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Parkinson’s Disease Dementia

Parkinson’s disease is a fairly common neurological disorder, affecting nearly two percent of older adults over the age of 65. Parkinson’s disease dementia is the degenerative impairment in thinking and reasoning that often develops with Parkinson’s disease. Parkinson’s disease dementia is the result of deep-brain changes that affect brain cells and often presents similarly to dementia with Lewy bodies. It’s estimated that 50-80% of Parkinson’s disease sufferers eventually develop Parkinson’s disease dementia.

Parkinson’s disease dementia shares similarities in symptoms with other dementias. Lewy bodies are present in Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease. Many people who have dementia with Lewy bodies also experience some of the same movement symptoms associated with Parkinson’s disease, such as rigid muscles, hunched posture, trouble initiating movement and a shuffling gait. This correspondence of symptoms and other scientific evidence suggests a link between these three causes of dementia.

Symptoms of Parkinson’s Disease Dementia

On average, the timeframe between the onset of Parkinson’s disease symptoms to a dementia diagnosis is 10 years. Common symptoms of Parkinson’s disease dementia include:

  • Muffled speech
  • Changes in memory, concentration and/or judgment
  • Trouble understanding and interpreting visual cues
  • Experiencing varying degrees of depression and/or anxiety
  • Visual hallucinations, delusions and paranoid thoughts and/or ideas
  • Sleep disturbances, which include excessive daytime drowsiness and REM sleep disorder
  • Irritability and anxiety

Brain or Physical Changes Associated with Parkinson’s Disease Dementia

Changes begin in the region of the brain that plays a key role in movement. This often causes the classic shuffling gait associated with Parkinson’s disease. As the disease continues to affect the brain, mental functions begin to be impacted as well. These functions often include memory, the ability to pay attention, ability to plan the steps necessary to complete a task and the ability to make sound judgments.

Parkinson’s disease dementia leads to changes in the brain exhibited as microscopic, abnormal protein deposits called Lewy bodies, just like those common to dementia with Lewy bodies. Many people with Parkinson’s disease dementia and dementia with Lewy bodies also have the hallmark plaques and tangles associated with Alzheimer’s disease. Much research still needs to be done to discover the close ties and similarities these three types of dementia share.

Causes/Risk Factors of Parkinson’s Disease Dementia

Obviously, the greatest risk factor for developing Parkinson’s disease dementia is having Parkinson’s disease. Additionally, certain other risk factors at the time of the Parkinson’s disease diagnosis increase a person’s likelihood of developing the associated dementia. Those risk factors include a person having any of the following at the time of their initial Parkinson’s diagnosis:

  • Mild cognitive impairment
  • Significant and excessive daytime drowsiness
  • Hallucinations, especially in a person who doesn’t have other dementia symptoms
  • Gait disturbance, specifically known as “postural instability and gait disorder” or PIGD which includes difficulty initiating movement, shuffling, “freezing” in mid-step, problems with balance and falling

Other specific risk factors that may also increase the development of Parkinson’s disease dementia (if present at the time of the Parkinson’s diagnosis) is:

  • Being older
  • Having motor function symptoms that are considered severe

Diagnosis, Treatment and Care of Parkinson’s Disease Dementia

No one test, or group of tests, exist to conclusively confirm a Parkinson’s disease dementia diagnosis; however, when a person with Parkinson’s disease presents with dementia symptoms a year or more after the original disease diagnosis, the diagnosis of Parkinson’s disease dementia is generally given.

Since a person with Parkinson’s disease is at greater risk of developing dementia as the Parkinson’s disease progresses, healthcare professionals monitor those with Parkinson’s closely for signs of cognitive and other thinking changes. At first sign of cognitive changes, a healthcare professional will request magnetic resonance imaging (MRI) to rule out tumors, evidence of vascular disease or any other structural changes.

Currently, there are no treatments to slow or stop the brain cell damage brought on by Parkinson’s disease dementia; however, medications are used to help with the symptoms. It’s very important to work closely with your healthcare professionals to find the medications that work for you and to find the most effective dose.

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