For years, we have heard multiple times over that Michael J. Fox has Parkinson's Disease. Recently announced, his new film is coming out that highlights his struggle with the disease and acceptance of having Parkinson's Disease.
What is Parkinson's Disease?
Parkinson's Disease is considered a neurological movement disorder. It is due to neurons in our brains breaking down and dying, creating neurological dysfunctions in movement and motor functioning, typically occurring on one side of the body to start with.
In 2020 there have been nearly one million diagnosed with Parkinson's Disease (PD). PD is considered a movement disorder mainly diagnosed by motor signs and symptoms.
However, over the past 50 years it has become apparent with treatments, studies, research, and the ability to live longer with PD that there is increased awareness that has shown neuropsychiatric symptoms (NPS) and cognitive complications with the disease as well.
Most studied neuropsychiatric symptoms are cognitive impairment such as dementia, depression, Alzheimer's disease, and psychosis. Clinically significant complications present themselves in patients as compulsive behaviors and impulse control disorders, anxiety symptoms, sleep issues, wakefulness, apathy, and fatigue.
A range of demographic and clinical correlates and potential risk factors for identifying PD patients at risk for more rapid cognitive decline have emerged, including increasing age and duration of PD (often correlated), male sex (which differentiates PD from AD), “atypical” parkinsonian features (i.e., postural instability gait disorder instead of tremor-dominant features), psychiatric disorders (e.g., psychosis, apathy, depression, and RBD), impaired olfaction, autonomic changes (e.g., orthostatic hypotension [OH]), and comorbid vascular disease (e.g., diabetes mellitus, hypertension, and hyperlipidemia)." states the National Library of Medicine website.
Neurotransmitter defects are associated with cognitive impairment. These neurotransmitters are dopamine, acetylcholine, and nori-epinephrine. Neuroimaging has shown neurodegeneration of gray and white matter in patients, along with hyperintensities presenting in white matter and metabolic decline in PD.
In terms of PD medications, there is no evidence that choice of the initial PD medication makes a difference in terms of long-term dementia rates, but the association between anticholinergic medication use and long-term cognitive decline in PD is a concern given the common use of medications with anticholinergic properties in this population. For non-pharmacological approaches, there is preliminary evidence that cognitive and physical training/activity may lead to at least short-term benefit in some cognitive abilities. Given the association between vascular risk factors and pathology and cognitive impairment in PD, and the association between both OH and obstructive sleep apnea (OSA) and cognitive performance in PD, treating other common medical or non-motor symptoms is important as well." states the National Library of Medicine website.
This information guides us to understand that our central nervous system that includes our brain, is just as important to protect and take care of as the rest of our body. It also sheds light on the importance of our health as Alzheimer's Disease and Dementia rapidly become just as prevalent worldwide.