What Is The Difference Between Parkinsons Disease And Parkinsonism
Parkinsons disease is a neurodegenerative disorder that leads to movement symptoms and non-movement symptoms. It is sometimes called idiopathic , but the cause is believed to be a combination of genetic and environmental factors.
Parkinsonism is a more general term that encompasses the symptoms of Parkinsons disease. A variety of disorders or syndromes can lead to Parkinsonism, and these syndromes can lead to faster progression of symptoms, increased falling, presence of hallucinations, and can be non-responsive to levodopa .
The majority of people with the symptoms of Parkinsons disease will be diagnosed with idiopathic Parkinsons disease. Between 10% to 15% of these people will be diagnosed with Parkinsonism that is caused by something else.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
How Does Parkinsons Disease Affect Womens Sexual Functions
The effects of Parkinsons disease on womens sexuality are not well understood because women tend to share fewer of these symptoms with their neurologists, who are mostly men.
Women often mention experiencing a loss of desire, lack of orgasm, pain during intercourse, and vaginal dryness. These symptoms are also associated with age.
Sexual arousal can be at its peak when all stressors, distractions and pain are removed. Optimizing treatment and taking into account variations in the effectiveness of antiparkinsonian drugs are the first factors to address.
On the other hand, psychological factors and depression also need to be treated effectively to help with sexual desire.
Vaginal discomfort and dryness can be alleviated by using lubricants during intercourse. Estrogen-based creams applied daily can also soften the vagina and increase its lubrication.
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How Parkinsonism Differs From Parkinsons Disease
Parkinsons disease is one of many types of parkinsonism. Its caused by a loss of cells in the part of your brain that produces the neurotransmitter dopamine.
Parkinsons disease and the different types of parkinsonism progress in different ways. Some may progress more rapidly than Parkinsons disease. Others, like secondary parkinsonism, may be reversible.
The conditions also respond differently to treatments. For instance, someone who has a type of parkinsonism may not respond to the drug levodopa, which is commonly used for Parkinsons disease.
It can be hard to tell the difference between types of parkinsonism. Heres a look at some of the identified categories of parkinsonism with their typical symptoms and treatments.
- involuntary muscle contractions
Treatment
No treatment has been found to slow the progression of corticobasal syndrome. Parkinsons drugs are generally ineffective but may help manage stiffness in some people.
Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- medication
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
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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
- Rigidity
- 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
- Challenges performing everyday tasks such as balancing a checkbook
Palliative Care In Dementia
The first evaluated palliative care program specific to dementia was described in 1986 . The volume of research has grown exponential after 2000 . There are few randomized controlled trials, and therefore, there is still little evidence on effectiveness . However, many western countries have funded observational studies resulting in numerous publications describing patient, family and professional caregiver needs .
Research specific to dementia is important because the course of the disease is highly variable and uncertain. Because of the progressive dementia, patients themselves often cannot remain involved in decision making. Also, health services and changes such as transfer to a hospice, do not necessarily represent optimal care for people with dementia . Palliative care in dementia needed a clear conceptualization, and the European Association for Palliative Care along with experts agreed to a distinct concept in terms of eleven domains, different from usual palliative care .
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Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.
How Is Parkinson’s Disease Managed
Your doctors will tailor your treatment based on your individual circumstances. You will manage your condition best if you have the support of a team, which may include a general practitioner, neurologist, physiotherapist, occupational therapist, psychologist, specialist nurse and dietitian.
While there is no cure for Parkinson’s disease, symptoms can be treated with a combination of the following.
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Key Brain Changes Are Different
The key brain changes linked to Parkinsons disease and Parkinsons-related dementia are abnormal deposits of common brain proteins, called alpha-synuclein. These deposits are known as Lewy bodies, named after the doctor who discovered them. As more of these proteins clump in the brain, normal brain cells begin to die off.1
In Alzheimers disease, the key brain changes include the buildup of different brain proteins, called amyloid and tau. When amyloid proteins clump together, they form abnormal structures known as plaques. Abnormal groups of tau proteins form tangles.3 Over time, the buildup of these proteins causes normal brain cells to die, and affected parts of the brain may shrink.5
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What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy. This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinson’s will affect your life
For more information, visit our Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
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How Do Doctors Diagnose Lewy Body Dementia
Unfortunately, LBD is usually the most frequently misdiagnosed type of dementia. LBDA estimates that it often takes about three doctors and over a year and a half to diagnose LBD. Their survey of nearly 1,000 participants with LBD discovered that about 80 percent of them were misdiagnosed. In an article published in nature, Susan Schneider Williams, Robin Williams wife, writes about their struggle to get an accurate diagnosis and determine what was happening to his brain. My hope is that it will help you understand your patients along with their spouses and caregivers a little more. And as for the research you do, perhaps this will add a few more faces behind the why you do what you do, she writes.
People can either be diagnosed with dementia with Lewy bodies or Parkinsons disease dementia. If someone is experiencing symptoms that could be LBD, they should try visiting a neurologist, rather than a general physician, to try and get an accurate diagnosis. While LBD can still only be officially diagnosed by an autopsy, doctors use the following methods to determine if someone may have LBD:
They can look for biomarkers of Lewy Body Dementia, including abnormal proteins, with the following:
- A SPECT or PET scan
- cardiac scintigraphy, which looks at how nerves are functioning in the hearts blood vessels
- Sleep tests that monitor brain waves
In addition, doctors may do the following:
Complementary And Alternative Therapies
Some people with Parkinson’s disease find complementary therapies help them feel better. Many complementary treatments and therapies claim to ease the symptoms of Parkinson’s disease.
However, there’s no clinical evidence they’re effective in controlling the symptoms of Parkinson’s disease.
Most people think complementary treatments have no harmful effects. However, some can be harmful and they shouldn’t be used instead of the medicines prescribed by your doctor.
Some types of herbal remedies, such as St John’s wort, can interact unpredictably if taken with some types of medication used to treat Parkinson’s disease.
If you’re considering using an alternative treatment along with your prescribed medicines, check with your care team first.
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Is The Dementia Caused By Parkinsons Or Something Else
Indications that dementia may be caused by something other than Parkinsons disease include agitation, delusions , and language difficulties. If the onset of cognitive symptoms is sudden, theyre more likely due to something other than Parkinsons diseaseeven reversible causes such as infection, a vitamin B12 deficiency, or an underactive thyroid gland.
Depression can mimic dementia by causing similar symptoms such as apathy, memory problems, and concentration difficulties. Since depression is very common in Parkinsons patients, its important to recognize the signs and symptoms of depression in older adults.
Parkinsons disease dementia vs. other dementias
Other types of dementia that can be commonly mistaken for Parkinsons disease dementia include:
Lewy Body Dementia is characterized by fluctuations in alertness and attention, recurrent visual hallucinations, and Parkinsonian motor symptoms like rigidity and the loss of spontaneous movement. In this disorder, cognitive problems such as hallucinations tend to occur much earlier in the course of the disease and often precede difficulties with walking and motor control.
Alzheimers disease and Parkinsons disease are both common in the elderly, especially in those over 85. Patients with Parkinsons who develop dementia may even develop Alzheimers dementia as well. Therefore, its important to be aware of the signs of Alzheimers Disease and how its treated.
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What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
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The Genetics Of Parkinsons
A 2020 study including 1,676 people with Parkinsons in mainland China suggested that genes play a role in the development of the condition. An estimated 10 to 15 percent of people with Parkinsons have a family history of the condition.
In fact, a number of specific genes have been linked to the development of Parkinsons.
How do genetics factor into Parkinsons in some families? According to Genetics Home Reference, one possible way is through the mutation of genes responsible for producing dopamine and certain proteins essential for brain function.
Dementia With Lewy Bodies
- Dementia with Lewy bodies is a progressive, neurodegenerative disorder in which abnormal deposits of a protein called alpha-synuclein build up in multiple areas of the brain.
- DLB first causes progressive problems with memory and fluctuations in thinking, as well as hallucinations. These symptoms are joined later in the course of the disease by parkinsonism with slowness, stiffness and other symptoms similar to PD.
- While the same abnormal protein is found in the brains of those with PD, when individuals with PD develop memory and thinking problems it tends to occur later in the course of their disease.
- There are no specific treatments for DLB. Treatment focuses on symptoms.
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What Role Do Genes Play
Your genes are like your body’s instruction book. So if you get a change in one of them, it can make your body work in a slightly different way. Sometimes, that means you’re more likely to get a certain disease.
There are several genetic mutations that can raise your risk for Parkinson’s, each by a little bit. They have a part in about 1 in 10 cases.
If you have one or more of these changes, it doesn’t mean you’ll get Parkinson’s. Some people will, but many won’t, and doctors don’t know why. It may have to do with other genes or something in your environment.
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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Number Of People Affected
Parkinsons disease is thought to affect about 2 percent of Americans over 65. Of those, about 50 to 80 percent will go on to develop Parkinsons-related dementia.1 The Parkinsons Foundation estimates that nearly 1 million Americans will be living with Parkinsons by 2020. The disease affects 1.5 times more men than women.7
Approximately 5.8 million Americans are currently living with Alzheimers disease. That number is expected to increase to 14 million by 2050.8 There is little difference between numbers of men and women who develop Alzheimers, but there are more women with the disease, because women tend to live longer than men.3
Whats The Difference Between Dementia With Lewy Bodies And Parkinsons
In dementia with Lewy bodies, dementia always appears first. There can also be changes in alertness as well as visual hallucinations. However, because of the presence of Lewy bodies throughout the entire brain, characteristics of this disease not only include cognitive characteristics, but also physical, sleep, and behavioral changes. As the disease progresses, the motor symptoms common to Parkinsons such as tremor, slowness, stiffness, and walking and balance problems will appear.
For more information on dementia with Lewy bodies, visit www.lbda.org.
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What Are The Symptoms
Symptoms of PD vary from person to person, as does the rate of progression. A person who has Parkinson’s may experience some of these more common “hallmark” symptoms:
- Bradykinesia – slowness of movement, impaired dexterity, decreased blinking, drooling, expressionless face.
- Tremor at rest – involuntary shaking that decreases with purposeful movement. Typically starts on one side of the body, usually the hand.
- Rigidity – stiffness caused by involuntary increase in muscle tone.
- Postural instability – sense of imbalance. Patients often compensate by lowering their center of gravity, which results in a stooped posture.
Other symptoms that may or may not occur:
Freezing or being stuck in place Shuffling gait or dragging of one foot Stooped posture Cognitive impairment
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 .
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