Theres A Spectrum Of Pathologies
Scientists have been examining this linkand how the two diseases often overlapfor some time, but still arent completely certain how they contribute to one another. As a result, physicians sometimes group the diseases into different combinations when making diagnoses.
Dementia in Parkinsons patients can present itself in varying forms. In some cases, the Parkinsons pathology can trigger the dementia pathologya situation that results in whats known as Parkinsons disease dementia, says Dr. Aaron Ritter, Director of the Clinical Research Program at the Cleveland Clinic Lou Ruvo Center for Brain Health.
A substantial subset of folks with Parkinsons who live long enough, will develop dementia, Ritter said.Its separate from Alzheimers, but its likely related to Parkinsons pathology, a sort of spreading of Parkinsons.
In other cases, patients may develop a form of dementia like Alzheimers separately from their Parkinsons disease, though this isnt visible until after death, through an autopsy.
Many people with Parkinsons may also develop Lewy body dementia shortly after their diagnosis. When you have Parkinsons, and see cognitive declineor things like hallucinations and delusionsup to a year after your Parkinsons diagnosis, you may have Lewy body dementia, Oguh said.
Meet The Disease That Feels Like Als Parkinson’s And Alzheimer’s All At Once
Being released this week is a new documentary from intrepid filmmaker Lucy Walker about confronting one of life’s most daunting moments.
Breakthroughs in modern science allow us the ability to take a peek under our genetic “hoods” at minimal cost and with unprecedented speed. Services like 23andMe allow any consumer to explore their gene profile, which could be empowering or frightening depending on your perspective and family history. This data, when used in the clinic, provides physicians incredible tools in the quest to practice fully personalized medicine.
Our genes provide the blueprint for our individuation, and come replete with a mixed bag of advantages and potential disadvantages — a natural person-to-person variation which was essential to driving our species forward by way of natural selection. Today, being tethered to negative health outcomes, especially when we can see these risks decades before their potential emergence, are inconvenient in a time when overcoming our biological limitations seems to be as natural as genes themselves.
In The Lion’s Mouth Opens, Walker focuses on young actress Marianna Palka as she finds out whether she has inherited this fate, an incurable degenerative disorder which took her father and now has a 50 percent chance of taking her body and her mind.
I couldn’t wait to ask my friend Lucy Walker about her experience documenting this harrowing journey, her thoughts on genetic testing, and how to get involved with Marianna’s story.
Diagnosis: Parkinsons Dementia Or Dementia With Lewy Bodies
During assessment, a specialist may look at when the dementia symptoms first appeared before reaching a diagnosis of Parkinsons dementia or dementia with Lewy bodies.
If there have been motor symptoms for at least one year before dementia symptoms occur, specialists will often give a diagnosis of Parkinsons dementia.
If dementia symptoms occur before or at the same time as motor symptoms, specialists will usually give a diagnosis of dementia with Lewy bodies.
However, it should be noted that in some cases of dementia with Lewy bodies, no motor symptoms develop at all.
Theres no single test diagnosis is made through several different assessments, usually starting with an appointment with your GP or Parkinsons nurse.
Some people find it helps to go to the appointment with someone who knows them well, who can give the GP or Parkinsons nurse information about changes theyve noticed.
Your GP can discuss your symptoms with you and carry out a physical examination, including blood and urine tests, to rule out other potential causes of the symptoms .
Your GP may also review your medication, in case your symptoms are side effects.
If your GP thinks you have dementia, they can refer you to a specialist, such as a neurologist, psychiatrist or geriatrician.
You might be referred to a memory clinic or memory service. In some areas of the country, you can refer yourself to these services.
But if you feel you need to see the specialist again, you can ask to be referred back.
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Sex Differences In Alzheimers And Parkinsons Diseases
Determining sex differences in disease phenotypes is the gateway to precision medicine, said Dr Maria Teresa Ferretti, co-founder of the Womens Brain Project, Switzerland, and co-chair of a symposium at ADPD2022 in which new evidence was presented on sex differences in an Alzheimers disease biomarker and aging-related sex differences in brain connectivity.
Sex-dependent changes in biomarkers
A biomarker of microglial activation and inflammation increases in men over time
The effect of sex on changes in biomarkers over time in cerebrospinal fluid samples have been investigated by Dr Claudia Cicognola, Lund University, Sweden.
Samples were collected at baseline and then every 2 years for 810 years from 801 cognitively unimpaired individuals and 265 individuals with mild cognitive impairment from the longitudinal Swedish BioFINDER cohort,1 explained Dr Cicognola.
A significant increase in soluble Triggering Receptor Expressed on Myeloid cells 2 , which is a biomarker of microglial activation and inflammation, was observed in men compared with women independently of amyloid-beta status.1
Aging-related sex differences in brain connectivity
Sex differences in normal aging brain could help explain different prevalences of neurodegenerative diseases in men and women
A novel multilayer analysis of brain connectivity captures the interaction between positive and negative connections
Results from all analyses revealed that:
Unsupervised Machine Learning For Patient Clustering
Based on the 15 dimensional SNP burden profile of each patient derived from SNP data we clustered patients. We here relied on sparse non-negative matrix factorization . Briefly, sNMF factorizes a patients times mechanisms matrix \ into a product of two non-negative matrices \ and \, where \ represents a sparse mapping of mechanisms to clusters and \ a soft assignment of patients to clusters,. That means, for each patient cluster it is possible to identify the most influencing mechanisms . Hence, sNMF effectively yields a bi-clustering. The entire clustering procedure is in practice is an iterative process that is dependent on the initialization of both matrices and should thus be repeated a number of times to yield a consensus. This consensus was used for further analysis.
The number of clusters \ corresponds to the number of columns of matrix \ and the number of rows of matrix \. We chose \ based on inspection of three statistical criteria and in comparison to a randomly permuted cluster assignment,,. We then decided for the minimal number of clusters \ yielding the most stable clustering solution that was at the same time exhibiting a significantly larger silhouette index and cophenetic correlation than expected by chance. Details are explained and shown in Supplements on page 28.
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Differences Between Parkinsons Disease And Alzheimers Disease
The primary difference between Alzheimers and Parkinsons disease is that they affect different areas of the brain. Alzheimers disease affects the brains memory and language center. Therefore, patients struggle with remembering incidents and taking part in conversations.
On the other hand, Parkinsons disease affects the cognitive area of the brain. Therefore, patients struggle with problem-solving, mood, memory, speed thinking, even moving muscles.
For the majority of patients, Alzheimers appears late in their life, typically after 60 years of age. On the other hand, most patients can be diagnosed with Parkinsons disease, typically between 50 to 65 years of age.
Although cognitive impairment is common in both diseases, many Parkinsons patients may not experience dementia.
Hearing loss may be a triggering factor for both of these diseases. However, some patients may experience hearing loss due to Parkinsons disease. Parkinsons patients lack dopamine and serotonin hormones that protect the cochlea from loud noises. Without enough of these hormones, many patients may develop hearing loss as a symptom of the disease rather than being a triggering factor.
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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Alzheimers Disease Vs Parkinson Disease
The main difference between Alzheimers disease and Parkinsons disease is that a deficiency of acetylcholine is linked to Alzheimers disease and usually induces the symptoms of Alzheimers patients whereas Parkinsons disease is mainly caused by a drop in dopamine levels in the brain. Both the diseases are brain disabilities with neurological malfunctioning along with reversed psychological tendencies.
Alzheimers disease is a neurodegenerative condition that causes the central nervous system to shrink and the death of brain cells.
Alzheimers disease is by far the most prevalent degenerative brain disease, which is defined as a progressive loss of cognitive, behavioral, and social abilities that impairs a persons capacity to operate alone
Dementia With Lewy Bodies And Parkinson Disease Dementia
, MD, PhD, Department of Neurology, University of Mississippi Medical Center
Dementia with Lewy bodiesParkinson disease dementia
Dementia is chronic, global, usually irreversible deterioration of cognition.
Dementia with Lewy bodies is the 3rd most common dementia. Age of onset is typically > 60.
Lewy bodies are spherical, eosinophilic, neuronal cytoplasmic inclusions composed of aggregates of alpha-synuclein, a synaptic protein. They occur in the cortex of some patients who have dementia with Lewy bodies. Neurotransmitter levels and neuronal pathways between the striatum and the neocortex are abnormal.
Lewy bodies also occur in the substantia nigra of patients with Parkinson disease Parkinson Disease Parkinson disease is a slowly progressive, degenerative disorder characterized by resting tremor, stiffness , slow and decreased movement , and eventually gait and/or… read more , and dementia may develop late in the disease. About 40% of patients with Parkinson disease develop Parkinson disease dementia, usually after age 70 and about 10 to 15 years after Parkinson disease has been diagnosed.
Both dementia with Lewy bodies and Parkinson disease dementia have a progressive course with a poor prognosis.
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What Is Alzheimers Disease
Alzheimers is a degenerative brain disease that causes 60-80% of dementia cases worldwide. The most common early sign of Alzheimers is trouble remembering new information because it usually impacts the learning part of the brain first.
This means it starts by affecting short-term memory. Things like forgetting what you recently ate, where you put certain things, or what you were in the middle of doing.
Over time, confusion, disorientation, behavior changes, and difficulty speaking and swallowing take place. Eventually, people develop long-term memory loss where the names and faces of loved ones wont even ring a bell.
With Parkinsons, memory stays intact and most symptoms revolve around movement. With Alzheimers, people lose their memory, cognitive ability, and the ability to do most things on their own.
Association With Brain Imaging Derived Features In Ad And Pd
In ADNI, AD patients demonstrated highly significant pairwise differences when comparing 193 intracranial volume normalized subcortical brain structures of those patients which had a recent AD diagnosis at study baseline and correcting statistical differences for the confounding effects of age and sex. We found significant differences in several brain regions, such as the calcarine sulcus, the cuneus gyrus and the medial occipitotemporal gyrus .
Figure 5
Example of significant differences between clusters with respect to brain imaging derived features at study baseline/time of first disease diagnosis . left calcarine sulcus in AD patients left cuneus gyrus in AD patients volume of right medial occipitotemporal gyrus in AD patients DaTSCAN left Putamenratio to age expected value in healthy controls DaTSCAN Count Density Ratio: Caudate/Putamen DaTSCAN Count Density Ratio : Caudate contralateral/Putamen contralateral. The Figures shows statistical distributions as violin plots , and individual data points are shown as superimposed dots.
In PPMI, pairwise differences between the clusters were significant for in presynaptic dopaminergic imaging were identified in caudate and putamen . Also, the dopamine receptor density ratio of caudate versus putamen differed significantly between clusters.
Altogether, we concluded that our genetically derived clusters are associated with significant pathophysiological differences in the brain.
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How Is Lewy Body Dementia Treated
Theres no cure for Lewy body dementia . Medications and nonmedical therapies, like physical, occupational and speech therapies, manage symptoms as much as possible.
Medications that can help manage the symptoms of LBD include:
- Cholinesterase inhibitors: This type of medication, which includes rivastigmine, galantamine and donepezil, helps manage the cognitive symptoms of LBD.
- Carbidopa-levodopa: Symptoms of parkinsonism, like tremors, are usually treated with levodopa, a drug commonly used to treat Parkinsons disease. However, it has serious side effects and can lead to delusions, hallucinations and confusion.
- Pimavanserin: This medication can be used to treat psychosis in people with Parkinsons disease dementia.
- Clonazepamandmelatonin: These medications can help treat REM sleep behavior disorder.
- Antidepressants: Depression is common in people with LBD and often requires antidepressant therapy with selective serotonin reuptake inhibitors .
- Memantine: This drug is typically used to treat dementia caused by Alzheimers disease, but its been investigated in clinical trials and may work in people with LBD who are in the early phases of the condition.
People with LBD can take part in different therapies to improve their quality of life, including:
- Individual and family psychotherapies .
The Difference Between Parkinsons & Vascular Dementia
The biggest difference between vascular dementia and Parkinsons disease is that Parkinsons doesnt always lead to dementia. Parkinsons affects mobility, similar to vascular dementia, and both are brain disorders that may stem from vascular problems. Parkinsons disease may also affect memory like vascular dementia but not in every case.
Vascular dementia symptoms include memory loss, reduced ability to organize thoughts or actions, confusion and trouble concentrating, trouble paying attention.
Parkinsons disease symptoms include slowed movement, muscle rigidity, shuffled walking, quiet speech, issues with swallowing.
During the end-stage of all types of dementia, the symptoms tend to be the same across the board.
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How Is Parkinson Disease Treated
Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
Alzheimers Vs Parkinsons Disease Dementia
The dementia of Parkinsons disease has some similarities to the dementia of Alzheimers disease. And there are some differences, too. Alzheimers disease causes dementia slowly over time, while the dementia of Parkinsons disease often develops more quickly and dramatically.
The symptoms of Parkinsons dementia can come and go from day to day, while the symptoms of Alzheimers dementia will not go away.
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Treatment Of Pdd And Dlb
Unfortunately, since both types of Lewy Body Dementia often display similar symptoms, patients suffering from either PDD of DLB can get misdiagnosed and subsequently prescribed the incorrect medication and method of treatment. Caregivers and medical professionals alike can increase their understanding of symptoms for each disease to help them more quickly and accurately diagnose and treat each one.
The Lewy Body Dementia Resource Center provides literature, support groups, and help for caregivers grappling with care and treatment of a loved one who has Lewy Body Dementia. Our helpline is available 12 hours a day, 7 days a week for caregivers who have questions or are in need of support. Our online resource center seeks to bring awareness and support to caregivers of those suffering with Lewy Body Dementia. Please dont hesitate to reach out to us.
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Main Differences Between Alzheimers Disease And Parkinson Disease
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What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
Hallucinations Illusions And Delusions
Your loved ones doctor may talk to you about psychosis. The word psychosis refers to a break with reality and may range from confusion to seeing things that arent there , to believing things that are not true .Between 20-40% of people with Parkinsons report the experience of psychosis. These statistics sometimes include temporary symptoms due to medication side effects or hallucinations.
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Theres No Cure For The Diseases But Some Therapies May Help
Certain drugs, like cholinesterase inhibitors and antipsychotic medications, are prescribed as treatment for people with Parkinsons and dementia. And lifestyle changesfrom improved diet, sleep, exercise and socializinghave been shown to have beneficial effects on patients with these diseases.
Oguh noted she hopes that improved treatments that will help some of the emotional and behavioral problems in these patients will be on the horizon soon.
Im hoping that with the new advances in medication, well be able to control better, Oguh said. I believe there will be better medication to improve cognition in patients, and that that will be seen in the next five to 10 years.