AARP Eye Center
Many symptoms of Parkinson's disease — shuffling gait, quivering hands, stooped posture — are easy to spot. But this disease can also cause problems that are far less visible but no less distressing. Perhaps the most worrisome is cognitive decline, which affects about 50 percent of patients.
"This is a scary, confusing and concerning topic for a lot of people,” says neurologist Rachel Dolhun, M.D., senior vice president of medical communications at the Michael J. Fox Foundation. While these feelings are natural, common misconceptions can exacerbate patients’ fears.
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For starters, cognitive decline doesn't necessarily equal full-blown dementia, and many people with Parkinson's develop only mild impairment. Another misconception is that even slight memory slippage signals that rapid deterioration is imminent — but that's far more common with Alzheimer's disease than it is with Parkinson's, says Tsao-Wei Liang, M.D., chief of the movement disorders division at Jefferson Health. “It's not always relentlessly progressive, and more often than not, symptoms can be managed with medication, caregiver support and basic organizational strategies,” he says.
It's also important to know that many Parkinson's patients with some cognitive impairments are able to form new short-term memories, even if they struggle with attention and multitasking. “People with Parkinson's will often remember [something recently discussed] if you give a clue or prompt them,” Dolhun says.
What muddles memory
Parkinson's is a neurodegenerative condition, so it's not surprising that memory loss is often part of it. The disease is associated with a decline in acetylcholine, a neurotransmitter that's important for memory, Liang explains. In patients who have more serious dementia, the buildup of alpha-synuclein proteins (also called Lewy bodies) in areas of the brain that are important for memory, thinking or language is likely to blame, says Michael Okun, M.D., national medical adviser to the Parkinson's Foundation and executive director of the Norman Fixel Institute for Neurological Diseases at University of Florida Health.