Parkinson's disease dementia

Parkinson's disease dementia (PDD) is dementia that is associated with Parkinson's disease (PD).^[1] Together with dementia with Lewy bodies (DLB), it is one of the Lewy body dementias characterized by abnormal deposits of Lewy bodies in the brain.^[2][3][4][5]

Parkinson's disease starts as a movement disorder, but progresses in most cases to include dementia and changes in mood and behavior.^[6] The signs, symptoms and cognitive profile of PDD are similar to those of DLB;^[2] DLB and PDD are clinically similar after dementia occurs in Parkinson's disease.^[5] Parkinson's disease is a risk factor for PDD; it speeds up decline in cognition leading to PDD.^[2] Up to 78% of people with PD have dementia.^[2] Delusions in PDD are less common than in DLB,^[2] and persons with PD are typically less caught up in their visual hallucinations than those with DLB.^[7] There is a higher incidence of tremor at rest in PD than in DLB, and signs of parkinsonism in PDD are less symmetrical than in DLB.^[8]

Parkinson's disease dementia can only be definitively diagnosed after death with an autopsy of the brain.^[6] The 2017 Fourth Consensus Report established diagnostic criteria for PDD and DLB.^[9] The diagnostic criteria are the same for both conditions, except that PDD is distinguished from DLB by the time frame in which dementia symptoms appear relative to parkinsonian symptoms. DLB is diagnosed when cognitive symptoms begin before or at the same time as parkinsonism. Parkinson's disease dementia is the diagnosis when Parkinson's disease is well established before the dementia occurs; that is, the onset of dementia is more than a year after the onset of parkinsonian symptoms.^[9]

Cognitive behavioral therapy can help people with Parkinson's disease with parkinsonian pain, insomnia, depression, anxiety, and impulse disorders, if those interventions are properly adapted to the motor, cognitive and executive dysfunctions seen in Parkinson's disease, including Parkinson's dementia.^[10]

Society and culture

Further information: Lewy body dementia § Society and culture, and Lewy body dementias § Notable individuals

General awareness about LBD lags well behind that of Parkinson's and Alzheimer's diseases, even though LBD is the second most common dementia, after Alzheimer's.^[11]

References

1. Weil RS, Lashley TL, Bras J, Schrag AE, Schott JM (2017). "Current concepts and controversies in the pathogenesis of Parkinson's disease dementia and Dementia with Lewy Bodies". F1000Res (Review). 6: 1604. doi:10.12688/f1000research.11725.1. PMC 5580419. PMID 28928962.
2. Gomperts SN (April 2016). "Lewy Body Dementias: Dementia With Lewy Bodies and Parkinson Disease Dementia". Continuum (Minneap Minn) (Review). 22 (2 Dementia): 435–63. doi:10.1212/CON.0000000000000309. PMC 5390937. PMID 27042903.
3. Pezzoli S, Cagnin A, Bandmann O, Venneri A (July 2017). "Structural and Functional Neuroimaging of Visual Hallucinations in Lewy Body Disease: A Systematic Literature Review". Brain Sci (Review). 7 (12): 84. doi:10.3390/brainsci7070084. PMC 5532597. PMID 28714891.
4. Galasko D (May 2017). "Lewy Body Disorders". Neurol Clin (Review). 35 (2): 325–338. doi:10.1016/j.ncl.2017.01.004. PMC 5912679. PMID 28410662.
5. Walker Z, Possin KL, Boeve BF, Aarsland D (October 2015). "Lewy body dementias". Lancet (Review). 386 (10004): 1683–97. doi:10.1016/S0140-6736(15)00462-6. PMC 5792067. PMID 26595642.
6. "Lewy body dementia: Hope through research". National Institute of Neurological Disorders and Stroke. US National Institutes of Health. December 8, 2017. Retrieved April 6, 2018.
7. Burghaus L, Eggers C, Timmermann L, Fink GR, Diederich NJ (February 2012). "Hallucinations in neurodegenerative diseases". CNS Neurosci Ther (Review). 18 (2): 149–59. doi:10.1111/j.1755-5949.2011.00247.x. PMC 6493408. PMID 21592320.
8. St Louis EK, Boeve AR, Boeve BF (May 2017). "REM sleep behavior disorder in Parkinson's disease and other synucleinopathies". Mov. Disord. (Review). 32 (5): 645–58. doi:10.1002/mds.27018. PMID 28513079. S2CID 46881921.
9. McKeith IG, Boeve BF, Dickson DW, et al. (July 2017). "Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium". Neurology (Review). 89 (1): 88–100. doi:10.1212/WNL.0000000000004058. PMC 5496518. PMID 28592453.
10. Zečević I (March 2020). "Clinical Practice Guidelines Based on Evidence for Cognitive-Behavioral Therapy in Parkinson's Disease Comorbidities: A Literature Review". Clin Psychol Psychother (Review). 27 (4): 504–514. doi:10.1002/cpp.2448. PMID 32196842. S2CID 214601157.
11. Taylor A, Yardley C (2014). "Advocacy, education, and the role of not-for-profit organizations in Lewy body dementias". Alzheimers Res Ther (Review). 6 (5): 59. doi:10.1186/s13195-014-0059-0. PMC 4468791. PMID 26082807.

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