We explain all the details of this neurodegenerative disease.
In this article we will learn about Parkinson’s disease , a movement disorder that can lead to dementia (in this case, subcortical dementia). We will know what this disease consists of, its types, symptoms and causes.
- Recommended article: “The 7 most common types of dementia (causes and symptoms)”
What is Parkinson’s?
Parkinson’s disease is a type of movement disorder that involves significant motor disturbances. Between 20-60% of people diagnosed with this disease end up manifesting Parkinson’s dementia.
Parkinson’s usually begins around 50-60 years of age (especially at 60) , but can appear earlier (early Parkinson’s). At the level of proportions, it is much more prevalent among men than among women. Its deterioration is usually slow and progressive.
- You may also be interested in: “Types of Alzheimer’s (characteristics, causes and symptoms)”
Causes
Parkinson’s disease is genetic in some cases, but in most cases it does not occur between members of the same family . Thus, its etiology is really unknown, although it is related to an alteration in the nigrostriatal fasciculus (decreased dopaminergic function).
That is, it happens that the nerve cells (neurons) do not produce enough dopamine , a chemical essential for the proper functioning of the brain.
Types
Parkinson’s can be of two types, based on its causes. The most used classification is the following.
1. Primary Parkinson’s
It does not originate in a pathology or by a chemical product. It can be of genetic, idiopathic or sporadic origin, associated with other degenerative processes or other disorders.
2. Secondary Parkinson’s
This is Parkinson’s caused by a previous pathology or by medications or toxic substances. Some of its causes are the following: repeated head trauma, infectious or metabolic diseases, toxins or medications.
Symptoms
Symptoms of Parkinson’s disease start slowly, usually on only one side of the body , and progressively affect both sides of the body. The most characteristic symptoms that appear are the following.
1. Tremor in the hands, arms, legs, jaw, and face
In Parkinson’s, the so-called rest tremor appears. It is an uncontrollable movement that affects a limb when it is at rest, and that disappears during a voluntary movement.
2. Stiffness in the arms, legs and trunk
Rigidity manifests itself when the muscles remain constantly tense and contracted; the person feels pain or feels stiff. The stiffness becomes obvious when someone else tries to move or extend the person’s arm.
3. Slowness of movements
Also called bradykinesia (and which, as we will see, also appears in Parkinson’s dementia).
4. Balance and coordination problems
Postural instability appears, alterations in balance and coordination, which can lead to falls.
5. Difficulty starting and stopping an activity
The person has difficulties to start and/or stop any activity they carry out, thus significantly affecting their autonomy.
6. Feasting March
It is a type of shuffling walk with short steps.
7. Other symptoms
As the disease progresses and symptoms worsen, difficulties walking or doing simple tasks may occur. In addition, on a psychological level, problems or disorders such as depression, sleep disorders or difficulties in chewing, swallowing or speaking may appear.
Diagnosis
There is no diagnostic test for Parkinson’s disease; The diagnosis is based on clinical symptoms, and on an exhaustive analysis of the patient’s clinical history by the doctor, in addition to applying a neurological examination.
Treatment
Parkinson’s disease has no cure; The treatment consists of the prescription of certain medications that help to greatly improve the symptoms .
On the other hand, in severe cases, surgery and deep brain stimulation (electrodes implanted in the brain that send pulses to stimulate the parts of the brain that control movement) are applied, which can help control symptoms and alleviate the negative sensations suffered by patients. patients.
Dementias: types
As we have seen, Parkinson’s disease can lead to dementia when it progresses . At the clinical-anatomical level, there are two types of dementia: localized and global.
1. Localized
These, in turn, are subdivided into cortical dementias (where the fundamental characteristic is a cognitive alteration), subcortical dementias (predominantly motor alteration) and axial dementias.
The cortical prototype is Alzheimer’s dementia, the subcortical prototype is Parkinson’s dementia, and the axial prototype is Korsakoff syndrome.
2. Global
These are vascular or mixed. It is a group of heterogeneous dementias, which involve a broad cognitive impairment and a course in steps. They are the only treatable (reversible) ones, unlike localized dementias, in which the symptoms can be treated but the deterioration cannot be completely stopped.
Parkinson’s dementia
When Parkinson’s dementia develops, it is classified in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as a neurocognitive disorder (major or mild) due to Parkinson’s disease.
In these cases, a dysexecutive syndrome (alterations in executive functions) linked to memory loss usually appears. In addition, in this dementia there is a decrease in motivation (apathy, asthenia and abulia), bradypsychia (slowing down of the thought process) and impoverishment of language.
Bradykinesia (slowness of movement) also appears, which we had already seen in Parkinson’s disease itself. The classic aphaso-apraxo-agnosic syndrome that does appear in Alzheimer’s dementia does not appear.
Finally, visuospatial and visuoconstructive alterations appear. Parkinson’s dementia is also frequently related to depression .
bibliographical references
- APA (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid. Pan American.
- Belloch, A.; Sandin, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
- NIH: National Institute of Neurological Disorders and Stroke. (2019). Parkinson’s disease. MedlinePlus.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
