What is Parkinson’s dementia?
Parkinson’s dementia is the term used by doctors to describe a dementia disorder in people with Parkinson’s syndrome that meets certain requirements. These include the fact that the dementia begins gradually and progresses slowly. In addition, at least two so-called cognitive functions must be impaired, for example attention, language or memory.
The impairments must be so severe that they restrict daily life, regardless of the motor symptoms associated with Parkinson’s syndrome.
Frequency of Parkinson’s dementia
Not all people with Parkinson’s disease develop dementia. However, the risk is around six times higher than for the general population. Experts assume that around 40 to 80 percent of those affected will develop Parkinson’s dementia during the course of the disease.
How long does the final stage of Parkinson’s dementia last?
However, it is known that Parkinson’s dementia increases mortality: many sufferers die within around five years of the onset of Parkinson’s dementia.
What are the symptoms of Parkinson’s dementia?
Parkinson’s dementia manifests itself through various disorders of cognitive functions:
- Impaired attention: Tasks that require a high level of attention are difficult for those affected to perform
- Difficulties in planning and carrying out activities
- Slowed thinking
- Impairments in spatial orientation and perception
- Difficulty recalling recent events or newly learned content
- Sometimes difficulty finding words and problems forming complicated sentences
In contrast to Alzheimer’s disease, which primarily affects short- and long-term memory, Parkinson’s dementia mainly affects attention and the speed of thought processes. The ability to learn itself is also retained, but learned content can only be recalled with a delay.
Parkinson’s dementia: diagnosis
If dementia such as Parkinson’s dementia is suspected, the doctor will carry out various examinations. First, however, they will take a medical history (anamnesis) by talking to the person affected and their relatives. For example, the doctor will ask for a detailed description of the symptoms, such as problems with concentration. The doctor will also ask how long these symptoms have existed, whether there are any other illnesses and what medication the patient is taking.
The medical history interview is followed by a physical examination. The doctor will also take a blood sample for laboratory analysis.
The doctor uses so-called short cognitive tests to check whether the person concerned is actually suffering from Parkinson’s dementia (or other dementia). However, these tests are not very meaningful in cases of mild dementia. In this case, an in-depth neuropsychological examination may be necessary.
If dementia is suspected, the brain is often imaged – using computer tomography (CT) or magnetic resonance imaging (MRI). In people with dementia, the images show that the brain tissue has shrunk (atrophy). In unclear cases of dementia, further examinations follow.
Parkinson’s dementia: treatment
Drug treatment for dementia
There are also medications that specifically alleviate the symptoms of Parkinson’s dementia. These primarily include preparations containing the active ingredient rivastigmine, which 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 remedies this deficiency by inhibiting the enzyme that normally breaks down acetylcholine. This means that brain functions such as thinking, learning and remembering are retained for longer. In addition, those affected can cope better with everyday life.
Be careful with antipsychotics!
Antipsychotics (neuroleptics) are drugs used to treat psychotic symptoms such as hallucinations. They are used for certain forms of dementia. In Parkinson’s dementia, however, most antipsychotics (classic and many atypical antipsychotics) are taboo. The reason for this is that those affected have an increased risk of side effects. In particular, such drugs can severely impair mobility and alertness (vigilance) in Parkinson’s syndrome.
Non-drug measures
Memory training (“brain jogging”) is suitable for mild forms of Parkinson’s dementia, as long as those affected participate with pleasure and without frustration. Artistic-expressive forms of therapy such as painting, music and dance may also have a positive effect on the well-being and health of those affected.
With Parkinson’s dementia, it is also important to design living spaces to meet the needs of the patient. This includes eliminating potential sources of danger and injury. For example, small carpets should be removed (tripping and slipping hazards!). To make it easier for those affected to find their way around their own four walls, it is a good idea to mark the different rooms with colors or symbols on the door, for example.
