Parkinson’s dementia develops in approximately one-third of people with Parkinson’s disease (shaking palsy). It differs in several ways from Alzheimer’s disease, the most common form of dementia. Read more about Parkinson’s dementia here: symptoms, differences from Alzheimer’s disease and treatment!
What is Parkinson’s dementia?
As Parkinson’s dementia refer to physicians dementia disease in Parkinson’s patients, which meets certain conditions. This implies that dementia begins slowly and slowly progresses. In addition, at least two so-called cognitive functions must be impaired, for example attention, language or memory. Only then can the doctor diagnose Parkinson’s dementia.
Frequency of Parkinson’s dementia
Not all Parkinson’s patients develop dementia. However, the risk is higher than in other people: Parkinson’s patients are about six times more likely to be dementia than the general population.
There is a risk of Parkinson’s dementia, especially in older age: in the group of over 75 year olds, about every second Parkinson’s patient additionally develops dementia. On the other hand, those who suffer from shaking palsy before the age of 40 are almost never denied.
Parkinson’s dementia: differences to Alzheimer’s
The most common form of dementia is Alzheimer’s disease. It is mainly associated with memory disorders: First, the short-term memory decreases, in later stages of the disease, the long-term memory.
In Parkinson’s dementia, on the other hand, other symptoms come to the fore: In those affected attention is impaired and thinking slows down. In addition, depression and hallucinations often develop. However, people with Parkinson’s dementia do not have memory problems until later stages of the disease.
Another difference between Parkinson’s dementia and Alzheimer’s dementia concerns the ability to learn: Alzheimer’s patients are no longer able to learn new things. In Parkinson’s dementia, on the other hand, the ability to learn remains intact – even if the patients can only retrieve the newly stored content with a delay.
Parkinson’s dementia: diagnosis
If you suspect dementia, such as Parkinson’s dementia, the doctor will perform various tests. First, however, first raises the medical history (anamnese) in conversation with the patient and relatives. For example, he can be described in detail the symptoms of the patient, such as the concentration problems. In addition, the doctor asks, since when these symptoms exist, if other diseases are present and what medication the patient takes.
After the anamnesis interview follows one physical examination.In addition, the doctor takes one blood sample for a laboratory analysis.
With so-calledcognitive short tests The doctor can check whether the patient actually has Parkinson’s dementia (or other dementia). However, these tests are not very meaningful in mild dementia. Then a deepening neuropsychological examination be necessary.
In dementia suspicion, the brain is often depicted – by means of Computed tomography (CT) or magnetic Resonance Imaging (MRI). In demented patients can be seen on the images that the brain tissue has shrunk (atrophy).
In unclear cases of dementia further investigations follow.
Parkinson’s dementia: treatment
First, it may be necessary to adapt the drugs to Parkinson’s disease itself. Some supplements can increase dementia. They should therefore be replaced with others who do not.
Drug treatment of dementia
There are also drugs that specifically alleviate the symptoms of Parkinson’s dementia. These include, in particular, preparations containing the active ingredient rivastigmine, This is a so-called acetylcholinesterase inhibitor:
Acetylcholinesterase is an enzyme that breaks down the nerve messenger (neurotransmitter) acetylcholine in the brain. As with Alzheimer’s dementia, there is also a lack of acetylcholine in Parkinson’s dementia. Rivastigmine can remedy this deficiency by inhibiting the breakdown enzyme of acetylcholine. Brain services such as thinking, learning and remembering are retained longer. In addition, the patients get along better in their everyday lives.
Rivastigmine can be taken as a capsule in early and middle stages of Parkinson’s dementia.
Another acetylcholinesterase inhibitor (donepezil) also seems to improve the brain performance and general condition of patients with Parkinson’s dementia. Its use in this disease, however, takes place without official approval (“off-label use”).
Beware of antipsychotic drugs!
Antipsychotics (antipsychotics) are medicines for psychotic symptoms such as hallucinations. They are used in certain types of dementia. In Parkinson’s dementia, however, most antipsychotics (classic and many atypical antipsychotics) should not be given. The reason is that patients are at an increased risk for side effects. Above all, such agents can significantly impair the mobility and alertness (vigilance) of Parkinson’s patients: the Parkinson’s symptoms are exacerbated and there are attacks of somnolence (somnolence).
Only the antipsychotics clozapine and (possibly) quetiapine can be used in Parkinson’s dementia.
Non-drug measures
In addition to medicines, non-pharmacological measures for Parkinson’s dementia (and other dementias) are very important. Recommended for example physiotherapy, healthy eating and a lot of exercise, Memory Training (“Brain jogging“) Lends itself to mild forms of Parkinson’s dementia, as long as those affected participate with joy and without frustration.
Artistic-expressive forms of therapy such as Painting, music and dance can also have a positive effect on the well-being and health of patients.
In Parkinson’s dementia, it is also important that living rooms to suit your needs, This includes eliminating possible sources of danger and injury. So you should remove, for example, small carpets (tripping and slipping hazard!). In addition, one can mark the different rooms (bath, kitchen etc.) in color or with symbols on the door. That helps people with Parkinson’s diseaseto better orient yourself in your own home.