Cognitive and Mood Disorders in Parkinson's

Non-motor symptoms can be a major cause of disability in Parkinson’s disease. Depression, Anxiety, Apathy or cognitive impairment can be the greatest factor in determining the person’s quality of life.

Depression is common in people with Parkinson’s disease it often begins years before any of the other symptoms of PD emerge. Depression affects about 50% of people with Parkinson’s disease.

Symptoms:

• Fatigue

• Weight changes

• Sadness

• Decreased concentration

• Low motivation to follow any treatment program

• Loss of interest or pleasure in activities

• Sleep disturbances

• Difficulty with concentration or making decisions

• Irritability

• Feelings of worthlessness

• Excessive guilt

• Thoughts of death

Anxiety is a common non-motor symptom of PD it affects about 40% of people. It is important to note that people with Parkinson’s may experience anxiety, either because of worries about living with their condition, or because of possible changes in brain chemistry. Anxiety is likely to reduce quality of life, for the person with Parkinson’s and can be stressful for their caregivers.

Symptoms:

• Can contribute to sleep problems

• Nightmares

• Uncontrollable or unwanted thoughts

• Excessive fear and worry

• Pounding heart

• Cold and sweaty hands

• Dizziness

• Nausea

• Decreases quality of life

• Often accompanied by depression

Apathy is one of the most challenging and baffling non-motor symptoms of Parkinson’s disease it is defined as a feeling of indifference or a general lack of interest, enthusiasm and motivation. It interferes with the effective management of Parkinson's disease symptoms. Apathy can both accompany depression and mimic depression.

Early cognitive changes are different from dementia. The same brain changes that lead to motor symptoms can also result in slowness in memory and thinking. Stress, medication and depression can also contribute to these changes.

Symptoms:

• Slow mental processing

• Problems with working memory

• Issues with executive function

• Difficulty with multitasking

• Impaired spatial function

Dementia affects about 40% of people with living with Parkinson's disease dementia is a decline in thinking and reasoning that develops at least a year after diagnosis. The key brain changes linked to Parkinson’s dementia are abnormal microscopic deposits composed mostly of alpha-synuclein, a protein found widely in the brain with a normal function not yet known. The deposits are called “Lewy bodies” named after the neurologist Frederick H. Lewy, MD who discovered them while working in Dr. Alois Alzheimer’s laboratory during the early 1900s.

Symptoms:

• Leads to increased mortality

• Muffled speech

• Loss of memory, concentration and judgment

• Visual hallucinations

• Depression, Irritability and anxiety

• Sleep disturbances, excessive daytime drowsiness and rapid eye movement (REM) sleep disorder.

• Greatest source of disability in advanced PD

• Most common cause for nursing home placement