The cognitive symptoms of Parkinson’s, Part 1

Cognitive decline is quite possibly the worst – or at least the most feared – symptom of Parkinson’s disease. 

Of course, losing the ability to walk without help is crushing. And dealing with tremorous limbs, random pains, and chronic fatigue is awful.

But losing your power to think is devastating.

OK, this is getting too heavy already. We all know cognitive symptoms in Parkinson’s can severely impact quality of life. So I’m going to lighten up with experiences I’ve had and ideas to help keep our brains ticking well. Relax and breathe deep, here we go.

Cognitive decline is normal

As people age, their brains shrink. Really! The gray matter actually gets smaller. Shrinkage can start as early as age 40, and it typically hastens the older one gets.

With Parkinson’s, however, the decline in cognition often happens even faster. It’s something that’s important to keep track of.

I survived Test Day 

During a routine physical exam five years after my diagnosis, I was told to make an appointment with the neuropsychologist on staff.

“Wait. Why?” I asked my neurologist, as pictures of brain halos and electrodes filled my mind.  “Do I seem anxious? Did I answer your questions nonsensically?”

The doctor explained that getting a baseline on cognitive abilities is a good idea for anyone with Parkinson’s. Something to measure against if things go south. That made sense. Even so, I wondered if I was making sense.

And so I spent three hours in cognitive testing. I answered personal questions, filled in blanks, restated number sequences, named items in drawings, repeated back a string of nouns, and listed as many fruits as I could in one minute, among other mind-numbing tasks. 

It was grueling, frustrating, and tedious work. I left the office feeling like a used up battery. I don’t even remember the drive home. 

But I survived, and I now have a solid starting point for comparison of cognitive symptoms, should the dreadful day come when I repeat the same stories all the time, or lose my keys way too often. 

I found my keys. But in the fridge?

This actually happened to me once, a long time ago, perhaps even before my brain had become the incredible shrinking cerebrum.

I probably went, keys in hand, directly from the car to the kitchen with a bag of food needing to go in the refrigerator, and I opened the door and absent-mindedly set the keys next to last night’s leftovers.

This momentary lapse may have been a one-time thing – or maybe not. We Parkinson’s people are always looking back in time for clues that may have foreshadowed our PD diagnosis: the loss of smell, the arm that doesn’t swing when you walk. It’s a form of self torture.

Short-term memory glitches are common among people who are aging – with or without Parkinson’s. It’s true, loss of dopamine affects thinking ability along with movement, but that doesn’t mean a Parkinson’s diagnosis also sentences you to severe dementia.

One recent study shows that the older you are at the time of a Parkinson’s diagnosis, the higher the probability of a dementia diagnosis in the next one, five, or ten years. Other studies on cognitive symptoms in Parkinson’s vary, but a general consensus is that one-quarter to one-third, perhaps even one-half, of people with advanced Parkinson’s develop dementia.

Is there anything a person with PD can do?

Why, yes! In Part 2, I outline some what can help. Click the link and read on.

Part 2: How to delay cognitive decline when you have Parkinson’s