and long-term memory
- Difficulty putting a sequence of events in correct order
- Problems using complex language and comprehending others complex language
Persons with Parkinsons disease, with or without dementia, may often respond slowly to questions and requests. They may become dependent, fearful, indecisive, and passive. As the disease progresses, many people with Parkinsons disease may become increasingly dependent on spouses or caregivers.
Major mental disorders are common in Parkinsons disease. Two or more of these may appear together in the same person.
The combination of depression, dementia, and Parkinsons disease usually means a faster cognitive decline and more severe disability. Hallucinations, delusions, agitation, and manic states can occur as adverse effects of drug treatment of Parkinsons disease, this might complicate the diagnosis of Parkinsons dementia.
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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.
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Dementia And Cognitive Change
Cognition or cognitive function is a term used to describe the thought processes of your brain.
Cognition includes judgement, reasoning, problem-solving and memory. It is thought that the majority of people with Parkinsons experience some changes to their cognition. This is known as cognitive impairment. In people living with Parkinsons the level of cognitive impairment is mild in most cases.
What Are The Symptoms Of Lewy Body Dementia
LBD is a progressive disease. This means that the symptoms start slowly and get worse over time. The most common symptoms include changes in cognition, movement, sleep, and behavior:
- Dementia, which is a loss of mental functions that is severe enough to affect your daily life and activities
- Changes in concentration, attention, alertness, and wakefulness. These changes usually happen from day to day. But sometimes they can also happen throughout the same day.
- Visual hallucinations, which means seeing things that are not there
- Problems with movement and posture, including slowness of movement, difficulty walking, and muscle stiffness. These are called parkinsonian motor symptoms.
- REM sleep behavior disorder, a condition in which a person seems to act out dreams. It may include vivid dreaming, talking in one’s sleep, violent movements, or falling out of bed. This may be the earliest symptom of LBD in some people. It can appear several years before any other LBD symptoms.
- Changes in behavior and mood, such as depression, anxiety, and apathy
In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease gets worse, people with LBD need more help due to problems with thinking and movement. In the later stages of the disease, they often cannot care for themselves.
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Diagnosis: Parkinsons Dementia Or Dementia With Lewy Bodies
During assessment, a specialist may look at when the dementia symptoms first appeared before reaching a diagnosis of Parkinsons dementia or dementia with Lewy bodies.
If there have been motor symptoms for at least one year before dementia symptoms occur, specialists will often give a diagnosis of Parkinsons dementia.
If dementia symptoms occur before or at the same time as motor symptoms, specialists will usually give a diagnosis of dementia with Lewy bodies.
However, it should be noted that in some cases of dementia with Lewy bodies, no motor symptoms develop at all.
Theres no single test diagnosis is made through several different assessments, usually starting with an appointment with your GP or Parkinsons nurse.
Some people find it helps to go to the appointment with someone who knows them well, who can give the GP or Parkinsons nurse information about changes theyve noticed.
Your GP can discuss your symptoms with you and carry out a physical examination, including blood and urine tests, to rule out other potential causes of the symptoms .
Your GP may also review your medication, in case your symptoms are side effects.
If your GP thinks you have dementia, they can refer you to a specialist, such as a neurologist, psychiatrist or geriatrician.
You might be referred to a memory clinic or memory service. In some areas of the country, you can refer yourself to these services.
But if you feel you need to see the specialist again, you can ask to be referred back.
Are There Medicines To Treat Pdd
Though there is no cure for PDD yet, there are medications that help manage the symptoms. These medications are called cholinesterase inhibitors, and they can help if a person with PDD is having memory problems. Some examples of these medicines are donepezil, rivastigmine and galantamine. Sleep problems may be managed by sleep medications such as melatonin.
Because people with PDD are usually very sensitive to medications, any new medication, even one that is not being used for the brain, needs to be reviewed with the persons provider to avoid potential contraindication.
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Where To Get Help
- Your local community health service
- Your local council
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care Tel. 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Respite and Carelink Centres Tel 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
Treating Parkinsons Disease Dementia
A treatment plan for PDD typically includes medications that boost the brains level of certain neurotransmitters and help improve memory and processing speed, Dr. Petrossian says. Exercise is also an important part of the treatment planDr. Petrossian recommends skill-based activities like boxing or dance to boost cognitive function as well as fitness. PDD symptoms should be monitored long-term by a neurologist, and in some cases a psychiatrist, says Dr. Okun. In many cases, physical, occupational, speech, and social work therapy can also be useful since PPD affects all aspects of life.
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How Is Parkinsons Disease Dementia Different From Alzheimers Disease
Parkinsons disease Dementia must not be confused with Alzheimers disease. Dementia is a hallmark feature of Alzheimers whereas a patient may not necessarily contract Dementia if he happens to contract Parkinsons. Having mentioned that, Dementia does have a greater social and occupational impact on the functioning of people when it affects someone with Parkinsons as compared to Alzheimers.
This is due to the combination of motor and cognitive impairments. Parkinsons directly affects problem-solving functions in a person, besides other aspects such as the speed of thinking, memory, and mood. Parkinsons Dementia Aggression can also be related to Lewy bodies, where sticky clumps of protein are found in the nerve cells of people diagnosed with Parkinsons.
Finally, it must be known to all those associated with Parkinsons in any capacity, whether be it a patient or a caregiver, that majority of people with Parkinsons may experience some of the other forms of cognitive impairment over time. Though cases vary from person to person, the development of Dementia in those diagnosed with Parkinsons cannot be predicted. To put it in numbers, 30 percent of people with Parkinsons never develop dementia as a part of their progression.
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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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.
Behaviors Seen In Parkinsons Disease Dementia
As dementia progresses, managing disorientation, confusion, agitation, and impulsivity can be a key component of care.
Some patients experience hallucinations or delusions as a complication of Parkinsons disease. These may be frightening and debilitating. Approximately 50 percent of those with the disease may experience them.
The best thing to do when giving care to someone experiencing hallucinations or delusions from Parkinsons disease dementia is to keep them calm and reduce their stress.
Take note of their symptoms and what they were doing before they exhibited signs of hallucinating and then let their doctor know.
This element of the disease can be particularly challenging for caregivers. Patients may become unable to care for themselves or be left alone.
Some ways to make caregiving easier include:
- sticking to a normal routine whenever possible
- being extra comforting after any medical procedures
- limiting distractions
- using curtains, nightlights, and clocks to help stick to a regular sleep schedule
- remembering that the behaviors are a factor of the disease and not the person
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How Can We Support The Sleep/wake Cycle Of Pdd
For people with PDD who are confused about the day-night cycle, some daily strategies can be helpful. At night, starting a lights out routine that happens at the same hour every day, where all curtains are closed and lights are turned off, can help the person understand that it is sleep time. During the day, opening the curtains, allowing the person with PDD to spend as much time in the daylight as possible, avoiding naps, and organizing stimulating activities, can be helpful. Having lots of calendars and clocks in every room might also help a person with PDD be less confused about the time of day.
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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.
How Are Parkinsons And Dementia Related
Parkinsons and dementia are two of the most common degenerative neurological conditions in this country, affecting many thousands of people. However, there are a lot of myths and misunderstandings about the illnesses.
If you have been told that you have either condition, the future may seem bleak and bewildering. Whether youve found this blog having been recently been diagnosed, or are worried about a loved one, then read on, hopefully, we can help you to gain some understanding.
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Frontotemporal Dementia With Parkinsonism
One form of familial FTD, also known as frontotemporal dementia with Parkinsonism-17 , is caused by genetic changes in the gene for tau protein, located on chromosome 17. No other risk factors for this condition are known.
FTDP-17 is rare and accounts for only three per cent of all cases of dementia. Symptoms progressively get worse over time and usually appear between the ages of 40 and 60. The condition affects both thinking and behavioural skills and movements such as rigidity, lack of facial expression and problems with balance .
It can be distressing to be told that you have a genetic disorder or are at risk of having one. Genetic counselling provides the person and their family with information about a genetic disorder and its likely impact on their lives. This can assist a person with FTDP-17 to make informed medical and personal decisions about how to manage their condition and the challenges it presents to their health and wellbeing. Prenatal genetic counselling is also available for parents to help them decide about a pregnancy that may be at risk of FTDP-17.
What Are The Types Of Lewy Body Dementia
There are two types of LBD: dementia with Lewy bodies and Parkinson’s disease dementia.
Both types cause the same changes in the brain. And, over time, they can cause similar symptoms. The main difference is in when the cognitive and movement symptoms start.
Dementia with Lewy bodies causes problems with thinking ability that seem similar to Alzheimer’s disease. Later, it also causes other symptoms, such as movement symptoms, visual hallucinations, and certain sleep disorders. It also causes more trouble with mental activities than with memory.
Parkinson’s disease dementia starts as a movement disorder. It first causes the symptoms of Parkinson’s disease: slowed movement, muscle stiffness, tremor, and a shuffling walk. Later on, it causes dementia.
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How Does Parkinsons Disease Develop
As the disease progresses people who have Parkinsons are increasingly likely to have a tremor, shaking, slowness of movement and rigidity. It can also cause problems with balance, sleep, swallowing, speech and increase the risk of falls. This can cause embarrassment, distress, discomfort and social isolation.
Research has indicated that in Parkinsons disease the persons cognitive processes can also be affected and these may get progressively worse over the years, with some people going onto develop dementia in the later stages of Parkinsons. The cognitive changes could include:
- forgetfulness
- a reduction in reasoning, judgement, planning and decision-making abilities
- difficulty learning new things
The person may also show signs of depression or anxiety.
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.
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Dementia With Lewy Body
Cortical Lewy bodies are found in different types of degenerative dementia, which are collectively called as LBD. Clinicopathologically, it encompasses PDD, DLB, and Lewy body variant of Alzheimer’s disease . The last of the three is characterized by cortical Lewy bodies and Alzheimer’s type neuropathological changes in the brain and constitutes about 70% of LBD. In different literatures the terms LBD and DLB have been used interchangeably and the term diffuse LBD has been used to denote classical DLB. Because 25%30% of PD patients develop dementia and most DLB patients have parkinsonism, it has been hypothesized that PD, PDD, and DLB are not distinct entities, but may exist along the spectrum of LBD. A DLB/PDD Working Group recently proposed the use of LBD as an umbrella for studying the biology of these disorders, although they also suggested that the three individual terms should be maintained for clinical needs. Consensus criteria artificially divide patients with PDD and DLB by the one year rule where dementia appears within 1 year of appearance of parkinsonian features in the latter condition.
DLB consensus criteria has been put forward by McKeith et al. see .