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Parkinson's Disease with Dementia -
Special Challenges

Remember that if someone is going to develop dementia, there is generally a “lag” of at least 10 to 15 years. If dementia develops earlier, it is important to take note of the symptoms and discuss them with your physician. Correctly diagnosing the cause will make treatment and adjustments much easier. Some signs that the dementia is caused by something other than Parkinson’s disease include: anxiety, restlessness, and even delusions (irrational thought processes). Speech or language difficulties are also a signal that the dementia is not caused by Parkinson’s.

Finally, depression can mimic the signs of dementia in Parkinson’s patients. Depression is a common companion to PD, and having your loved one fully evaluated can aid in their recovery from these troublesome symptoms if depression is the underlying cause. Medications to treat depression can bring relief and can even improve memory and mood. 

Lewy Bodies and their Role in Dementia:

In patients who develop dementia, Lewy bodies are usually present. Lewy bodies are protein deposits on the nerve cells. Scientists haven’t determined yet if the Lewy bodies play a role in killing the cells or if the cells, in the process of dying, are more susceptible to developing the protein deposits. Perhaps even the Lewy bodies develop as a method to repair the cell, and instead play a role in developing dementia.

Dopamine is the neurotransmitter involved in regulating movement. In Parkinson’s patients, the ability to regulate the amount of dopamine is damaged. For this reason, medications such as Levodopa, try to increase the amount of dopamine in the brain, thus helping the movement issues with Parkinson’s. Lewy bodies generally damage not just dopamine, but other neurotransmitters as well. By impairing movement and thought processes, the person with Parkinson’s demonstrates the symptoms of dementia: unable to process new information, blankly staring off into space, unable to recall specific incidences, and inability to make sound judgments. There are other symptoms as well, depending on the area of the brain that is damaged.

Medication-induced Dementia:

In some patients, the type of medication that they are taking can induce the symptoms of dementia. Regardless of the cause, your doctor needs to be involved as soon as symptoms are noted in the patient. By adjusting medications, your physician may be able to detect whether or not Lewy bodies are to blame or if the medication is actually causing the problem. Dementia is not a normal process of PD; and in the cases of medication inducing the dementia, it can be reversed.

Vascular Dementia:

Although not common in Parkinson’s, it is possible to have vascular dementia. Vascular dementia generally develops when there are small, unnoticed strokes. By determining if vascular dementia is indeed present, doctors can sometimes halt the advancement by treating the underlying causes. Further tests will be needed to find out if these strokes have occurred and what the underlying cause of the stroke was. By stabilizing the patient’s vascular health, you can greatly improve chances of improving vascular dementia.

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