Early Symptoms Parkinson’s Disease Dementia

What Is The Self

Protein in the diet may affect the absorption of levodopa, the major medication used to treat Parkinson’s disease. Fluctuations in the level of levodopa may worsen some behavioral and cognitive symptoms. A low-protein diet may reduce fluctuations in dopamine levels. In some patients with these fluctuations, dietary changes can improve symptoms. However, it is important to ensure that the person is getting adequate calories and other nutrients.

People with Parkinson’s disease should remain as active as possible. Physical therapy helps the person maintain mobility.

In general, people with Parkinson’s disease plus dementia should no longer drive vehicles. Movement problems may prevent quick reactions in hazardous driving situations. Certain medications, especially those given to treat symptoms of dementia, may make them less alert. However, this should be determined on an individual basis and in compliance with the laws of the state.

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What Are The Complications Of Parkinson Disease

Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.

Parkinson disease dementia can cause problems with:

• Speaking and communicating with others
• Problem solving
• Forgetfulness
• Paying attention

If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.

Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.

Managing Depression In Parkinsons Disease

People with Parkinsons, family members and caregivers may not always recognize the signs of depression and anxiety. If you are experiencing depression as a symptom of Parkinsons, it is important to know it can be treated.

Here are some suggestions:

• For information and support on living well with Parkinsons disease, contact our Information and Referral line.
• As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself.
• You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinsons, including nortriptyline and citalopram .

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Movement Problems And Lewy Body Dementia

Some people with LBD may not experience significant movement problems for several years. Others may have them early on. At first, movement symptoms, such as a change in handwriting, may be very mild and easily overlooked. Movement problems may include:

• Muscle rigidity or stiffness

• Restless leg syndrome

What Is Vascular Dementia

Vascular dementia is the second most common type of dementia in the UK after Alzheimer’s disease. It occurs when the brain is damaged due to a lack of blood flow.

Sometimes people have both vascular dementia and Alzheimer’s, giving them a diagnosis of “mixed dementia”.

If the vascular system within the brain becomes damaged – so that the blood vessels leak or become blocked – then blood cannot reach the brain cells and they will eventually die.

This death of brain cells can cause problems with memory, thinking or reasoning, and when these cognitive problems are bad enough to impact on daily life, it is known as vascular dementia.

Dementia symptoms specific to vascular dementia include stroke-like symptoms, suchas as muscle weakness, movement and thinking problems and mood changes, such as depression.

There are several different types of vascular dementia, due to the varying levels of damage on the affected part of the brain.

They include stroke-related dementia, single-infarct and multi-infarct dementia and subcortical vascular dementia.

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Treatment And Care For Lewy Body Dementia

While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. An LBD treatment plan may involve medications, physical and other types of therapy, and counseling. A plan to make any home safety updates and identify any equipment can make everyday tasks easier.

A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers.

What Is Parkinsons Disease Dementia

Parkinsons disease dementia is a brain disorder that occurs in somebut not allpeople living with Parkinsons disease. The brain cell damage caused by the disease can lead to a loss of memory and other cognitive functions such as problem solving and speed of thinking. These changes in thinking and behavior can impact your daily living, independence, and relationships.

In those who do develop Parkinsons disease dementia, there is at least one yearand usually 10 to 15 yearsbetween the Parkinsons diagnosis and the onset of dementia. According to estimates by the Alzheimers Association, 50% or more of people with Parkinsons disease eventually experience dementia, although there are a number of risk factors that impact the likelihood of developing symptoms:

• Parkinsons patients who experience hallucinations, excessive daytime sleepiness, and more severe motor control problems are at higher risk for dementia.
• Dementia is more common in people who are older at onset of Parkinsons.
• Dementia is a bigger risk factor in non-tremor predominant Parkinsons.
• Overwhelming stress, cardiovascular disease, and adverse reactions to the Parkinsons disease drug levodopa can also indicate an increased risk for developing dementia.
• Dementia is relatively rare in people who develop Parkinsons before age 50, no matter how long they have had the disease.

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Your Symptoms Are Unique To You

Article written by Jackie Hunt Christensen.

Since that life-altering moment you received your diagnosis, you probably have learned about the symptoms of Parkinsons disease and your treatment options. But what you should also know is that your Parkinsons and how you deal with it are as unique as you are.

For some people embracing new activities that refocus their attention away from troubling symptoms and onto things that are intrinsically satisfying can help. The key, she says, is to find ways to bring joy and happiness into your life every day.

Dementia Signs And Symptoms

A long list of symptoms is associated with dementia, but many overlap with other health conditions, meaning that having some of them does not confirm that an individual is cognitively impaired.

That said, dont hesitate to consult a healthcare provider if you or a loved one is showing signs of dementia, which can be cognitive or psychological in nature:

• Trouble remembering new information
• Exhibiting signs of paranoia
• Exercising poor judgment

Not everyone will notice these symptoms right away, and a checklist alone cant determine if a person has a dementia-related disorder. In fact, not even a test can do so.

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How Is Parkinsons Disease Diagnosed

Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.

To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.

If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.

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.

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How Is Vascular Dementia Diagnosed

Your healthcare provider will gather your medical history and family medical history, review your medications and conduct a physical exam. They may order additional tests such as blood work, brain scans, neuropsychological evaluation or psychiatric/psychological assessment. You may be referred to a neurologist for some of the evaluations and tests.

Medication review

Some medications side effects can cause confusion, which is also a symptom of vascular dementia. These medications include sleeping pills, drugs for urinary incontinence, tranquilizers, antihistamines and pain relievers.

Blood tests

Blood tests may be ordered to detect health problems that affect brain function. Your blood will be examined for signs of infection, inflammation, underactive thyroid, vitamin deficiency and liver or kidney function problems.

Imaging test of your brain may include

• Computed tomography or magnetic resonance imaging . CT uses X-rays and a computer to show detailed images of your brain. MRI uses magnets, radiowaves and a computer to create detailed images of your brain. These imaging tests look for evidence of stroke, bleeding, tumors and fluid on your brain.
• FDG-PET scan. This is a special type of brain scan that aids in determining the type of dementia by the pattern of how a type of glucose is absorbed by brain tissue.

Neuropsychological testing

Psychiatric/Psychological evaluation

What Is Parkinson’s Disease Dementia

Parkinson’s disease is an age-related degenerative disorder of certain brain cells. It mainly affects movements of the body, but other problems, including dementia, may occur. It is not considered a hereditary disease, although a genetic link has been identified in a small number of families.

• The most common symptoms of Parkinson’s disease are tremor of the hands, arms, jaw, and face rigidity of the trunk and limbs slowness of movement and loss of balance and coordination.
• Other symptoms include shuffling, speaking difficulties, , facial masking , swallowing problems, and stooped posture.
• The symptoms worsen gradually over years.

Depression, anxiety, personality and behavior changes, sleep disturbances, and sexual problems are commonly associated with Parkinson’s disease. In many cases, Parkinson’s disease does not affect a person’s ability to think, reason, learn, or remember .

About 500,000 people in the United States have Parkinson’s disease, and about 50,000 new cases are diagnosed each year. The number of those who have some cognitive symptoms is difficult to pinpoint because accurate data are lacking for the following reasons:

Most people have the first symptoms of Parkinson’s disease after the age of 60 years, but Parkinson’s disease also affects younger people. Early-onset Parkinson’s disease strikes people around the age of 40 years, or even earlier.

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Stiffness And Slow Movement

Parkinsons disease mainly affects adults older than 60. You may feel stiff and a little slow to get going in the morning at this stage of your life. This is a completely normal development in many healthy people. The difference with PD is that the stiffness and slowness it causes dont go away as you get up and start your day.

Stiffness of the limbs and slow movement appear early on with PD. These symptoms are caused by the impairment of the neurons that control movement. A person with PD will notice jerkier motions and move in a more uncoordinated pattern than before. Eventually, a person may develop the characteristic shuffling gait.

What Are The Early Signs Of Dementia

Confusion, memory loss, and personality changes are just a few of the early signs that a person has dementia, an umbrella term describing the symptoms of several different brain disorders that can interfere with ones ability to live independently.

Depending on the cause, sometimes dementia symptoms are treatable, but, in other cases, they are permanent or progressive. This is why early detection of cognitive decline is important. The right medical treatment might reverse or relieve symptoms.

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How Long Can Person With Vascular Dementia Care For Themselves

A person with vascular dementia will need help with at least some aspects of daily function, such as managing medications, paying bills or preparing food. You or your family member with vascular dementia may be able to do many things for themselves although, it may not be safe for them to live alone, depending on what abilities are affected. For some people with vascular dementia, more specialized care may be required from facilities that care specifically for people with dementia.

What Is Needed For A Parkinson’s Disease Dementia Diagnosis

There is no definitive medical test that confirms cognitive decline or dementia in Parkinson’s disease. The most accurate way to measure cognitive decline is through neuropsychological testing.

• The testing involves answering questions and performing tasks that have been carefully designed for this purpose. It is carried out by a specialist in this kind of testing.
• Neuropsychological testing addresses the individual’s appearance, mood, anxiety level, and experience of delusions or hallucinations.
• It assesses cognitive abilities such as memory, attention, orientation to time and place, use of language, and abilities to carry out various tasks and follow instructions.
• Reasoning, abstract thinking, and problem-solving are tested.
• Neuropsychological testing gives a more accurate diagnosis of the problems and thus can help in treatment planning.
• The tests are repeated periodically to see how well treatment is working and check for new problems.

Imaging studies: Generally, brain scans such as CT scans and MRIs are of little use in diagnosing dementia in people with Parkinson’s disease. Positron emission tomographic scan may help distinguish dementia from depression and similar conditions in Parkinson’s disease.

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Parkinsons Disease Dementia: The Synergistic Effects Of

Table 1. Changes of -syn, tau, A, and iron in PDD.

Figure 2. Interaction of tau, -syn, A, iron, and GSK3. The synergistic effect of -syn and A. Iron promotes the overexpression of -syn and A. Iron promotes the activation of GSK3. -Syn and A can promote an increase in GSK3, which can, in turn, promote the expression of -syn and A. GSK3 promotes the phosphorylation of tau.

Colom-Cadena et al. found that the density of MAPT·H1 haplotypes and amyloid deposits was related to the number of A and -syn deposits in the brains of patients with dementia with LBs. A deposition has also been pathologically associated with synuclein PD and PDD cases. In addition, misfold-mediated heterotypic binding induced by the binding of -syn and tau K18 has been reported to synergistically promote the formation of A . Lu et al. found that two variants of monomers -syn and tau synergistically promoted amyloid fibril formation, causing them to co-aggregate in vitro. Nuclear magnetic resonance spectroscopy experiments showed that -syn directly interacted with tau23 and K19 by virtue of its highly negatively charged carbon terminal. The C-terminal deletion effectively eliminated its association with tau23 and K19, and its synergistic effect of promoting fibrillation .

Who Is Affected By Tremor

About 70% of people with Parkinsons experience a tremor at some point in the disease. Tremor appears to be slightly less common in younger people with PD, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.

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What Medications Are Used To Treat Parkinsons Disease

Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.

Medications combat Parkinsons disease by:

• Helping nerve cells in the brain make dopamine.
• Mimicking the effects of dopamine in the brain.
• Blocking an enzyme that breaks down dopamine in the brain.
• Reducing some specific symptoms of Parkinsons disease.

Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .

Do What You Can While You Can

I have had Parkinsons disease for nearly 20 years. My wife is a teacher, so we travel every summer when she is not working. Since my diagnosis, I have been to China, Nepal, Prague, Paris and many other places. The Parkinsons comes along, too, so our trips require more planning than they used to and we involve my care team. We factor in daily naps and take it slow. My balance isnt as good as it used to be and too much walking wears me out so we bring a collapsible wheelchair along or make sure one is available. I also use a cane. I dont know how many more places we will get to visit as my disease continues to progress, but we have made some wonderful memories that we wouldnt have if we had let my Parkinsons dictate every aspect of our lives. Nicholas, diagnosed at 52, still traveling at 72

Many people with Parkinsons disease are not allowing the condition to take over their lives. Despite the everyday setbacks they face, they are still creating fulfilling lives for themselves by redirecting their attention to people and activities that bring them joy. You can do the same. Try building a few hobbies into your routine that will give you a break from dwelling on the disease. Find some activities that help you forget about Parkinsons for a while. That may be painting, writing, gardening, or reading to your grandchildren.

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