根据 美国国立卫生研究院在美国，大约有50万人.S. have been diagnosed with Parkinson’s disease (PD), and that number is expected to double by 2040. Many of these patients have no cognitive impairment; others develop mild cognitive impairment, which does not affect their ability to perform daily tasks independently. But an estimated one-fourth of patients diagnosed with PD develop Parkinson’s disease 痴呆 (PDD), 根据 医学博士Jumana Alshaikh； 神经学 专家和联合主任 帕金森病卓越中心 大发娱乐助理教授 神经内科.
“对一些病人来说,ir cognitive impairment progresses to a point where they have 痴呆,阿尔谢赫解释道, “meaning that their cognitive symptoms affect their ability to be independent and they need help from others for their day-to-day tasks.”
根据… 文章中的 神经科学杂志, 痴呆 is more likely for patients who have been living with PD for more than 10 years. 另外, Alshaikh said that patients who are diagnosed with Parkinson’s at an older age are more at risk for PDD. ”也, more advanced and severe your other Parkinson’s symptoms are, 患PDD的风险就越大,她说。.
PDD症状
病人 who develop PDD experience impairments in different areas of cognition. 更加突出,se impairments occur in executive and visuospatial functions and attention, 包括计划困难, 组织, 沙拉酱, 开车, 和多任务处理. 尽管PDD患者可能会出现健忘——这是抑郁症的标志 阿尔茨海默病这通常是由于思想混乱造成的, Alshaikh说, 当大发娱乐提供线索时，病人可能能够回忆起事情. 病人 with PDD can also develop other symptoms such as hallucinations and delusions.
如何诊断PDD?
PDD is diagnosed after the patient has an established diagnosis of Parkinson’s disease and develops cognitive symptoms that start after at least one year from the time that movement symptoms of Parkinson’s began. 为了让认知障碍被称为痴呆, it must be severe enough that the patient requires assistance from others to complete their daily activities.
“We base this information from the history provided by the patient and their caregivers,阿尔谢赫说, “and then we perform cognitive assessments with an office-based cognitive test such as the MoCA (Montreal Cognitive Assessment). 如果需要进一步的信息, 大发娱乐可能会进行额外的测试, refer the patient to a 神经psychologist for more detailed cognitive assessments, or order imaging studies such as an MRI brain or PET scan to rule out other causes of 痴呆.”
PDD的治疗
药物可以大发娱乐治疗PDD. 这些药物会提高乙酰胆碱的水平, a chemical in the brain that is involved in cognition and memory. Increasing the levels of acetylcholine can even help with hallucinations related to Parkinson’s. Some patients with severe hallucinations may also need anti-psychotic medications, though Alshaikh recommends caution about which of those medications can be prescribed. Some of those medications need to be avoided since they can worsen the movement symptoms associated with Parkinson’s.
药物只能缓解PDD的症状. 然而,y don’t reverse the underlying disease process or slow down what’s happening in the brain. But some studies suggest exercising regularly—"especially exercises that get your heart rate up,阿尔谢赫说. “Aerobic exercises or cardio exercises might have an effect on slowing down the progression of Parkinson’s disease. In addition to that, exercise can also improve cognition and memory.”
Physical activity must be tailored to the patient’s abilities and movement issues associated with Parkinson’s disease, which is why it’s ideal to set up an exercise program with a physical therapist.
另外, it’s important to look at other things that might contribute to the patient’s cognitive symptoms. “例如, poor sleep quality can make cognition worse since sleep plays an important role in the consolidation of our memories,阿尔谢赫说. Problems like anxiety or depression and hearing impairment can also worsen cognition.
给护理人员的建议
Alshaikh对护理人员有以下建议：
- Encourage your loved one with PDD to exercise regularly and engage in activities that they enjoy.
- Be present for medical appointments so that you can provide important collateral information to their doctors that can help with their treatment.
- Get involved with helping your loved one implement the treatment plan discussed with their doctor.
- Try to create an environment or opportunities for social interaction.
- Be patient as a Parkinson’s patient may be slower to respond to questions. Don’t assume that because they take a long time to answer,y don’t know the answer to a question.
- Regularly review the patient’s medications with their 神经logist to see whether medications are making cognition worse—these could be medications given for other routine medical conditions.
If cognition declines rapidly or suddenly and your loved one or patient becomes much more confused than normal, seek medical attention right away as a medical problem such as a urinary tract infection could be exacerbating the PDD symptoms.
Caregivers are often unprepared for many of the tasks and challenges they will face. Educating yourself and practicing self-care are important tools for success. 你可以在网上找到有价值的信息和建议 帕金森基金会, 全国老龄问题委员会，和 全国护理员联盟 网站.