This article focuses on Parkinson’s dementia and how it develops or affects patients with Parkinson’s disease. It shows symptoms, discusses potential treatment options, and answers frequently asked questions about the condition.

Parkinson’s disease is a progressive neurological condition indicated by uncontrolled or unintended movements such as stiffness, shakiness, and problems with balance and coordination. As the disease progresses, the symptoms become worse and a patient is more susceptible to various complications. One serious condition that arises from this neurological disorder is Parkinson’s disease dementia.

Read on to learn more about the causes, Parkinson’s dementia stages, treatment options, and more.

Parkinson’s dementia overview

Parkinson’s disease dementia (PDD) is defined as a decline in reasoning and thinking skills that occurs in some people with Parkinson’s disease (PD) at least after their diagnosis. Dementia is an umbrella term that refers to impaired cognitive abilities including memory, thinking, and decision-making.

Not all patients with Parkinson’s disease will develop PDD. The average prevalence of dementia in people with Parkinson’s disease is 30% to 40%[1]. However, estimates show that 50% to 80%[2] of people with PD will eventually develop Parkinson’s dementia symptoms.

Parkinson’s dementia is just one type of Lewy body dementia, a disease characterized by abnormal deposits of alpha-syncline protein in the brain. These particular deposits are referred to as Lewy bodies and may cause problems with memory, thinking, mood, or behavior. Lewy body dementia is divided into two types. One type is PDD, diagnosed only in people who are living with Parkinson’s disease. The second type is dementia with Lewy bodies, which is diagnosed in cases when cognitive decline appears as the first symptom or when motor symptoms and cognitive decline appear together.

Signs and symptoms of Parkinson’s dementia

Parkinson’s dementia symptoms may vary from one patient to another because dementia is a wide-ranging condition. However, patients generally experience the following signs and symptoms:

  • Forgetfulness and memory loss
  • Changes in judgment
  • Difficulty interpreting visual information
  • Problems making decisions
  • Difficulty staying focused
  • Disturbed sleep pattern
  • Problems staying awake fully
  • Mood disturbances (anxiety, depression, and apathy)
  • Muffled or slurred speech
  • Visual hallucinations
  • Delusions (especially paranoia)
  • Disorientation and confusion
  • Changes in energy levels
  • Appetite changes
  • Loss of interest

Parkinson’s dementia stages

At this point, Parkinson’s dementia stages are unclear and they require further research. However, Parkinson’s disease itself develops in five stages, which are important to mention.

The first stage of Parkinson’s disease, or the initial stage, refers to the appearance of mild symptoms, but they don’t affect the daily activity of the patient. At this stage, movement symptoms and tremors affect one side of the body only. A person may experience changes in facial expressions, posture, and walking.

The second stage of PD involves worsening of the symptoms e.g. tremors affect both sides of the body. While a patient with Parkinson’s disease retains their independence, daily tasks become more difficult to perform.

The third stage of Parkinson’s disease, or mid-stage, is characterized by loss of balance. Motor symptoms become worse and a patient experiences problems such as falling.

In stage four of Parkinson’s disease, symptoms are fully developed. The disease becomes disabling, but patients can still walk without the assistance of their caregivers.

Stage five of Parkinson’s disease is the most advanced and debilitating form of the disease. At this point, a patient can’t walk due to stiffness in the legs.

While Parkinson’s dementia stages are unknown, it is worth noting that dementia is a progressive condition. A patient with PD may start experiencing less severe symptoms of cognitive decline first, but not think they’re anything serious at the beginning. Unless a patient gets regular checkups and necessary tests, dementia is identified only when symptoms and behaviors become more severe.

Causes of Parkinson’s dementia

The exact cause of Parkinson’s dementia is unknown. However, Parkinson’s disease’s impact on the brain and neurotransmitter dopamine could play a role. Dopamine participates in many functions including muscle control and coordination. As Parkinson’s disease progresses, it destroys nerve cells that produce dopamine. When dopamine is not present, the nerve cells can’t relay instructions throughout the body adequately. In turn, problems with coordination ensue.

With the progression of PD, a patient experiences major changes in the brain areas that regulate movement. With time, Parkinson’s disease affects several brain regions including areas that are responsible for cognitive abilities such as memory. Continuous progression of PD deprives the brain of its functioning, which worsens cognitive decline. For that reason, a patient with PD may start experiencing Parkinson’s dementia symptoms.

The underlying mechanisms through which PD causes dementia or Parkinson’s dementia stages aren’t fully understood. However, connection with Lewy bodies shows Parkinson’s disease could be associated with the same underlying abnormalities in the brain processing of Lewy body deposits as dementia with Lewy bodies. This means the impact of Parkinson’s disease on the brain is incredibly complicated and requires further exploration.

As mentioned above, not all patients with PD will experience Parkinson’s dementia. Some factors increase the risk of developing this condition.

The risk for Parkinson’s dementia symptoms is higher in PD patients with older age, mild cognitive impairment, severe motor symptoms, and hallucinations. Other potential risk factors[3] include excessive daytime sleepiness, and PIGD (postural instability and gait disturbance). PGID is indicated by difficulty initiating movement, balance problems, falling, and “freezing” mid-step.

Causes of Parkinsons dementia

Behaviors observed in Parkinson’s dementia

A person with Parkinson’s dementia may experience a wide range of behavioral changes due to the influence of the symptoms and complications of the disease. As disease progresses, it influences behaviors and patients may not be able to control them.

One example of Parkinson’s dementia behavior is impulsiveness or mood changes. Impulsive behavior in people with PDD may result from being overwhelmed with their disease or due to difficulty accepting they have less control over what they can or can’t do. Language problems, disorientation, and confusion can make a person feel powerless and contribute to their frustration and impulsiveness. That’s exactly why they exhibit strong mood changes i.e. being happy one moment and angry or sad the next. In some cases, impulsiveness may lead to more serious behaviors such as aggression.

Parkinson’s dementia behavior is also influenced by hallucinations and delusions, symptoms of psychosis. Hallucination is defined as the false perception of reality; a person may see or hear people, voices, or sounds that aren’t there. Delusions are false beliefs in which a person believes no matter what.

Hallucinations (usually visual) and delusions affect behaviors in a way that a person with PDD may lose trust in their caregivers or refuse to take medications, and they may display aggressive or erratic behaviors when others try to convince them that what they see, hear, or believe isn’t true. Supplement for brain health could help support brain functions and reduce the severity of behaviors associated with cognitive problems.

Possible Treatments for Parkinson’s dementia

Parkinson’s dementia treatment focuses on the management of symptoms in order to improve a patient’s quality of life. Treatment can’t eliminate dementia or stop its progression. A healthcare provider may recommend a combination of different approaches including medications and therapies or routines.

Medications in Parkinson’s dementia treatment are prescribed to reduce the severity of symptoms and improve sleep quality. In most cases, doctors prescribe cholinesterase inhibitors and antipsychotic drugs to patients with Parkinson’s disease dementia. The main purpose of cholinesterase inhibitors (Donepezil, Galantamine, Rivastigmine) is to manage changes in behavior and thinking, but they can also address symptoms such as memory problems and hallucinations.

The primary objective of prescribing antipsychotic medications is to manage Parkinson’s dementia behavior. However, these drugs are associated with side effects such as worsening PD symptoms, psychosis, confusion, difficulty swallowing, and sudden changes in consciousness.

Besides prescription medications, over-the-counter products such as Provasil brain health supplement could support brain functioning and improve a person’s quality of life.

The role of routines and therapies in Parkinson’s dementia treatment is to provide guidance to patients who experience difficulty understanding the day-night cycle. There are different kinds of therapy for patients with PDD. A good example is physical therapy to help patients regain strength and flexibility in stiffened muscles or to relieve movement symptoms. Patients may also receive guidance on how to exercise at home. They could also benefit from speech therapy, getting enough sleep, a well-balanced diet, and management of other health conditions that affect their brain (sleep apnea, diabetes, etc.).

Routines are incredibly important to patients with PDD. For that reason, caregivers are instructed to set bedtime at the same time every day. In order to help a patient understand the day-night cycle, it is necessary to keep indicators of time (calendar and clock) in visible places. Patients should avoid napping during the day.

Caregivers play a role in the treatment of Parkinson’s disease dementia because they develop a routine that a patient may follow. Also, caregivers are in charge of diet and communicate with doctors. On that note, before you give a supplement for brain health to the patient, make sure to consult a doctor first to ensure it won’t interact with other medications.

Parkinsons dementia kill

Frequently Asked Questions

Can Parkinson’s dementia kill you?

Parkinson’s disease dementia doesn’t directly cause death, but it can increase the risk for factors that lead to lethal outcomes and there is no Parkinson's dementia treatment that would cure the condition entirely. More precisely, complications of PDD can cause death. Dementia is associated with decreased life expectancy due to increased difficulty treating the motor problems[4] in Parkinson’s disease.

A study from the journal NPJ Parkinson’s Disease confirmed[5] that Parkinson’s disease is linked to increased mortality independently of age, sex, smoking, and comorbidity status. Increased mortality risk in patients with PD is disease-related and becomes evident early during the course of the condition. Additionally, a population-based study from Neurology revealed[6] that PD patients with normal cognitive function tend to have a better life expectancy. Mild cognitive impairment is associated with shorter survival.

People with Parkinson’s dementia may develop symptoms of psychosis (hallucinations and delusions). As a result, it becomes difficult to treat motor problems as aggressively as in patients without dementia. This can worsen problems with balance and lead to accidents, falls, and life-threatening injuries.

When does dementia start in Parkinson’s?

The average timeframe for the onset of dementia in people with Parkinson’s disease is 10 years. A review from the Journal of the Neurological Sciences reported[7] that at least 75% of Parkinson’s disease patients who survive for more than 10 years will develop Parkinson’s dementia.

However, some people with PD can develop dementia early in the disease course. Earlier onset of dementia in patients with Parkinson’s disease correlates with more structural brain changes. Factors that cause dementia in the early stages of PD include old age, severity of motor symptoms (especially postural and gait disturbances), mild cognitive impairment, and visual hallucinations.

Before a person develops Parkinson’s dementia symptoms, they experience mild cognitive impairment. In fact, around 30% of Parkinson’s disease patients[8] tend to develop mild cognitive impairment after five years.

How does Parkinson’s dementia start?

Parkinson’s dementia starts are mild cognitive impairment. A patient with PD doesn’t wake up one day with dementia. Dementia, as a progressive disease, develops gradually. Mild cognitive impairment is an early stage of cognitive ability loss and memory loss. The symptoms of mild cognitive impairment are not as severe as dementia, which is why people tend to overlook them.

Mild cognitive impairment doesn’t include personality changes and other serious symptoms[9] of dementia. Instead, it may manifest itself as losing things frequently, forgetting to go to appointments or events, or experiencing difficulties coming up with words than other people of the same age. A person with mild cognitive impairment doesn’t exhibit typical Parkinson’s dementia behavior and they are still capable of taking care of themselves and participating in normal daily activities.

Memory lapses are common in people with mild cognitive impairment. Family and friends may notice these problems, and patients as well. As the condition progresses, mild cognitive impairment may lead to symptoms of dementia. Parkinson’s dementia stages are still unclear.

Where does Parkinson’s disease affect the brain?

Parkinson’s disease affects the brain in the area called substantia nigra pars compacta, a small area in the midbrain and a part of the basal ganglia in the brain. This region in the brain modulates motor activity. Basal ganglia are specific types of neurons, that are involved in motor function and movement, but also participate in functions such as emotions, memory, and behaviors. Parkinson’s disease affects these neurons. Parkinson’s disease involves the impairment or death of nerve cells in the basal ganglia.

Moreover, Parkinson’s disease is associated with tissue loss in the frontal and temporal lobes[10] of the brain, areas that participate in processing sensory information, forming memories, expressive language, voluntary movement, and higher level executive functions. Tissue loss in frontal and temporal lobes contributes to cognitive decline in patients with Parkinson’s disease.

In Parkinson’s disease patients, brain atrophy is present in cortical and subcortical areas[11]. The volume of the thalamus (involved in language, attention, and memory) decreases in Parkinson’s disease by up to 30% to 40%. The disease affects the hypothalamus and limbic structures too. These changes in the brain could contribute to Parkinsons dementia behavior.

Concluding remarks

Parkinson’s dementia tends to develop after PD diagnosis. This progressive condition further affects a patient’s quality of life and has a strong impact on their behaviors. The exact causes of PDD are unclear, but they could result from the impact of Parkinson’s disease on the brain and the onset of mild cognitive impairment[12].

While PDD has no cure, doctors may prescribe medications to manage symptoms and reduce their severity. Supplement for brain health could be practical, but make sure to consult a doctor first. Well-structured routine is necessary for patients with PDD.