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Parkinson’s And Dementia Link

Dementia Outcomes According To Baseline Motor Features

Possible link between vitamin B12 levels and dementia in Parkinsons disease

Among motor variables , the proportion of gait involvement at baseline , falls , and freezing predicted dementia. Poor performance on the Purdue Pegboard Test and alternate tap test , but not the UPDRS predicted dementia. Patients developing dementia were more likely to report bilateral onset of motor symptoms . There was no association between dementia status and PD subtype, although the dementia-converted group had slightly more patients with akinetic-rigid Schiess scores than the group without dementia . Baseline UPDRS part III scores, total UPDRS scores, Timed Up and Go, Hoehn and Yahr stage, and axial-limb ratio were not predictive of dementia status.

Coping With Dietary Problems

Many people with Parkinsons experience various eating and dietary problems, such as constipation, chewing and swallowing difficulties, and upset stomach. The following tips can help you minimize the symptoms.

If you suffer from constipation Drink lots of water and eat fiber-rich foods, including beans, brown rice, whole grains, and fruit.

If you have trouble chewing or swallowing food Cut foods into smaller portions to avoid choking and to encourage digestion, and remain upright for 30 minutes after eating.

If youre struggling with fatigueLimit the amount of sugar youre eating. Also avoid alcohol and caffeine, especially before bed, as they can reduce the quality of your sleep.

If you take levodopa Dont eat meat or other protein-rich foods for at least 30-60 minutes after taking levodopa, as protein blocks your bodys ability to absorb the medication.

If your medication gives you an upset stomach Take your medication with a full glass of water and a small non-protein based snack, such as a piece of toast or fruit.

Some Parkinsons disease medications need to be taken promptly at specified times before or after eating, so it can also help to establish a regular routine for meal and medication times.

Early Signs And Symptoms Are Different

Parkinsons disease generally begins as a movement disorder. Early signs and symptoms include:2

  • Tremor, which often begins in the hand or fingers
  • Slowed movement, which may include foot dragging
  • Slowed automatic movements such as blinking, smiling, and swinging your arms when you walk

Alzheimers disease generally begins as noticeable memory loss. Early signs and symptoms include:3,4

  • Trouble remembering familiar words

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Alzheimers Vs Parkinson’s Disease Dementia

The dementia of Parkinsons disease has some similarities to the dementia of Alzheimers disease. And there are some differences, too. Alzheimers disease causes dementia slowly over time, while the dementia of Parkinsons disease often develops more quickly and dramatically.

The symptoms of Parkinsons dementia can come and go from day to day, while the symptoms of Alzheimers dementia will not go away.

Behaviors Seen In Parkinsons Disease Dementia

Parkinsons Disease

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

Read Also: What Are The Early Signs And Symptoms Of Parkinson’s Disease

Exploring The Link Between Parkinsons And Dementia

Relatives of patients with Parkinsons disease may have an increased risk of developing dementia or memory problems, researchers report. And the younger the age at which Parkinsons appears, the greater the likelihood that family member will develop dementia. The findings appeared in the October issue of the Archives of Neurology, one of the journals from the American Medical Association.

Doctors have long sought clues that may link Alzheimers disease, the most common form of dementia, and Parkinsons, a distinct neurologic ailment. Parkinsons disease is characterized by a decline in the functions of the central nervous system, including the ability to walk, move and speak. Several clinical and population studies have shown an increased risk of dementia in first-degree relatives of people with Parkinsons disease. However, other studies have not confirmed a link between the two.

The study group surveyed the participants with a telephone questionnaire as well as cognitive tests and a review of medical histories to assess the occurrence of memory problems. These would include conditions like mild cognitive impairment, as well as more serious conditions like Alzheimers and other forms of dementia. They found that relatives of patients with Parkinsons disease were at increased risk of cognitive impairment or dementia.

By www.ALZinfo.org, The Alzheimers Information Site. Reviewed by , Ph.D., Fisher Center for Alzheimers Research Foundation at The Rockefeller University.

What Are Parkinsons Disease Dementia Medical Treatment And Medications

There is no specific therapy for dementia in Parkinsons 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 Parkinsons disease.

Parkinsons disease dementia medications

Various medications are used to treat the movement disorders of Parkinsons 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 Parkinsons disease may respond to drugs used in patients with Alzheimers 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.

Also Check: Parkinsons Disease And Mental Health

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Alzheimers And Parkinsons Disease: Similarities And Differences

James M. Ellison, MD, MPH

Swank Center for Memory Care and Geriatric Consultation, ChristianaCare Configure

Explore the similarities and differences between two common degenerative brain disorders.

Ron brings his 78-year-old wife, Sara, to the Memory Clinic, with a pressing concern. Sara is forgetting things more often even though her Parkinsons disease symptoms appear to be under good control with standard medications, healthy diet, and plenty of physical activity. She is losing her train of thought mid-sentence and she became very confused about where she was while driving the well-traveled route to her daughters home. Is she developing dementia? Is that a part of Parkinsons disease? Or is she developing Alzheimers disease? And what are the differences between Alzheimers and Parkinsons?

Whats The Difference Between Lewy Body Dementia Parkinsons Disease And Alzheimers Disease

What’s the latest on Parkinsons Disease

Lewy body dementia is an umbrella term for two related clinical diagnoses: dementia with Lewy bodies and Parkinsons disease dementia. These disorders share the same underlying changes in the brain and very similar symptoms, but the symptoms appear in a different order depending on where the Lewy bodies first form.

Dementia with Lewy bodies is a type of dementia that causes problems with memory and thinking abilities that are severe enough to interfere with everyday activities. It specifically affects a persons ability to plan and solve problems, called executive function, and their ability to understand visual information. Dementia always appears first in DLB. The motor symptoms of Parkinsons such as tremor, slowness, stiffness and walking/balance/gait problems usually become more evident as the disease progresses. Visual hallucinations, REM sleep behavior disorder, fluctuating levels of alertness and attention, mood changes and autonomic dysfunction are also characteristic of DLB.

Finally, Alzheimers is characterized by different abnormal clumps called amyloid plaques, and jumbled fiber bundles called tau tangles. These microscopic structural changes in the brain were discovered by Dr. Alois Alzheimer in 1906. These plaques and tangles, together with loss of connections between nerve cells, contribute to loss of coherence and memory, as well as a progressive impairment in conducting normal activities of daily living.

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Parkinson’s Disease And Dementia

Parkinson’s disease and dementia are both progressive conditions that get worse over time. They are also both far more common among the older population:

What’s more, a person with Parkinson’s disease may have a higher chance of developing dementia at some stage. It’s thought that this happens in roughly half of all people with Parkinson’s. Results of studies that tracked patients over 10 years and eight years respectively suggest that dementia is diagnosed in between 30% and almost 80% of people with Parkinson’s.

Yet, it’s important to understand Parkinson’s and dementia as two different degenerative conditions:

  • They don’t have the same primary causes or primary symptoms.
  • It’s common to develop one without the other.

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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.

Lewy Bodies: More Than Lbd

Pin on Parkinson

LBD is characterized by the presence of Lewy bodies in the nerve cells of the brain, meaning that LBD patients have Lewy bodies in the brain.2 However, Lewy bodies are also common with other conditions, such as Alzheimers and Parkinsons disease. In fact, most people with PD also have Lewy bodies in their brain. However, even if they have Lewy bodies, not all Parkinsons patients will also develop LBD.2

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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.

Metabolic And Perfusion Impairments

Reductions in brain glucose metabolism, as measured using 18F-fluorodeoxyglucose PET imaging, and in perfusion measured with SPECT, have been found in PD patients with both cognitive impairment and with dementia. Deficits appear global and widespread, affecting parietal, frontal and occipital cortices .

Principal component analyses with FDG PET to identify areas of the brain which co-vary in function, have found salient metabolic networks that are disrupted in PDD . One of these covariance networks, the so-called PD-related cognitive pattern which includes prefrontal, midline frontal, precuneus and inferior parietal regions is associated with cognitive impairment in PD, and reduced activity in this network is longitudinally associated with declining cognitive function. Perfusion and metabolism deficits in distributed brain areas including frontal , parietal and temporal cortex have also been associated with visual hallucinations, although there is a lack of consensus on precisely which brain areas are involved.

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Dementia Outcomes According To Baseline Autonomic Variables

Orthostatic systolic blood pressure drop was strongly associated with dementia risk . Having a baseline systolic decrease > 10 mm Hg increased dementia odds 7-fold . In addition, the mean baseline systolic blood pressure in the group with dementia was higher than in the group without dementia . Baseline occurrence of urinary symptoms , erectile dysfunction , and bowel dysfunction was higher in those with dementia but not statistically different compared with the group without dementia.

Study Design Cohorts And Covariates

Parkinson’s Motor Symptoms Co-Management: Occupational Therapy and Neurology

This was a retrospective cohort study from 2002 to 2012. We selected 5932 eligible patients with PD between 2002 and 2003 from a previous study for which sample selection details were discussed previously. In brief, the PD cohort in this study included all cases with at least three medical claims with a diagnostic code of PD who are receiving at least three times of prescriptions of anti-Parkinsonism medications, including L-dopa or dopamine agonist prescriptions after a first-time diagnosis between 2002 and 2003. Moreover, the first and last outpatient or inpatient visits and anti-Parkinsonism medication records were separated by at least 90 days to avoid accidental inclusion of miscoded patients.

To ensure that the PD diagnosis was reliable and consistent, cases were excluded if: an age on the index date of less than 40 years who are more likely to have a genetic aetiology a diagnostic code of secondary Parkinsonism during the study period receipt of any neuroleptic medication 180 days prior to the index date and three or more medical claims with diagnostic codes of dementia prior to the index date. The first date of initial diagnosis of PD in the period of 2002 to 2003 was set as the index date.

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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.

Assessments Of Visual Function

Visual measures were all performed before mydriasis. Visual acuity was measured binocularly using a logMAR chart . Contrast sensitivity was measured binocularly using a Pelli-Robson chart . Color vision was assessed using the D15 test, and error scores log transformed.

LogMAR visual acuity chart. Adapted by permission from BMJ Publishing Group Limited. Relationship between the risk of PD dementia and visual acuity. Pelli-Robson chart for assessing contrast sensitivity. Relationship between the risk of PD dementia and contrast sensitivity. Cats-and-Dogs test of higher-order visuoperception. The task is to identify whether the animal shown is a cat or a dog, with differing amounts of skew applied to the image to determine the level of skew tolerated. Relationship between the risk of PD dementia and higher-order visuoperception, tested by skew tolerance. Biological motion. Dots are shown at the position of the major joints of the body. The dots move to give the strong percept of a person walking. Extra dots are added, and the number of dots tolerated, where the participant can still detect a person moving, is calculated. Relationship between the risk of PD dementia and higher-order visuoperception, tested with biological motion. Poorer performance in each of these measures is linked with a higher risk of PD dementia.

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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.

How Is Parkinsons Disease Dementia Diagnosed

Metformin Linked to Dementia, Parkinson

No single test can diagnose Parkinsons disease dementia. Instead, doctors rely on a series or combination of tests and indicators.

Your neurologist will likely diagnose you with Parkinsons and then track your progression. They may monitor you for signs of dementia. As you get older, your risk for Parkinsons dementia increases.

Your doctor is more likely to conduct regular testing to monitor your cognitive functions, memory recall, and mental health.

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Pd Dementia And 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 and try to:

  • 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.
  • Look into medical alert systems. These systems can be critical in the event of a fall or if your loved one wanders outside of the home. Many types of systems are available, from bracelets and pendants to smartwatches 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 bringing it up with their doctor and taking additional safety precautions.

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