Understanding How This Dementia Differs From Alzheimer’s Can Help Patients Know What To Expect And Feel Less Fearful
by Barbara Brody, AARP, April 6, 2021
En español | Many symptoms of Parkinson’s disease shuffling gait, quivering hands, stooped posture are easy to spot. But this disease can also cause problems that are far less visible but no less distressing. Perhaps the most worrisome is cognitive decline, which affects about 50 percent of patients.
“This is a scary, confusing and concerning topic for a lot of people, says neurologist Rachel Dolhun, M.D., senior vice president of medical communications at the Michael J. Fox Foundation. While these feelings are natural, common misconceptions can exacerbate patients fears.
For starters, cognitive decline doesn’t necessarily equal full-blown dementia, and many people with Parkinson’s develop only mild impairment. Another misconception is that even slight memory slippage signals that rapid deterioration is imminent but that’s far more common with Alzheimer’s disease than it is with Parkinson’s, says Tsao-Wei Liang, M.D., chief of the movement disorders division at Jefferson Health. It’s not always relentlessly progressive, and more often than not, symptoms can be managed with medication, caregiver support and basic organizational strategies, he says.
It’s also important to know that many Parkinson’s patients with some cognitive impairments are able to form new short-term memories, even if they struggle with attention and multitasking. People with Parkinson’s will often remember if you give a clue or prompt them, Dolhun says.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
What Are The Symptoms Of Parkinson’s Disease Dementia
Cognitive impairment in Parkinson’s 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 Parkinson’s 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 Parkinson’s disease include the following:
- Loss of decision-making ability
- Loss of short- and long-term memory
- Difficulty putting a sequence of events in the correct order
- Problems using complex language and comprehending others’ complex language
Persons with Parkinson’s 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 Parkinson’s disease may become increasingly dependent on spouses or caregivers.
Major mental disorders are common in Parkinson’s disease. Two or more of these may appear together in the same person.
The combination of depression, dementia, and Parkinson’s disease usually means a faster cognitive decline and a more severe disability. Hallucinations, delusions, agitation, and manic states can occur as adverse effects of drug treatment of Parkinson’s disease, this might complicate the diagnosis of Parkinson’s dementia.
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Let Your Brain Breathe
The Alzheimers Association has found strong links between smoking and dementia. Smoking causes damage to your heart and blood vessels. Cigarette smoke can also cause swelling in your brain that is linked to dementia.
Action Strategy: Smoking can be a lifelong habit, which makes it very difficult to quit. There are many programs that can be helpful. Consider talking to your doctor or browsing the Smoke Free website. You might be surprised at the apps, programs and support available.
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Take Prebiotics And Probiotics
Gut dysbiosis plays a pivotal role in the development and progression of Parkinsons disease. Accordingly, probiotics have the potential to help with onset of the disease, as well as management of its symptoms. A combination of Lactobacillus acidophilus, Bifidobacterium bifidum, L. reuteri, and L. fermentum has been found to relieve constipation, improve insulin sensitivity, and improve antioxidant status in people with PD, thus correcting several of the characteristic features of the disease.
Prebiotics, fermentable fibers that feed beneficial gut bacteria, may be another useful intervention for preventing Parkinsons disease. FOS and GOS, two types of prebiotic fibers, increase brain-derived neurotrophic factor, a protein important for neuronal protection, survival, and plasticity. Brain-derived neurotrophic factor is abnormally low in Parkinsons disease patients boosting its levels may have neuroprotective effects.
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How To Prevent Parkinsons
While its not yet known if there are surefire ways to prevent Parkinsons disease, there are a few things experts recommend.
For example, you might try incorporating physical activity into your routine and eating a healthy and balanced diet for a variety of health reasons. So far, research into nutritional supplements is lacking. However, if you have specific dietary needs, talk to your doctor to see if supplementation is appropriate.
Could CBD oil help? Its possible, but we dont know for sure yet. Some research, including , suggest that cannabidiol might help prevent Parkinsons disease. However, the studies are mostly animal studies and there is not yet a body of research involving humans and CBD.
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What Is Parkinsons Disease
Parkinsons disease is a neurodegenerative disease characterized by a gradual loss of neurons in the brain that produce the crucial neurotransmitter dopamine mitochondrial dysfunction neuroinflammation oxidative stress and an accumulation of misfolded proteins in neurons. Together, these factors damage the central nervous system and impair motor function, causing the hallmark symptoms of PD:
- Stiff muscles
- Difficulty with standing, walking, and other bodily movements
- Involuntary movements
- Reduced or lost sense of smell
- Reduced facial expression
Parkinsons disease is increasingly common, but it doesnt have to be. Here are the most common causes of the disease and 11 ways you can prevent it through diet, exercise, and lifestyle. #optimalhealth #healthylifestyle #chriskresser
What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
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Risk Factors For Dementia
A risk factor is something that increases your likelihood of developing a condition.
Some dementia risk factors are difficult or impossible to change. These include:
- age: the older you are, the more likely you are to develop dementia. However, dementia is not a natural part of ageing
- genes: in general, genes alone are not thought to cause dementia. However, certain genetic factors are involved with some of the less common types. Dementia usually develops because of a combination of genetic and “environmental” factors, such as smoking and a lack of regular exercise
- lower levels of education
- keeping your blood pressure at a healthy level
The Nicotinic Receptors In The Striatum
In vertebrate species, 17 different subunits of the nAChRs have been identified . The subunits form homo-and heteropentameric receptors, and the different combinations change their specific pharmacological properties . The nAChRs are composed of 4, 6, 7, 2, and 3 subunits, with preferential expression of the 42 and 62 receptors . Under basal conditions, binding of ligands to the 7nAChR induces a conformational change of the receptor that opens the central channel permitting the influx of sodium and calcium ions and the efflux of potassium ions . The 7nAChRs are detectable in cortical glutamatergic terminals, potentially directly modulating corticostriatal transmission . In the striatum, the nAChRs are not expressed in the MSN however, they are extensively distributed on GABAergic interneurons and dopaminergic and glutamatergic terminals, thereby having the physiological mechanism for a fine-tuned modulation of the striatum . Additional studies showed that activation of nAChRs, stimulated the GABAergic interneurons , indirectly affecting the striatal dopaminergic activity .
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Have An Nhs Health Check
An NHS Health Check is a free check-up of your overall health for people aged 40 to 74 who do not have heart disease, diabetes or kidney disease, and have not had a stroke. It’s offered every 5 years.
The NHS Health Check can help find early signs and tell you if you’re at higher risk of certain health problems that can also increase your risk of dementia. These include:
- heart disease
- kidney disease
If you’re over age 65, you’ll be told the signs and symptoms of dementia to look out for. You’ll also be given advice on how to lower your risk of dementia.
If you have not been invited for an NHS Health Check, ask your GP surgery.
Depression And Dementia Risk
People who are developing dementia are more likely to become depressed, Livingston said. Depression is also a risk factor of dementia, though she noted that researchers still arent sure why. Some scientists suggest depression can speed up brain aging and lead to shrinking of the brain.
Heres what you can do:Exercising and interacting with at least some people can help with depression and lower our risk of dementia, Livingston said. As the causes of depression vary among individuals, she recommended people with depression to see their general practitioner, and decide whether therapy or medication would help.
Read more about past research on cognitive decline and depression
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Physical Activity Can Reduce The Risks Of Parkinson’s Disease
Physical activity plays an active role in the prevention and treatment of PD. The relationship between physical activity and risk of PD was first reported in the Nurses’ Health Study and HPFS, and later in five other longitudinal studies . The results of prospective epidemiological studies suggest that active physical activity reduces the risk of PD in men, but the mechanism is uncertain . There is no strong supporting evidence for the hypothesis that physical activity can prevent male PD in the Harvard Alumni Health Study. Nevertheless, a smaller sample size study shows a negative and nonsignificant association between physical activity and PD . A study of 143,325 participants from CPS-II-N has found that vigorous activity was associated with PD in men and women, while a reduction in PD risk through moderate to vigorous activity . The study of 213,701 participants of NIH-AARP Diet and Health Study cohort also confirmed this view that higher levels of moderate to vigorous activities at ages 35-39 or in the past ten years as reported in 1996-1997 were associated with low PD incidence after 2000, which was with a significant dose-response relationship. Compared to individuals who were inactive during the two periods, the risk of PD reduced by approximately 40% in the further analysis . Another study from the Swedish National March cohort showed that the total amount of daily activity was associated with a lower risk of PD, but women’s correlation was not apparent to men .
Tips For Starting And Sticking With An Exercise Plan
If youve been inactive for a while, starting an exercise program can be intimidating. But remember: a little exercise is better than none. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your health.
Choose activities you enjoy and start smalla 10-minute walk a few times a day, for exampleand allow yourself to gradually build up your momentum and self-confidence.
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In Summary Reduce Your Stress
The most important thing we can do for our long-term health, both physical and cognitive, is to reduce the stress in our bodies. All stress physical, emotional and chemical causes inflammation and long-term damage throughout the body.
Whether youre seeking Parkinsons prevention techniques or ways to alleviate symptoms, any of the above dietary and lifestyle practices can have long-term health benefits. Drinking green tea, eating organic, local vegetables, and regular aerobic exercise all significantly reduce the long-term cumulative damage done by stress.
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Adopt A Regular Sleep Rhythm
Optimizing your circadian rhythm and improving your sleep promotes brain health and may reduce your risk of developing Parkinsons disease. To optimize your rhythm, create a regular sleepwake schedule and sleep in a room that is completely dark and free of light pollution from electronic devices. Avoid using blue light-emitting devices, such as computers and cell phones, several hours before bed. If you must use these devices, wear a pair of blue light-blocking glasses while doing so the glasses prevent blue light from disrupting your sleep rhythm.
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What You Should Do For Alzheimers Prevention
Even though we dont have enough evidence that all healthy lifestyle choices prevent Alzheimers, we do know they can prevent other chronic problems. For example, limiting alcohol intake can help reduce the risk for certain cancers, such as breast cancer. Best advice: make as many healthy lifestyle choices as you can. Theyre all beneficial, and if they help you avoid Alzheimers, all the better, says Dr. Marshall.
Know the symptoms of Alzheimers
Forgetting where you parked your car can be annoying. If it happens all the time, it can be disturbing, and you may worry that its a sign of a more serious condition. But dont panic. Theres a difference between normal age-related memory slips, such as forgetting where the car keys are, and more serious signs of memory loss, such as forgetting what car keys are used for.
Early symptoms of Alzheimers disease include frequent memory loss, confusion about locations, taking longer to accomplish normal daily tasks, trouble handling money and paying bills, loss of spontaneity, and mood and personality changes. If you have a decline in your memory or thinking that affects your ability to perform any of your daily routines, ask your doctor for a screening to evaluate you for Alzheimers and related conditions, says Dr. Gad Marshall, a Harvard Medical School assistant professor of neurology.
Pillar #: Quality Sleep
There are a number of links between poor sleep patterns and the development of Alzheimers and dementia. Some studies have emphasized the importance of quality sleep for flushing out toxins in the brain. Others have linked poor sleep to higher levels of beta-amyloid in the brain, a sticky protein that can further disrupt the deep sleep necessary for memory formation.
If nightly sleep deprivation is slowing your thinking and or affecting your mood, you may be at greater risk of developing or deteriorating symptoms of Alzheimers disease. To help improve your sleep:
Establish a regular sleep schedule. Going to bed and getting up at the same time reinforces your natural circadian rhythms. Your brains clock responds to regularity.
Set the mood. Reserve your bed for sleep and sex, and ban television and computers from the bedroom .
Create a relaxing bedtime ritual. Take a hot bath, do some light stretches, listen to relaxing music, or dim the lights. As it becomes habit, your nightly ritual will send a powerful signal to your brain that its time for deep restorative sleep.
Quiet your inner chatter. When stress, anxiety, or worrying keeps you awake, get out of bed. Try reading or relaxing in another room for twenty minutes then hop back in.
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What Are Parkinson’s Disease Dementia Medical Treatment And Medications
There is no specific therapy for dementia in Parkinson’s disease. Although cognitive symptoms initially may appear to respond to drugs that promote dopamine production, the improvement is mild and transient in contrast to the early responses to motor control improvement with medication in patients with Parkinson’s disease.
Parkinson’s disease dementia medications
Various medications are used to treat the movement disorders of Parkinson’s disease, some may exacerbate symptoms related to dementia.
- These include dopamine given in the form of levodopa medications known as dopamine agonists that act on the dopamine receptor and medications that slow down the metabolism of dopamine. They are often used in conjunction with monoamine oxidase inhibitors such as rasagiline. In addition, anticholinergic drugs are sometimes used.
- Unfortunately, these drugs may affect cognitive symptoms and mood disorders.
- Anticholinergic drugs, for example, help balance levels of dopamine and acetylcholine, another neurotransmitter, in the brain. These drugs can improve movement disorders but often make memory loss worse.
The dementia of Parkinson’s disease may respond to drugs used in patients with Alzheimer’s disease. However, these drugs, called cholinesterase inhibitors , lead to only small and temporary improvements in cognition.
Mood disorders and psychoses are usually treated with other medication.
Take Your Brain For A Walk
Getting up and moving helps to keep your body and brain strong. Research is unclear on whether exercise prevents dementia, but there are many studies that suggest regular activity is good for your brain. One even showed low dementia risk among very fit women. Physical activity helps prevent other health conditions linked to dementia including:
- High blood pressure
Action Strategy: Just do it. Start small but make sure you start. Add a small activity, depending on your level of physical fitness. This could be as simple as walking up and down a hallway a few times or as challenging as a 5-mile hike with friends. Aim to fit 150 minutes of physical movement that gets your heart beating faster into each week.
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