Parkinson's disease is a neurodegenerative disease, that means, there is progressive loss of the functions of the nervous system. This shut down does not happen overnight, but very, very slowly. A patient gradually slips down a deep abysses of no return. Parkinson's is very similar to Alzheimer's disease and only a doctor can differentiate between the two. Parkinson's normally strikes people who are over 60 years, but nowadays, it is striking people at a younger age. Parkinson's dementia is also known as Parkinson's disease dementia or PDD. Before we go onto learning a bit about the stages and treatment, of this disorder, in the following paragraphs, you need to know that the most uncommon feature of Parkinson's disease is dementia. Studies have shown that only about 20% people with Parkinson's disease may develop Parkinson's dementia or PDD. Patients with Parkinson's who develop hallucinations are at higher risk of developing dementia.
What is Parkinson's Disease?
This is a chronic progressive disease that happens when the group cells in the substantia nigra of the brain undergo malfunctioning and as a result die. Their death causes loss of a neurotransmitter, called dopamine. This chemical messenger is very important for carrying the signals from the brain that controls movement, coordination and initiation causing problems with decision-making and memory.
The patient starts losing balance, becomes slow and develops muscle rigidity as well as tremor. There is no cure for Parkinson's disease at present, but there are variety of treatments that help in improving the symptoms of the disease.
What is Parkinson's Dementia?
Dementia is a condition where patients suffer from loss of brain function. Each person suffers from different forms of dementia and experience different symptoms. There are a few people who develop dementia after they are diagnosed with Parkinson's for at least a year. This type of dementia is called Parkinson's dementia. Another condition is called as dementia with Lewy bodies. This condition is seen in patients who have Parkinson's-like symptoms affecting their motor skills or is showing symptoms of dementia.
Parkinson's Dementia Causes
The causes are not yet very clear. It is said the neurotransmitters malfunctioning can be due to high levels of herbicides and pesticides in the environment. Another Parkinson's disease cause may be a very serious physical or emotional trauma. In some cases, Parkinson's disease dementia is caused due to genetics and hereditary factors. When one inherits the Parkinson's disease A gene through an autosomal dominant trait, it may result in Parkinson's disease.
People with Parkinson's who experience hallucinations or delusions are at high risk of developing dementia. In some cases, when one person in the family suffers from dementia, there are chances that the patient with Parkinson's may develop dementia too.
Parkinson's Dementia Stages
There are five stages. These Parkinson's disease stages are explained as follows:
This is the mild or early stage. These early symptoms of Parkinson's disease usually affects only one side of the body. These symptoms tend to be a bit inconvenient to the patient, but are not fully disabling. There is tremor in one limb, slight changes in posture, movements and facial expression seen.
In this stage, both sides of body are affected and the person has a normal posture. There is minimal disability with some problems in the normal gait. These symptoms include rigidity of limbs and slow body movements. The patient tends to show positive response to medications.
Here, both sides of body get affected with minor imbalances while standing and walking. Even in this stage, the patient is independent and has moderately severe generalized disability. The patient shows dyskinesias, wearing off effects of the medications, etc.
This is an advanced stage where the patient has disabling instability while standing or walking. There is marked change in the posture and the patient has problems speaking, sleeping and the autonomic nervous system impairment and can lead to him falling down frequently. In this stage, the person requires help and the tremors seem to reduce as compared to the initial stages.
This the severe and fully developed Parkinson's disease stage. The patient becomes restricted to a chair or bed. The patient shows cognitive functions, loss of motor skills and needs constant nursing care. The patient has incontinence of bowel and bladder, loss of ability to turn over while sleeping, inability to speak or find the correct word. The patient has intelligence deterioration and develops infections such as pneumonia.
The patient tends to develop loss of appetite, breathing difficulty, swallowing problems, and severe agitation. They tend to fall more than often leading to lot of injuries. They develop depression and anxiety due to their condition. It is very common to observe Parkinson's dementia hallucinations in the end stage. This is because of the neurodegenerative process that also causes delusions, phobias and personality changes apart from hallucinations.
Parkinson's Dementia Treatment
There is no cure for Parkinson's disease dementia, but there are treatment options available that help in reducing the symptoms. These treatment options help make Parkinson's disease prognosis better. The Parkinson's treatment include medications like levodopa, carbidopa, entacapone, dopamine agonists and monoamine oxidase inhibitors. Surgical options include deep brain stimulation (DBS) that helps in reduction of the muscle rigidity and slow movements. Physical therapy, exercises and group wellness programs are a part of treatment.
Parkinson's Dementia Life Expectancy
The Parkinson's disease dementia gradually progresses with time. The life expectancy is less than those without the disease. In some people, the disease may take over 20 years to progress and in some, it may progress very quickly. The cause of death is never the disease itself. It is mostly due to complications associated with it. These may include a fatal fall, choking, sepsis, stroke, vascular disease of the brain or chronic infection. The Parkinson's disease life expectancy has improved with the treatment options available today as well as the quality of life for these patients has improved a lot.
People suffering from Parkinson's dementia require a lot of care and attention. It becomes very frustrating for the patient when they cannot understand others or take care of themselves. In such a time, extend all your support to the patient. Do not get angry or irritated with the patient when they cannot understand you. Instead, have patience and treat them just as you would treat a child. Speak clearly, have a positive body language and make sure you make eye contact with the patient. They understand body language and may find it intimidating or upsetting to see an agitated or negative body language of the care-giver. Eye contact is necessary to hold their attention when you communicate with them. You can take care of a patient with Parkinson's at home. But, if the patient becomes extremely agitated or difficult to manage, it would be wise to take professional help or shift them to a nursing home. Remember, your love and care will help control their symptoms to a great extent.
Parkinson's disease as well as Alzheimer's disease is seen elderly who are well over 60. It is very common to see patients with Parkinson's developing Alzheimer's dementia as well. Thus, these patients can be benefited from medications for Alzheimer's dementia as well. It is very important to visit a neurologist who can determine whether it is Parkinson's dementia, Alzheimer's dementia or a similar disorder called the Dementia with Lewy Bodies (DLB). There is no cure but a neurologist experienced in treating this disorder may help in reducing the severity of symptoms.