Parkinsons Dementia

Super Memory Formula

Chinese Cure for Alzheimer

Get Instant Access

Parkinson's disease is associated with a loss of striatal dopaminergic neurons, particularly in the pars compacta region of the substantia nigra. Tremor is the best recognized symptom and is present in approximately half of individuals with PD (Martin et al., 1983). Often tremor begins unilaterally, increasing with stress and disappearing in sleep. Other early symptoms include aching, paresthesias, and numbness and tingling on one side of the body that ultimately spread to the other side. Other classic motor symptoms are rigidity, slowness of movement, and alterations in posture.

Not all individuals with PD develop dementia, and prevalence estimates vary. Marttila and Rinne (1976), in one of the most comprehensive studies of prevalence, reported it to be 29%. Other investigators have reported similar estimates of dementia prevalence (Rajput and Rozdilsky, 1975; Mindham, Ahmed, and Clough, 1982; Huber, Shuttleworth, and Christy, 1989). Widely debated is the cause of the dementia, with some attributing it to cortical degeneration and others to subcortical damage that impairs neurological control of attention (Brown and Marsden, 1988). Rinne and colleagues (2000) argue that reduced fluorodopa uptake in the caudate nucleus and frontal cortex produces impaired performance on neuropsychological tests that require executive function.

Individuals with PD, regardless of whether they develop dementia, have speech motor deficits because the disease damages the basal ganglia and striatal-cortical circuitry, which are involved in motor function. Those who develop dementia have problems communicating for other reasons, namely deficits in memory, attention, and executive functions. However, considerable evidence exists that language knowledge generally is preserved (Pirozzolo et al., 1982; Bayles and Tomoeda, 1983; Huber et al., 1986). Bayles (1997) argued that impaired performance on tests that manipulate language, such as confrontation naming and sentence comprehension, result more from nonlinguistic cognitive deficits than a loss of linguistic knowledge.

See also Alzheimer's disease.

—Kathryn A. Bayles References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders—Fourth edition. Washington, DC: Author. Bayles, K. A. (1997). The effect of Parkinson's disease on language. Journal of Medical Speech-Language Pathology, 5, 157-166.

Bayles, K. A., and Tomoeda, C. K. (1983). Confrontation naming impairment in dementia. Brain and Cognition, 19, 98-114.

Bayles, K. A., and Tomoeda, C. K. (1993). The Arizona Battery for Communication Disorders of Dementia. Austin, TX: Pro-Ed.

Bayles, K. A., and Tomoeda, C. K. (1994). The Functional Linguistic Communication Inventory. Austin, TX: Pro-Ed.

Bayles, K. A., and Tomoeda, C. K. (1995). The ABC's of dementia. Austin, TX: Pro-Ed.

Bayles, K. A., Tomoeda, C. K., Cruz, R. F., and Mahendra, N. (2000). Communication abilities of individuals with late-stage Alzheimer disease. Alzheimer Disease and Associated Disorders, 14, 176-181.

Brown, R. G., and Marsden, C. D. (1988). Internal versus external cues and the control of attention in Parkinson's disease. Brain, 111, 323-345.

Byrne, E. J., Lennox, G., Lowe, J., and Godwin-Austen, R. B. (1989). Diffuse Lewy body disease: Clinical features in 15 cases. Journal of Neurology, Neurosurgery, and Psychiatry, 52, 709-717.

Cercy, S. P., and Bylsma, F. W. (1997). Lewy bodies and progressive dementia: A critical review and meta-analysis. Journal of the International Neuropsychological Society, 3, 179-194.

Cummings, J. L., and Benson, D. F. (1992). Dementia: Definition, prevalence, classification and approach to diagnosis. In J. L. Cummings and D. F. Benson (Eds.), Dementia: A clinical approach. Boston: Butterworth-Heinemann.

Desmond, D. W., Erkinjuntti, T., Sano, M., Cummings, J. L., Bowler, J. V., Pasquier, F., et al. (1999). The cognitive syndrome of vascular dementia: Implications for clinical trials. Alzheimer Disease and Associated Disorders, 13, S21-S29.

Hansen, L., Salmon, D., and Galasko, D. (1990). The Lewy body variant of Alzheimer's disease: A clinical and pathologic entity. Neurology, 40, 1-8.

Heyman, A., Fillenbaum, G. G., Gearing, M., Mirra, S. S., Welsh-Bohmer, K. A., Peterson, B., et al. (1999). Comparison of Lewy body variant of Alzheimer's disease with pure Alzheimer's disease. Neurology, 52, 1839-1844.

Hopper, T., Bayles, K. A., and Kim, E. (2001). Retained neu-ropsychological abilities of individuals with Alzheimer's disease. Seminars in Speech and Language, 22, 261-273.

Huber, S. J., Shuttleworth, E. C., and Christy, J. A. (1989). Magnetic resonance imaging in dementia of Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 52, 1221-1227.

Huber, S. J., Shuttleworth, E. C., Paulson, G. W., et al. (1986). Cortical vs subcortical dementia: Neuropathological differences. Archives of Neurolology, 30, 1326-1330.

Lewy, F. H. (1912). Paralysis agitans: I. Pathologische Anatomie. In Lewandowsky (Ed.), Handbuch der Neurologie. New York: Springer.

Martin, W. E., Loewenson, R. B., Resch, J. A., and Baker, A. B. (1983). Parkinson's disease: A clinical analysis of 100 patients. Neurology, 23, 783-390.

Marttila, R. J., and Rinne, U. K. (1976). Dementia in Parkinson's disease. Acta Neurologica Scandinavica, 54, 431441.

McKeith, I. G., and O'Brien, J. (1999). Dementia with Lewy bodies. Australian and New Zealand Journal of Psychiatry, 33, 800-808.

McKeith, I. G., Perry, R. H., Fairbairn, A. F., Jabeen, S., and Perry, E. K. (1992). Operational criteria for senile dementia of Lewy body type (SDLT). Psychological Medicine, 22, 911-922.

Mindham, R. H. S., Ahmed, S. W., and Clough, C. G. (1982). A controlled study of dementia in Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 45, 969-974.

Pirozzolo, F. J., Hansch, E. C., Mortimer, J. A., et al. (1982). Dementia in Parkinson's disease: A neuropsychological analysis. Brain and Cognition, 1, 71-83.

Pohjasvaara, T., Erkinjuntti, T., Ylikoski, R., Hietanen, M., Vataja, R., and Kaste, M. (1998). Clinical determinants of poststroke dementia. Stroke, 29, 75-81.

Powell, A. L., Cummings, J. L., Hill, M. A., and Benson, D. F. (1988). Speech and language alterations in multi-infarct dementia. Neurology, 38, 717-719.

Rajput, A. H., and Rozdilsky, B. (1975). Parkinsonism and dementia: Effects of L-dopa. Lancet, 1, 1084.

Reichman, W., Cummings, J., McDanniel, K., Flynn, F., and Gornbein, J. (1991). Visuoconstructional impairment in dementia syndromes. Behavioral Neurology, 4, 153-162.

Rinne, J. O., Portin, R., Ruottinen, H., Nurmi, E., Bergman, J., Haaparanta, M., et al. (2000). Cognitive impairment and the brain dopaminergic system in Parkinson disease. Archives ofNeurology, 57, 470-475.

Tatemichi, T. K., Desmond, D. W., Mayeux, R., et al. (1992). Dementia after stroke: Baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology, 42, 1185-1193.

Was this article helpful?

0 0
All About Alzheimers

All About Alzheimers

The comprehensive new ebook All About Alzheimers puts everything into perspective. Youll gain insight and awareness into the disease. Learn how to maintain the patients emotional health. Discover tactics you can use to deal with constant life changes. Find out how counselors can help, and when they should intervene. Learn safety precautions that can protect you, your family and your loved one. All About Alzheimers will truly empower you.

Get My Free Ebook


Post a comment