We get so focused on Alzheimer’s disease that we often forget that there are many other possible causes of progressive cognitive decline and dementia.  One such disease that merits attention is Parkinson’s disease which is the third most common progressive neurodegenerative disorder behind Alzheimer’s and Lewy body disease.  There are an estimated one million people diagnosed with Parkinson’s disease and 50,000 new cases each year.  Parkinson’s disease is more common in men than women by a factor of about 2:1.  Age is the only known risk factor as the average age of onset is 60 and most cases of Parkinson’s disease occur in those 50 and older.  Family history does not appear to be a significant risk factor for developing Parkinson’s disease.

“Parkinsonism” is associated with a variety of causes including viral encephalitis, use of anti-psychotic medications, carbon monoxide poisoning, and multiple strokes.   However, 85% of cases of Parkinson’s disease have no known cause.  As many as 50% of cases of Parkinson’s disease may decline to dementia and over 80% show more subtle cognitive deficits.  Parkinson’s disease is characterized by both motor and nonmotor symptoms.  The classical motor symptoms include slowness of movement, slowed reaction time, muscle rigidity, tremor, and proneness to falls.  The nonmotor features include gastrointestinal dysfunction, urinary or sexual dysfunction, orthostatic hypotension, profuse sweating, sleep disorders (e.g., excessive daytime sleepiness, excessive movements in sleep), loss of sense of smell, depression, anxiety, psychosis, poor memory and disorders of judgment.  I could go on but I hope you get the point.  Alzheimer’s disease is not the only risk we run as we age nor is it necessarily the worst neurodegenerative disorder.

As with Alzheimer’s disease, managing Parkinson’s disease also requires a proactive approach including awareness of possible early signs, especially given that there are treatments for the motor symptoms.  Nonmotor symptoms may precede the motor symptoms of Parkinson’s disease and the constellation of excessive daytime sleepiness, reduced sense of smell, constipation, and slowed reaction times are correlated with greater risk.  Individuals with this constellation of symptoms should be assessed and followed closely as should those with REM sleep disorders.  Early presentations of Parkinson’s disease (as also happens with Alzheimer’s disease) may be in the form of late onset depression, anxiety, or psychosis.  Those afflicted with Parkinson’s disease may be especially sensitive to certain medications such as antipsychotic medications.

Early interventions such as exercise and dance (who says therapy can’t also be fun) may be especially helpful to those at all stages of Parkinson’s disease.  Persons with Parkinson’s disease also need to be followed for memory and other cognitive skills and caregivers need attention and support.  There is help through the Parkinson’s Association of Southwest Florida (call 417-3465) as well as through many of the services for Alzheimer’s disease.