recognizing dementia

classic clinical signs of parkinson’s disease (PD) include:

1) resting tremor

2) rigidity (or stiffness)

3) postural instability (balance troubles)

and 4) bradykinesia (slowed movements, like rising from a chair)

However, nonmotor (i.e. pain, sleep difficulties) and psychological (i.e. apathy, depression, hallucinations) symptoms can also occur.

Dementia can also develop in PD. Epidemiology shows PD associated dementia (PDD) can occur in up to 80% of persons with PD, and is considered part of a spectrum of dementia diseases, that includes Alzheimer’s disease and Lewy Body diseases:

(Water, 2011)

What distinguishes PDD from other forms of dementia is that it develops at least 1-2 years after classic parkinsonian motor signs are evident. If the opposite it true (i.e. dementia signs first, then motor signs), it is recognized as dementia with Lewy Bodies.

PDD is mainly attributed to an accumulation of a protein, Lewy Body, in the brain.

There is overlap in both pathology and symptoms in the many forms of dementia, and this can make diagnosis difficult!

In PDD, people usually have major problems with attention, executive functioning (i.e. how to sequence actions and perform tasks), and memory retrieval (i.e. recalling information from your long-term memory). Whereas in Alzheimer’s disease, the memory problem is more often storing memories.

More and more research is being done to understand this tangled web of dementia pathologies and symptoms, especially to help with accurate diagnosis… but what are the implications for the PD caregiver? much love.

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