A monthly article brought to you by Senior Services Memory Support Programs

Parkinson’s disease dementia is a decline in thinking and reasoning that develops in many people living with Parkinson’s at least a year after diagnosis. The brain changes caused by Parkinson’s disease begin in a region that plays a key role in movement, leading to early symptoms that include tremors and shakiness, muscle stiffness, a shuffling step, stooped posture, difficulty initiating movement and lack of facial expression. As brain changes caused by Parkinson’s gradually spread, they often begin to affect mental functions, including memory and the ability to pay attention, make sound judgments, and plan the steps needed to complete a task.

The key brain changes linked to Parkinson’s disease and Parkinson’s disease dementia are abnormal microscopic deposits composed chiefly of a protein found widely in the brain with a normal function not fully known. The deposits are called “Lewy bodies”. Lewy bodies are also found in several other brain disorders, including dementia with Lewy bodies (DLB).

Causes and risk factors
An estimated 50 to 80 percent of those with Parkinson’s eventually experience dementia as their disease progresses. Some studies have reported that the average time from onset of Parkinson’s to developing dementia is about 10 years.

Certain factors at the time of Parkinson’s diagnosis may increase future dementia risk, including advanced age, greater severity of motor symptoms and mild cognitive impairment (MCI).

Additional risk factors may include:

• The presence of hallucinations in a person who doesn’t yet have other dementia symptoms
• Excessive daytime sleepiness
• A Parkinson’s symptom pattern known as postural instability and gait disturbance (PIGD), which includes “freezing” in mid-step difficulty initiating movement, shuffling, problems with balancing and falling.

Symptoms

• Commonly reported symptoms include:
• Changes in memory, concentration and judgment
• Trouble interpreting visual information
• Muffled speech
• Visual hallucinations
• Delusions, especially paranoid ideas
• Depression, irritability and anxiety
• Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder.

Diagnosis

There is no single test — or combination of tests — that conclusively determines that a person has Parkinson’s disease dementia.

Guidelines for diagnosing Parkinson’s disease dementia and DLB are:

• The diagnosis is Parkinson’s disease dementia when a person is originally diagnosed with Parkinson’s disease based on symptoms related to movement and dementia symptoms don’t appear until a year later or more.
• The diagnosis is DLB when dementia symptoms consistent with DLB either develop first; are present along with symptoms related to movement, or appear within one year after movement symptoms.

Because Parkinson’s disease and Parkinson’s disease dementia damage and destroy brain cells, both disorders worsen over time. Their speed of progression can vary widely.

There are no medical treatments to slow or stop the brain cell damage caused by Parkinson’s disease dementia. Current strategies focus on improving symptoms. If your treatment plan includes medications, it’s important to work closely with your physician to identify the medications that work best for you.

There are many non-pharmacological interventions that may help the person living with PD Dementia to improve their quality of life. Some of these may include: physical exercise focused on balance; cognitive activity designed for memory, concentration and language; and use of adaptive equipment (i.e. U-Step walker, weighted silverware)

Senior Services offers an array of memory support programs including free and confidential memory screenings to obtain a cognitive baseline, our early memory loss program, and educational classes along with support from Seasons Adult Day Health Services. If you or someone you know is experiencing increasing changes with their memory and could benefit from additional services, please contact Amy Sheridan, Family Support and Activity Manager at 989-633-3764.

Please continue to check out the section, Our Mind Matters, next month.