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.
Epidemiology Of Dementia And Parkinsons Disease
Dementia and PD are both diagnosed frequently and increase mortality . Perhaps dementia is perceived more so as a memory problem and a disease of old age, but the incidence of dementia and PD in younger age is similar. In the Netherlands, for dementia, the incidence per 1,000 person-years is 0.4 among those aged 6064 , and for PD, it is 0.3 . Dementia incidence patterns, however, show a much steeper increase with age mounting to 27 per 1,000 person-years for those 85 and over, compared to 4 for PD over 85. In view of similar mortality , therefore, the prevalence of dementia in the general population is much higher than prevalence of PD . However, adjusted for age and other factors, 6-year mortality in PD is higher than in Alzheimers dementia . Age adjustment is relevant also as it shows that comorbid disease may be equally prevalent for Alzheimersa main type of dementiaand PD across the same age groups .
Whats The Difference Between Lewy Body Dementia Parkinsons Disease And Alzheimers 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.
Also Check: Parkinson’s Medication Not Working
Theres No Cure For The Diseases But Some Therapies May Help
Certain drugs, like cholinesterase inhibitors and antipsychotic medications, are prescribed as treatment for people with Parkinsons and dementia. And lifestyle changesfrom improved diet, sleep, exercise and socializinghave been shown to have beneficial effects on patients with these diseases.
Oguh noted she hopes that improved treatments that will help some of the emotional and behavioral problems in these patients will be on the horizon soon.
Im hoping that with the new advances in medication, well be able to control better, Oguh said. I believe there will be better medication to improve cognition in patients, and that that will be seen in the next five to 10 years.
Dementia Caused By Huntingtons Disease
Huntingtons disease is an inherited degenerative brain disease that affects the mind and body. It usually appears between the ages of 30 and 50, and is characterised by intellectual decline and irregular involuntary movement of the limbs or facial muscles. Other symptoms include personality change, memory disturbance, slurred speech, impaired judgement and psychiatric problems.There is no treatment available to stop the progression of this disease, but medication can control movement disorders and psychiatric symptoms. Dementia occurs in the majority of people with Huntingtons disease.
Also Check: Does Parkinson’s Get Worse
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.
What Is Parkinsons Disease
Parkinsons disease was described by James Parkinson nearly 100 years before Dr. Alois Alzheimer described the dementia later named Alzheimers disease . Called the shaking palsy by Parkinson, PD is diagnosed when a person shows at least two of these three symptoms: slowed movements , muscle rigidity, and tremor . We recognize many other associated signs of PD, including expressionless face, quiet speech, cramped handwriting, shuffling gait, trouble getting out of a chair, and difficulty swallowing. Many of the symptoms of idiopathic Parkinson’s disease result when certain nerve cells that produce dopamine in the brain begin to malfunction and die.
Most cases are called idiopathic, meaning the cause remains unknown, although a small number of cases are linked with poisoning , head trauma, more complex PD-like neurological disorders , or reversible toxic medication effects ,
You May Like: Barrow Neurological Institute Parkinson’s Disease
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
See A Doctor If Youre Noticing Symptoms Beyond Parkinsons
Sometimes the mood or memory changes a person experiences cannot entirely be explained just by Parkinsons. If this is the case, the caregiver should explore other diagnoses, because if something cannot be explained by Parkinsons, theres certainly a risk of it being dementia, Oguh said.
She added that some signs to look for include increased memory and behavioral problems, like mood swings, anxiety or depression. Psychiatric behaviors, like hallucinations, delusions or paranoia, cannot just be explained by Parkinsons, and are more likely to be caused by a form of dementia like Lewy body dementia.
Oguh urged caregivers to be aware of changing symptoms like these.
I think sometimes family members are able to realize sooner than the patient, Oguh said. Often the patient might lack insight as to what is happening. I would encourage family members to seek expert opinion and treatment options.
You May Like: Caring For Someone With Parkinsons
You May Like: Parkinson’s Protocol Jodi Knapp
More Differences Found Between Alzheimer’s And Parkinson’s
Although some research points to the possibility of a pathologic overlap between Alzheimer’s disease and Parkinson’s disease , 2 recent studies highlight the differences between these age-related neurodegenerative diseases.
One study found no significant evidence supporting the presence of loci that increase the risk for both PD and AD, while another study concluded that cognitively impaired patients with PD don’t exhibit the same pattern of -amyloid deposition in the brain as those with AD.
Although patients with AD and PD can share common clinical symptoms and neuropathology, the gene study, August 5 in JAMA Neurology, did not find any evidence for overlap of the genetic risk factors that underpin the 2 diseases.
“Our study does not support the hypothesis that AD and PD form a biological continuum, but instead suggests that the diseases are innately distinct,” said lead author Valentina Moskvina, PhD, Medical Research Council Center for Neuropsychiatric Genetic and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, United Kingdom.
A meta-analysis of combined AD and PD GWA studies used a previously published mathematical approach to adjust for lack of independence caused by controls being used in both studies. This analysis revealed no significant evidence for the presence of alleles that increase the risk for both diseases.
Lewy Body Dementia: A Common Yet Underdiagnosed Dementia
While its not a household word yet, Lewy body dementia is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States. Because LBD symptoms can closely resemble other more commonly known disorders like Alzheimers disease and Parkinsons, it is often underdiagnosed or misdiagnosed. In fact, many doctors or other medical professionals still are not familiar with LBD.
You May Like: Best Parkinson’s Treatment Centers In The World
Psychotic Symptoms And More
In addition to the symptoms we have already mentioned, there are others that can occur in both diseases. In Alzheimers disease, for example, delirium sometimes occurs. However, this only rarely occurs in Parkinsons. It is important to remember that delirium is an organic disorder that primarily affects consciousness and attention.
In the case of psychotic symptoms, visual hallucinations may occur in both diseases, more or less in the same proportion. Delusions can also occur. They often occur with Alzheimers and sometimes with Parkinsons.
Also Check: Music Therapy For Parkinsons
What Medications Are Available To Manage Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, include:
- Cholinesterase inhibitors, including donepezil , rivastigmine and galantamine .
- NMDA receptor antagonist memantine .
- Anti-amyloid antibody aducanumab .
Healthcare providers use these drugs to treat people with some of the other forms of dementia.
Cholinesterase inhibitors and the NMDA receptor antagonist affect different chemical processes in your brain. Both drug classes have been shown to provide some benefit in improving or stabilizing memory function in some people with dementia.
Cholinesterase inhibitors manage the chemicals in your brain that allow messages to be sent between brain cells, which is needed for proper brain function. Memantine works similarly to cholinesterase inhibitors except it works on a different chemical messenger and helps the nerve cells survive longer.
Aducanumab targets amyloid proteins, which build up into the plaques seen in the brains of people with Alzheimers disease.
Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, healthcare providers prescribe the appropriate drugs used to treat those specific conditions. These other conditions include sleeping problems, depression, hallucinations and agitation.
Don’t Miss: Pharmacological Treatment Of Parkinson’s Disease
Alliance Homecare Provides Support
Living with Parkinsons or Alzheimers can be difficult. Caring for someone with either disease can be overwhelming. This is where we at Alliance homecare can help. Our expertly trained Alzheimers and Parkinsons homecare professionals are there to assist and support when daily activities become too difficult.
Its never easy to admit that you need help, but theres no shame in needing support. At Alliance, we respect your journey and are here to provide you with the personalized in home nurse care that will best support your needs.
Keep Your Mind Or Body
If you are wondering which is worse between Alzheimers and Parkinsons, one must decide whether you prefer to lose control of your mind or your body. Parkinsons disease is marked by the loss of control of the body.
Alzheimers affects the brain and progressively gets worse. You can read about the 7 stages of Alzheimers here.
Parkinsons patients will have symptoms like muscle rigidity, body tremors, slowed movements and shuffled walking. Its mostly the body that is affected. Parkinsons patients only have mild cognitive disabilities. On the other hand, the symptoms of Alzheimers are like memory loss, struggling to recall words and forgetting to do otherwise simple tasks like driving.
A Parkinsons patient may have their memory intact but have a problem walking straight or moving their body. An Alzheimers patient loses both their cognitive function and ability to do anything for their own. When you look at it from this perspective, then Alzheimers is usually considered worse off than Parkinsons.
But really, there should be no awful competition between the two conditions because both are known to be incurable and eventually lead to death. They also present some similarities in symptoms and they are both degenerative conditions.
Also Check: Acting Out Dreams And Parkinson’s
Psychotic Symptoms And Others
In addition to the symptoms we already mentioned, other symptoms may appear in both diseases. For example, in Alzheimers disease, delirium appears occasionally, while it rarely ever does in Parkinsons. Its vital to remember that delirium is an organic disorder that mainly affects consciousness and attention.
Regarding psychotic symptoms, visual hallucinations can appear in both diseases, more or less in the same proportion. Delusions may also arise. They occur often in Alzheimers and occasionally in Parkinsons.
What Are The Causes Of Dementia
Dementia is caused by damage to your brain. Dementia affects your brains nerve cells, which destroys your brains ability to communicate with its various areas. Dementia can also result from blocked blood flow to your brain, depriving it of needed oxygen and nutrients. Without oxygen and nutrients, brain tissue dies.
Damage to your brain results in different symptoms, depending on the area of your brain affected. Some dementias arent reversible and will worsen over time. Other dementias are due to other medical conditions that also affect your brain. Another group of health issues can result in dementia-like symptoms. Many of these conditions are treatable, and the dementia symptoms are reversible.
All of the possible causes of dementia are discussed in the question, Are there different types of dementia?
Recommended Reading: Top Selling Parkinson’s Drugs
Treatments For Parkinsons Disease Dementia And Dementia With Lewy Bodies
Treatments for DLB are similar to PDD and are aimed at symptom control. The motor symptoms of slowness, stiffness and walking difficulties can be treated with Levodopa. However, Levodopa can cause or exacerbate hallucinations, making it difficult to use it as a treatment for patients who have or are at risk of having hallucinations. Sometimes, clinicians will need to treat the hallucinations more aggressively in order for a patient to tolerate Levodopa given to help the motor symptoms. On the flipside, anti-psychotic medications to control hallucinations can worsen motor symptoms, so treating all the symptoms of LBD simultaneously can be a tricky balancing act.
What Is Alzheimers Disease
Alzheimers is named after Dr. Alois Alzheimer, a German neurologist who first discovered the cognitive function disease. Alzheimers disease is a neurologic disorder that is characterized by damage to the brain cells and actual brain shrinkage, or atrophy. Alzheimers disease is the leading cause of dementia, a generic term for behavioral and cognitive decline that may affect your basic ability to function as an AD patient.
While research still does not know the exact cause of Alzheimers disease, the basic mechanism involves dysfunction in brain proteins. This disrupts normal function in brain cells for an AD patient, known as neurons. The neurodegenerative disease results in damage to the neurons, a loss of connection between neurons, and eventually dead brain cells for an Alzheimers patient. This process typically starts in areas of the brain involved with memory, but this can start years prior to any noticeable cognitive symptoms. The neuronal atrophy eventually spreads to other regions of the brain, leading to increased brain shrinkage and severe cognitive issues.
There is currently no known cure for an Alzheimers patient, but medication can help to manage symptoms, maximize function, and slow the cognitive impairment diseases progress, enough to support your independence for some time.
Recommended Reading: Shoes For People With Parkinsons
Differences Between Alzheimers And Parkinsons
Were going to group the differences between both illnesses into different blocks and explain what each of them consists of. All of them have been extracted from two reference psychopathology manuals: Belloch, Sandín, and Ramos and the DSM-5 .
The first block of differences between Alzheimers and Parkinsons refers to their type of symptoms. Lets see what they are.
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
- Paying attention
If you have Parkinson disease and dementia, in time, you likely wont be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts dont 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 Alzheimers disease, another type of dementia.
Read Also: Drugs Prescribed For Parkinsons Disease
You May Like: Driving Test For Parkinson’s Patients