Doctor's Notes on Parkinson's Disease
Parkinson's disease (PD) is an age-related degenerative disorder of certain brain cells that affects body movements. In some people, one or more cognitive processes are impaired. When this impairment is severe enough to interfere with a person’s ability to perform daily tasks, this is considered Parkinson's disease dementia.
Symptoms of Parkinson's disease include tremors (shaking), stiffness of the trunk and limbs, slow of movement, loss of balance and coordination, shuffling, problems speaking, facial masking (expressionless, mask-like face), swallowing problems, and stooped posture. Parkinson’s patients (both those with and without dementia) may also become indecisive, fearful, dependent, and passive.
Dementia in Parkinson’s disease may range from mild to severe. Symptoms of Parkinson's disease dementia include
- the inability to make decisions,
- difficulty adapting to changes,
- disorientation in familiar surroundings,
- difficulty learning new things,
- problems with concentration,
- memory loss (short-term and long-term),
- difficulty sequencing events in correct order, and
- problems using and understanding language.
What Is the Treatment for Parkinson's Disease Dementia?
There are no current treatments to specifically treat Parkinson’s disease dementia. A team of providers including psychiatrists, geriatricians, and neurologists may be involved in the care of Parkinson’s disease dementia patients.
Various medications and therapies are used to treat the symptoms of Parkinson’s disease dementia. These medications and therapies include:
- Selective serotonin reuptake inhibitor (SSRI) antidepressants to treat mood disorders and depression
- Cholinesterase inhibitors help with thinking and behavior
- Melatonin for sleep problems, which are common
- Benzodiazepines may be used sparingly and in low doses to help anxiety and sleep problems
- Deep brain stimulators are being researched for treatment
Dementia from Parkinson’s disease is progressive and patients may ultimately need full-time nursing care.
Parkinson's Disease : Test Your Medical IQ Quiz
QuestionParkinson's disease is only seen in people of advanced age.
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Dementia (Loss of Memory)
Dementia is the loss of reasoning, memory, and other mental abilities. Dementia may be caused by irreversible causes such as Alzheimer's disease, Parkinson's dementia, Lewy body dementia, and vascular dementia. There are also treatable causes of dementia such as infections, head injury, normal hydrocephalus, and metabolic and hormonal disorders. Early symptoms of dementia include forgetting appointments and names, losing things, difficulties performing familiar tasks (driving, cooking, household chores), personality changes, mood swings, paranoia, and suspiciousness. There are 7 types of dementia. A variety of tests (blood tests, scans, assessment of family history) may be used to diagnose dementia. Treatment may include medication and behavioral therapy. -
How Does Parkinson's Affect Motor Control?
Motor symptoms of Parkinson's worsen over time and include shaking or tremor, stiffness or rigidity, postural instability, and slowness of movement (bradykinesia). -
How Does Parkinson's Start?
Parkinson’s disease usually starts slowly and may only cause mild symptoms early on, including shaking (tremors), slow movement (bradykinesia), or muscle stiffness or rigidity. Parkinson’s disease is a degenerative and chronic brain disorder that affects movement. It can affect other brain functions such as learning and memory. -
Lewy Bodies Dementia (LBD)
Dementia with Lewy bodies or Lewy body dementia is the name for a group in which dementia is caused by the presence of Lewy bodies in the brain. The cause is not known. Lewy body dementia symptoms include recent loss of memory, difficulty concentrating or paying attention, misperceptions of space and time, the inability to think or reason, abnormal movements of Parkinson's disease, depression, delusions, agitation, and unexplained fainting. Treatment for dementia with Lewy bodies is focused on lifestyle changes, care for the individual with dementia with Lewy bodies, and medication to manage symptoms. -
Parkinson's Disease
Parkinson's disease is progressive disease that affects movement, balance, and muscle control. Learn about symptoms, diagnosis, and treatment. -
Stroke-Related Dementia
Dementia is a blanket term to describe significant cognitive and memory decay that could be caused by a number of different conditions. A stroke is a bleed or blockage in the blood vessels that may starve parts of the brain of oxygen. Thought and memory impairment due to a stroke is called vascular dementia. Medications and behavioral therapy may prevent further strokes and slow cognitive decline, but stroke damage cannot be repaired after more than a few hours after the event. -
What Are the Five Stages of Parkinson’s Disease?
Parkinson's disease is a neurodegenerative disorder with symptoms that get worse over time. There are five stages of Parkinson’s disease, which range from mild movement symptoms to needing around-the-clock nursing care.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.