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Living with Dementia

Types of Dementia Parkinson’s Disease

  • - Parkinson's Disease Dementia
  • Jun 23, 2011
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Tags: | alpha-synuclein | alzheimer's disease | dementia parkinson's disease | depression |

Parkinson’s Disease is a common disorder of deep brain structures that help control movement. Over time, many people with Parkinson’s disease develop Parkinson’s Disease Dementia. The majority of Parkinson’s Disease patients over the age if 65 develop dementia within a few years. Even younger people with Parkinson’s Disease can develop dementia -  one community - based study found that just over one person in ten with Parkinson’s Disease between the ages of 50 and 60 had already developed dementia.

In Parkinson’s disease, an abnormal Protein accumulates inside neurons in deep brain structures known as the substantia nigra. This abnormal accumulation of what is called “alpha-synuclein” was first described by a Professor Lewy and still bears the name of being a “Lewy body”. Lewy bodies are also seen outside the deep brain structures, in the thinking” parts of the brain in Parkinson’s Disease Dementia and in Lewy body dementia.

The main difference between Parkinson’s Disease dementia and Lewy Body dementia is a bit arbitrary. If motor symptoms come first, by at least a year, and dementia develops later, the convention is to call it Parkinson’s Disease dementia. If the motor symptoms follow the dementia symptoms, the convention is to call it Lewy Body dementia (or dementia with Lewy bodies”).

In Parkinson’s disease,  one of the chief abnormalities is loss of the brain chemical (neurotransmitter) dopamine. The usual treatment consists of medications that can increase the levels of dopamine, either by supplying more of it, or by slowing its breakdown.

Symptoms of Parkinson’s Disease Dementia

Given that Alzheimer’s disease is so common, and its stages are so characteristic, one way to understand the symptoms of Parkinson’s Disease Dementia is that while they are similar to those of Alzheimer’s disease, they occur out of order. Early in the course of Parkinson’s disease dementia, mental slowing is seen. Another sign is mental inflexibility. Compared to people with Alzheimer’s disease, those with Parkinson’s disease dementia have somewhat worse visuospatial function, although at the early stages, this is usually demonstrated better by formal testing (such as the clock drawing task) than is seen in everyday life.

Hallucinations are often seen in Parkinson’s disease dementia. The hallucinations typically consist of seeing things that are not there. In Alzheimer’s disease, hallucinations generally occur late (e.g. in the severe stage), but in Parkinson’s Disease dementia, they usually occur early (when the dementia is in the mild stage. In fact, in Parkinson’s disease dementia, hallucinations can be an early sign of dementia. Even when seen as a reaction to too much dopamine, they can be a sign of dementia to follow later.

Symptoms that are more specific for Parkinson’s Disease dementia are a mild memory impairment that at first responds to hints and cues. just as in Lewy Body dementia, patients with Parkinson’s Disease dementia can show large changes in attention and alertness from day to day (one day they are able to hold conversation, next day the cannot). Other manifestations of fluctuation in symptoms are episodes of starring blankly, especially if if occurs to such an extent that you find yourself touching or even shaking the person you care for so that they will “snap out of it”. Daytime sleepiness can be another sign of fluctuation. Sometimes, for reasons that are not clear, the fluctuation in alertness can be made better by making changes to medications that smooth out the level of dopamine.

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