Parkinson’s Dementia: Symptoms, Causes And Treatment
Parkinson’s dementia arises from Parkinson’s disease This appears in 20-60% of the cases in which this condition occurs, and involves a series of motor symptoms (tremors, slowness…), impoverishment in language and thinking, and cognitive symptoms.
It is a subcortical dementia that usually appears at advanced ages. Although the cause is unknown, a significant decrease in the amounts of dopamine in the brain has been observed in patients with Parkinson’s dementia. Let’s see what its characteristics are.
Parkinson’s dementia arises from Parkinson’s disease. Specifically, between 20 and 60% of people with Parkinson’s disease also end up developing Parkinson’s dementia.
Regarding your course, Its onset occurs between 50 and 60 years of age The deterioration is usually slow and progressive, and affects the person’s cognitive, motor and autonomy skills. On the other hand, its incidence is 789 people per 100,000 (over 79 years of age).
Parkinson’s disease
Parkinson’s disease generates certain motor alterations, such as tremor at rest, slowness of movement, postural instability difficulty starting and stopping an activity, rigidity and festinating gait (dragging feet and short steps).
But, in this article we will focus on the dementia that arises as a result of the disease:
Symptoms
When the disease progresses into dementia, it is characterized by a series of symptoms. According to the Diagnostic Manual of Mental Disorders (DSM-IV-TR), a dysexecutive syndrome linked to memory loss usually appears. In addition, other symptoms that appear are:
This translates into apathy, asthenia and abulia That is, the person loses the desire to do things, the pleasure that was previously experienced with them disappears, there is no motivation or willpower, etc.
2. Bradypsychia
Another typical symptom of Parkinson’s dementia is bradypsychia, which involves a slowdown in the thinking process In addition, there is also an associated impoverishment of language.
3. Bradykinesia
Involves slowness of movement something that has to do with both the Central Nervous System and the Peripheral Nervous System.
4. Visuospatial and visuoconstructive alterations
An impairment also appears in the visuospatial and visuoconstructive areas, which translates into difficulties moving and locating oneself in space, drawing, locating objects in space, etc., as well as difficulties in building (for example a tower with cubes) and get dressed.
5. Depression
Parkinson’s dementia too It is very frequently accompanied by depressive disorders of greater or lesser severity
6. Neuropsychological alterations
Alterations appear in memory and recognition, although these are less serious than in the case of Alzheimer’s dementia, for example.
Regarding the encoding and retrieval of information, There are important flaws in the memory recovery processes
Causes
The causes of Parkinson’s disease (and therefore Parkinson’s dementia) are actually unknown. However, has been related to alterations in the nigrostriatal fasciculus, specifically with a decrease in dopaminergic functioning in that structure. Dopamine is a neurotransmitter that is closely related to movement and the disorders related to it, typical of Parkinson’s dementia.
Furthermore, it has been observed that in patients with Parkinson’s Lewy bodies appear in the substantia nigra of the brain and in other nuclei of the brain stem. It is not known, however, if this is a cause or consequence of the disease itself.
The population at risk for Parkinson’s dementia, that is, people most vulnerable to developing it, are elderly people, who have had a late onset of Parkinson’s disease with greater severity in the disease itself, and with predominant symptoms of rigidity and akinesia (inability to initiate precise movement).
Treatment
Today, Parkinson’s dementia is a degenerative disease with no cure. Treatment will be based on trying to delay the appearance of symptoms and in treating or compensating for existing ones, so that they affect as little as possible.
For it cognitive neurorehabilitation program will be used and external strategies that can help the patient in their environment (use of agendas and memory reminders, for example).
In addition, symptoms associated with dementia, such as depression or anxiety, will be treated on a psychological and psychopharmacological level.
Antiparkinsonian
At a pharmacological level and to treat motor symptoms of the disease (not so much of dementia), antiparkinsonians are usually used These are aimed at reestablishing the balance between the dopaminergic system (dopamine), which is deficient, and the cholinergic system (Acetylcholine), which is overexcited.
Levodopa is the most effective and most widely used drug. Dopamine agonists are also used which increase their effectiveness in combination with levodopa (except in very early stages of the disease, where they can be administered alone).
Parkinson’s as subcortical dementia
As we have mentioned, Parkinson’s dementia consists of subcortical dementia ; This means that alterations occur in the subcortical area of ​​the brain. Another large group of dementias are cortical dementias, which typically include another well-known dementia, that due to Alzheimer’s disease.
But, continuing with subcortical dementias, they also include Parkinson’s dementia (dopamine deficiency), Huntington’s dementia (which involves GABA deficits) and HIV dementia (which involves alterations in the white matter).
All subcortical dementias have characteristic symptoms of motor alterations (extrapyramidal symptoms), slowing, bradypsychia, and decreased motivation.
