Saturday, August 13, 2022

Parkinson’s Disease Alzheimer’s Disease

How Is Parkinsons Dementia Different From Alzheimers Disease

Dealing with Dementia in Parkinson’s Disease

The advanced cognitive changes that impact daily living in Alzheimers and Parkinsons disease are both types of dementia.

Parkinsons disease dementia can occur as Parkinsons advances, after several years of motor symptoms. Dementia with Lewy Bodies is diagnosed when cognitive decline happens first, or when Parkinsons motor symptoms and cognitive decline occur and progress closely together. Cognitive impairments in PDD, combined with the movement symptoms of the disease, produce a greater impact on social and occupational functioning than Alzheimers.

Alzheimers, a fatal brain disease, causes declines in memory, thinking and reasoning skills. Physicians can diagnose Alzheimers. Visit the Alzheimers Association to learn the 10 signs Alzheimers disease.

Fortunately for people with PD, Parkinsons disease dementia is less disabling than Alzheimers disease. People with Alzheimers have language difficulties earlier than people with Parkinsons, and no new memories are formed. People with PD also have more ability to compensate and adjust based on cues.

Pdd: A Type Of Dementia Caused By Parkinsons Disease

Parkinsons disease dementia is a brain illness that affects some persons with Parkinsons disease, but not all. The diseases destruction of brain cells can result in memory loss as well as other cognitive abilities like problem-solving and thinking speed. These mental and behavioral shifts might have an impact on your daily life, independence, and relationships.

There is at least a yearand generally 10 to 15 yearsbetween the Parkinsons diagnosis and the start of dementia in people who do get dementia due to Parkinsons disease. The Alzheimers Association believes that 50 percent or more of persons with Parkinsons disease may acquire dementia at some point, while there are a number of risk factors that influence the likelihood of acquiring symptoms:

Patients with Parkinsons disease who have hallucinations, excessive daytime sleepiness, or significant motor control deficits are more likely to develop dementia.

Dementia is more likely in persons who are older when they first develop Parkinsons disease.

What Causes Parkinsons Disease

The most prominent signs and symptoms of Parkinsons disease occur when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems associated with the disease. Scientists still do not know what causes the neurons to die.

People with Parkinsons disease also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinsons, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying position.

Many brain cells of people with Parkinsons disease contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons andLewy body dementia.

Also Check: Signs And Symptoms Of Parkinsons Disease

Things You Should Know About The Link Between Parkinsons And Dementia

Both Parkinsons disease and dementia were ravaging the brain and behavior of actor Robin Williams before his death, but at the time, he didnt realize he had the latter.

Despite the fact that the signs of this combination can be confusing, the double diagnosis of Parkinsons and dementia impacts a large number of people. Of the one million people who have Parkinsons in the U.S., 50 to 80 percent may have dementiaeither as a result of Parkinsons pathology, or separately.

Robin Williams widow, Susan, wrote an editorial published in Neurology that was addressed to neurologists after his death. In it, she shared what it was like seeing her husband experience both Parkinsons disease and Lewy body dementia firsthand.

My hope is that it will help you understand your patients along with their spouses and caregivers a little more, Susan wrote.

Williams was first diagnosed with Parkinsons disease, which at first seemed to provide some answers for his out-of-character symptoms.

But it wasnt until after his death that an autopsy revealed he had been in the later stages of Lewy body dementiaa common form of dementia characterized by deposits of Lewy body proteins in the brain, which can impact physical movement, mood, memory and behavior.

I will never know the true depth of his suffering, nor just how hard he was fighting, Susan wrote. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.

Sings Of Parkinsons Disease Dementia

Acoustic Neuroma

Dementia is a less common feature of Parkinsons disease. Approximately 20% of people with Parkinsons disease will develop Parkinsons Disease Dementia . Parkinsons patients who experience hallucinations and more severe motor control problems are at risk for dementia. For those patients with Parkinsons disease who go on to develop dementia, there is usually at least a 10- to 15-year lag time between their Parkinsons diagnosis and the onset of dementia. Signs of dementia in Parkinsons patients include:

  • Distractibility
  • Ask your healthcare provider to arrange a home safety evaluation.
  • Use grab bars in the tub and shower.
  • Use a bath chair or stool in the shower.
  • Keep your floors smooth but not slippery.
  • Store supplies in easy to reach cabinets.
  • Make sure stairwells and walkways are lit.
  • Get nightlights for bathrooms and hallways.
  • Keep walking areas free of clutter.
  • Wear low-heeled, comfortable shoes when walking around. Avoid walking in slippery socks and slippers.
  • Make sure carpets are fully tacked to the ground, and avoid throw rugs.

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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.

Tip : Make Additional Healthy Lifestyle Decisions

There are many additional things you can do to control Parkinsons symptoms and reduce your risk of dementia, in addition to regular exercise, a balanced diet, and social interaction.

1. Make an effort to keep your mind active. You may improve your cognitive skills and keep your mind sharp by continuing to study new things and challenging your brain. Learning a new talent, whether it is a musical instrument, a foreign language, a new computer program, or a new game or sport, is another excellent approach to boost brain function. You can learn new skills by enrolling in classes at community centers or institutions.

2. Boost the quality of your nighttime sleep. Toxins must be flushed out of the body, and the brain must be protected. The average adult needs 7 to 9 hours of restful sleep. Create calming night rituals, such as having a bath or doing some mild stretches, and switch off all electronics at least one hour before bedtime.

3. Take care of your tension. Stress that is not managed has a toll on the brain, diminishing a critical memory area, slowing nerve cell growth, and exacerbating many Parkinsons symptoms. Overwhelming stress may raise your chances of developing dementia. Exercise and relaxation techniques such as meditation or deep breathing, in addition to connecting face-to-face with others, can help you reduce stress levels.

If you are interested in more articles like this, check out this article about alcoholism and alcohol abuse.

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Coping With A Parkinsons Diagnosis

A diagnosis of Parkinsons can be a frightening experience for both you and your loved ones. While there is currently no cure, there are treatments available for Parkinsons symptoms and lifestyle changes you can make to slow the progression of the disease and delay the onset of more debilitating symptoms, including Parkinsons disease dementia. Early diagnosis can prolong independence and help you to live life fully for much longer.

If youve been diagnosed with Parkinsons you may feel anger, deep sadness, or fear about what the future will bring. These feelings are all normal. Its also normal to grieve as you deal with this enormous adjustment.

Give yourself some time to adjust. As with any major change in life, dont expect that you will smoothly snap into this new transition. You may feel alright for a while, and then suddenly feel stressed and overwhelmed again. Take time to adjust to this new transition.

Learn all you can about Parkinsons disease and Parkinsons disease dementia. Educating yourself and making important decisions early can help you feel more in control during this difficult time.

Reach out for support. Living with Parkinsons presents many challenges, but there is help available for this journey. The more you reach out to others and get support, the more youll be able to cope with symptoms while continuing to enrich and find meaning in your life.

How Does Parkinsons Affect The Brain

Alzheimers Disease FTD and Parkinsons Disease

When the disease occurs, some nerve cells might break down or die gradually.

Though due to this the dopamine level of your brain decreases, & if the dopamine decreases, the brain will start behaving in an abnormal way.

Albeit, people often get confused over the two terms Alzheimers & Parkinsons well both the disease are caused by damaged brain cells..but there are huge differences.

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What Causes Lewy Body Dementia

The causes of LBD are not yet well understood, but research is ongoing in this area. There are probably multiple factors involved, including genetic and environmental risk factors that combine with natural aging processes to make someone susceptible to LBD.

For more information, visit www.lbda.org.

Modified with permission from the Lewy Body Dementia Association

To learn more about motor symptoms related to Parkinsons, visit here.

To learn more about non-motor symptoms related to Parkinsons, visit here.

Changes In Cognition And Parkinsons Disease

Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.

Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.

Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.

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Systematic Review And Record Identification

Our initial search identified a total of 5,528 citations from PubMed, WanFang, VIP, and CNKI databases. After elimination of duplicates and records of irrelevancy or insufficient information, 364 records remained. After further full-text review, 265 records were excluded based on the inclusion and exclusion criteria . Thus, a total of 99 records were eligible for data extraction, including 75 records for AD and 24 for PD . The information of the included studies was described in Supplementary Tables 1, 2, including location, gender, setting, education, phase design, response rate, diagnostic assessment, diagnosis criteria, age, sample size, and quality score.

Figure 1. Flow diagram of study identification. AD, Alzheimer’s disease. PD, Parkinson’s disease Reason 1, not population-based Reason 2, not based in China Reason 3, no numerical prevalence measurement Reason 4, conducted in an unrepresentative population, such as hospital-based, in elderly social welfare, etc. Reason 5, overlapped data in different studies Reason 6, unclear diagnosis.

Data Extraction And Literature Quality Evaluation

Dementia caused by Parkinson

The authors N.-N. Hou and X. Zuo completed literature retrieval and selection independently. When there was a disagreement, L. Cui and H.-M. Wu participated to reach a consensus. Extracted from the studies were author name, publication year, gender, age range, study design, response rate, diagnostic criteria, case number, study location, urban/rural, education, and sample size. All eligible studies were systematically evaluated for quality based on their sample size, study design, response rate and diagnostic assessment. The detailed scoring criteria were performed as previously described by Prince et al. .

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Our Eyes May Provide Early Warning Signs Of Alzheimers And Parkinsons

Forget the soul it turns out the eyes may be the best window to the brain. Changes to the retina may foreshadow Alzheimers and Parkinsons diseases, and researchers say a picture of your eye could assess your future risk of neurodegenerative disease.

Pinched off from the brain during embryonic development, the retina contains layers of neurons that seem to experience neurodegenerative disease along with their cousins inside the skull. The key difference is that these retinal neurons, right against the jellylike vitreous of the eyeball, live and die where scientists can see them.

Early detection is sort of the holy grail, said Ron Petersen, director of Mayo Clinics Alzheimers Disease Research Center and the Mayo Clinic Study of Aging. By the time a patient complains of memory problems or tremors, the machinery of neurodegenerative disease has been at work probably for years or decades.

Experts liken it to a cancer that only manifests symptoms at Stage 3 or 4. When patients begin to feel neurodegenerative diseases impact on their daily life, its almost too late for treatment.

Catching the warning signs of neurodegenerative disease earlier could give patients more time to plan for the future whether thats making caregiving arrangements, spending more time with family or writing the Great American novel.

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Lewy Body Dementia Vs Parkinsons Disease Dementia

Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.

Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.

The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.

This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.

The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.

Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.

Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.

Parkinsons disease itself isnt fatal, but complications can be.

Research has shown a median survival rate of about

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Prevalence Of Ad And Pd By Year In Individuals Over 60 Years Old

The pooled prevalence rates of AD in 19972001, 20022006, 20072011, 20122016, and 20172018 were 1.68, 1.90, 3.65, 4.16, and 3.96%, respectively, with a significant increase in 20072011 and 20122016 compared to its respective previous period. The pooled prevalence rates of PD in 19851999, 20002014 and 20152018 were 0.94, 1.14, and 2.04%, respectively, with a significant increase in the latter two periods compared to its respective previous period .

Based on the yearly pooled prevalence of AD from 1997 to 2018 in China, a model was identified as the best fitting specification . The rate of AD showed a slightly increasing trend with no seasonal variation, and was predicted to be 3.81% , 5.24% , 5.35% , 4.84% , and 6.17% for the next 5 years from 2019 to 2023 . PD was not analyzed due to insufficient data.

Figure 3. Prediction of AD prevalence in Chinese over 60 years old in the next 5 years. AD, Alzheimer’s disease.

What Are The Types Of Lewy Body Dementia

Coping with Dementia in Parkinson’s disease for Care Partners

There are two types of LBD: dementia with Lewy bodies and Parkinsons 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 Alzheimers 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.

Parkinsons disease dementia starts as a movement disorder. It first causes the symptoms of Parkinsons disease: slowed movement, muscle stiffness, tremor, and a shuffling walk. Later on, it causes dementia.

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Environment And Exogenous Toxins

It has also been hypothesized that exposure to some exogenous agents may contribute to the development of Parkinsons disease. In fact, some studies conducted in the 1980s had observed that drug addicts who took synthetic heroin whose co-product was MPTP developed a parkinsonian syndrome that showed lesions, both anatomically and pathologically, at the substantia nigra level and which responded well to L-DOPA. MPTP is neurotoxic, but in itself, it would be harmless. Once introduced into the body, at the level of the central nervous system, it is taken up by cells which, through the activity of type B monoamine oxidase , metabolize it leading to the production of an active ion, 1methyl-4phenylpyridine or MPP +. So once produced, this ion accumulates within dopaminergic neurons, using the dopamine reuptake system.

Once re-captured, it concentrates at the mitochondria level, where it acts as a selective inhibitor of respiratory complex I . Following this inhibition, there is a reduction in ATP production and, consequently, a decrease in the efficiency of the Na + / Ca ++ proton pump. Then there is an increase in the intracellular concentration of Ca ++ ions, an increase in oxidative stress due to the increase in electron dispersion in complex I, and an increase in the production of superoxide ions by the mitochondria. All this then consequently leads to cell death.

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