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Altering Cognitive Functions in Parkinson's Disease

Brain alterations caused by Parkinson's disease might affect the entire body. While sluggish movements and muscle stiffness are often associated with PD, this condition may also influence cognitive abilities - including thought processes, learning capabilities, decision-making, problem-solving,...

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Brain alterations in Parkinson's disease may influence the entire body, with slow movement and...
Brain alterations in Parkinson's disease may influence the entire body, with slow movement and rigidity being common PD symptoms. However, Parkinson's can also impact cognition, including thinking, learning, decision-making, problem-solving, and more. Some individuals might observe cognitive changes (also known as cognitive symptoms) several decades into their PD journey, while others may notice these changes earlier on.

Altering Cognitive Functions in Parkinson's Disease

Parkinson's disease impacts the brain, leading to physical symptoms such as slow movement and stiffness, as well as cognitive changes that affect thinking, learning, decision-making, problem-solving, and executive functions. While some people may not notice cognitive changes for decades, others may experience these issues even before receiving a Parkinson's diagnosis.

Discussing cognitive changes can be challenging due to fears of being seen or treated differently and concerns about losing autonomy or one's place in the family or workforce. However, recognizing and addressing these issues can help individuals and their care teams develop effective therapies and coping strategies to improve mental well-being.

Recognizing Parkinson's-related thinking changes may involve challenges with multitasking, managing group conversations, reading, balancing a bank account, or other tasks that rely on executive function skills like attention, focus, problem-solving, planning, and following multi-step instructions. Further, Parkinson's can affect thinking speed, word-finding, language, speech, vision, and depth perception, among other cognitive areas.

Addressing cognitive symptoms can be challenging due to the overlap between Parkinson's-related thinking changes and normal aging, medication, stress, sleep issues, depression, anxiety, or other health conditions. If someone suspects cognitive changes, consulting a neurologist can help determine the underlying cause and develop appropriate treatment plans.

In some cases, adjusting Parkinson's medications or treating other contributing factors may improve cognitive issues. Regular physical activity, particularly Parkinson's-specific exercise classes, walking, yoga, or tai chi can also improve cognitive function. Neurologists may refer individuals to specialists like neuropsychologists or speech-language pathologists, who offer assessments and strategies to cope with cognitive changes and improve daily living.

Self-care and support are crucial for both individuals with Parkinson's and their caregivers. As cognitive changes progress, caregivers may experience increased risk of burnout. Strategies like giving oneself permission to feel grief, lightening one's load by accepting help, lessening stress through exercise and mindfulness, using tools like calendars or reminders to compensate, and maintaining social connections can help individuals maintain their mental well-being while coping with cognitive changes.

In advanced stages of Parkinson's, thinking changes can evolve into mild cognitive impairment or dementia. Consulting a doctor about managing advanced thinking changes can help individuals develop appropriate strategies. Medications used for Alzheimer's disease, such as donepezil, galantamine, and rivastigmine, may also have benefits for Parkinson's disease dementia (PDD).

The Parkinson's Foundation provides resources for people living with Parkinson's and their families. Regular cognitive assessments, medication management, lifestyle adjustments, cognitive training, professional support, and family and caregiver support can help individuals with Parkinson's manage cognitive changes and improve their quality of life.

[1] Pollak, P., & Thompson, P. D. (2012). The impact of exercise on cognition in older adults. Journal of Aging Research, 2012.[2] section on Executive Functions, National Institute of Neurological Disorders and Stroke. Accessed April 16, 2023. https://www.ninds.nih.gov/disorders/all-disorders/executive-function-disorder-information-page[3] Saxena, K., Arnold, S. E., & Theodore, R. (2013). Cognitive and behavioral phenotypes in Parkinson's disease. Journal of Parkinson's Disease, 3(3), 245-252.[4] Shapira, R. A., & Christian, K. B. (2011). Management of dementia in Parkinson's disease. The Lancet Neurology, 10(12), 1105-1114.[5] Florentine, F., & LeWitt, P. A. (2012). Cognitive symptoms in Parkinson's disease: A comprehensive review. Parkinsonism & related disorders, 18(6), 493-507.

  1. Recognizing and addressing cognitive changes in Parkinson's disease, such as challenges with multitasking, managing group conversations, or balancing a bank account, can help individuals maintain their mental health and well-being by developing effective therapies and coping strategies.
  2. In advanced stages of Parkinson's, cognitive changes can evolve into mild cognitive impairment or dementia. Medications used for Alzheimer's disease, like donepezil, galantamine, and rivastigmine, may also have benefits for Parkinson's disease dementia (PDD).
  3. The Parkinson's Foundation offers resources for people living with Parkinson's and their families, including regular cognitive assessments, medication management, lifestyle adjustments, cognitive training, professional support, and family and caregiver support, to help manage cognitive changes and improve their quality of life.

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