Dementia in Parkinson's disease
Parkinson' disease is known
as a movement disorder. The movement disorder is due to dopaminergic neurons
mainly in the substantia nigra. Motor symptoms always precede cognitive impairment
by several years signs with an involvement of cognitive impairment due to
a degeneration changes in cortical structures with generally presence of
Synonyms: Shaking palsy
Symptoms The key features of cognitive impairment including
dementia in ParkD is slowing of thought, reduced attention, and impairment
executive function (planning, organising, solving problems). Patient may
become obsessional, sometimes loss of emotional control, sometimes outbursts
of anger. Medications may cause or aggravate visual hallucinations.
Language problems (slower speech, not word finding difficulties)
Caregiver problems With movement disorder, slowness in
information processing (difficulty of communication) may lead to carer frustration.
Epidemiology Parkinson's disease is not RARE, however,
only 10-20 % of the patients develop cognitive impairment / dementia
Aetiology Abnormal aggregation of alpha synuclein in Lewy
bodies. It is more than Lewy bodies accumulation. There are inherited form
of Parkinson's disease associated with mutation on chromosomes xxx.
Heredity Families with familial PD (several chromosomes involved)
Diagnostic procedures Nothing specific.
Treatment and rehabilitation The movement disorder is treated by compounds augmenting dopamine transmission.
Medication may cause or aggravate hallucinations and psychotic symptoms.
Ongoing research / Clinical trials Trials have been conducted
on small patient samples demonstrating benefits of Cholinesterase inhibitors
on cognitive ability.
Available services Parkinson's disease societies in several
countries. They provide services for the movement disorders but have less
information on the cognitive problems associated with the disorder.
If dementia refer to AD associations.