Although people may live a normal life span with Parkinson’s, there is no cure. Treatment focuses on managing symptoms. Some people with Parkinson’s may benefit from Deep Brain Stimulation, in which a surgically implanted device delivers electrical stimulation to the areas in the brain responsible for controlling movement. This interrupts the abnormal nerve signals that cause tremors and other symptoms. Help with symptoms can also come from physiotherapy, occupational therapy, speech therapy, and exercise.
As Parkinson’s progresses, it will cause dementia in approximately 50-80% of sufferers. The dementia experienced by people with PD is associated with abnormalities that start in the mid-brain. These includes difficulties with attention, organizing, multi-tasking, shifting attention, task completion, decision-making, problem solving, memory retrieval and word-finding.
This can be compared to Alzheimer’s dementia, which typically starts in the entorhinal cortex, and often next spreads to the hippocampus, the area where memories are formed. The result is that Alzheimer’s disease tends to present first as short term memory loss.
When cognitive decline and/or dementia appears less than a year before or at the same time as the onset of motor symptoms the diagnosis of Lewy Body Dementia (LBD), may be made. When the motor symptoms appear more than a year before the dementia, it is generally diagnosed as Parkinson’s Disease. The two can appear very similar. People with PD or LBD both have abnormal clumps of proteins,called lewy bodies, in the brain stem. One of these proteins, alpha-synuclein, cannot be broken down by cells. Lewy bodies surround cells in the brain, causing the problems with motor coordination, and eventually leading to brain degeneration.
It is crucial that someone with PD takes their medication as prescribed and on time. If they do not, delirium may occur, the symptoms of which are similar to dementia. Thus, it is important to monitor how medications are taken. If you are concerned that dementia is developing, bring an accurate list of symptoms you are seeing or experiencing when you see your neurologist. If possible, a caregiver, friend or family member should be present during your appointment.
While primary help must come from a trusted medical team, people with Parkinson’s and their family members and caregivers should also seek out support and information from an organization such as the Parkinson Society British Columbia. They will give you tips, literature, and tools for managing the emotional and practical symptoms of the disease. Counselling and support groups are also available through them.
We are indebted to Courtney Hanna, MCP, RCC of the Parkinson Society of British Columbia for her collaboration in this article.She can be reached at at 1-800-668-3330. Any errors are those of the Elder Voice staff.