By Dr. Howard Gluss | Licensed Clinical Psychologist, executive coach, author and radio show host
Parkinson’s disease dementia is characterized by difficulties that individuals have with cognition and reasoning abilities associated with a diagnosis of Parkinson ’s disease. As neurological changes begin to occur in a Parkinson’s patient, they often times are accompanied by mental and psychological issues such as difficulties with judgement, challenges with focus and attention, depression and anxiety. One of the key changes that occur in the brain that is linked to Parkinson’s disease, and specifically dementia associated with Parkinson’s disease, is the accumulation of deposits that are called Lewy bodies. The accumulation of these Lewy bodies can cause issues of mild cognitive impairment and or dementia. For many individuals the same changes that lead to motor symptom difficulties can also result in the slowness in cognitive processing. This change in neuropsychological abilities can also be associated with higher degrees of stress, depression and anxiety. A diagnosis of mild cognitive impairment can often times allow an individual to still live independently; whereas a diagnosis of dementia may make independent living more challenging.
Symptoms of MCI are mild and will not necessarily interfere with an individual’s ability to lead a normal life. For many, these changes may not even be noticeable even though these changes may occur with the first signs of motor difficulties. Parkinson’s disease with dementia is a more serious decline in cognitive functioning which in addition to memory loss will usually be accompanied by an individual’s challenges in caring for themselves and functioning in social situations. Parkinson’s disease, mild cognitive impairment and dementia will often affect cognitive changes and mental states.
The diagnosis of dementia or Mild Cognitive Impairment (MCI) in Parkinson’s disease does not encompass the use of one single test but rather the implementation of a battery of psychological tests in addition to any medical testing. The diagnosis of Parkinson’s disease dementia or MCI is originally diagnosed with Parkinson’s based on movement symptoms and cognitive symptoms that do not appear until one year or more later. Neuropsychological testing can be an extremely valuable tool in diagnosing mild cognitive impairment and Parkinson’s related dementia. Neuropsychology is a field of psychology that focuses on the relationship between brain and behavior. Evaluations can determine cognitive and behavioral changes such as those evidenced in Parkinson’s disease. Typically, a neuropsychological evaluation involves an interview and administration of neuropsychological and psychological tests. These tests may include an evaluation of executive functioning, procedural memory, long term and short term memory, attention skills, working memory, verbal memory and visual memory. The neuropsychological tests are usually standardized which means they are given in a similar manner to patients over time. In addition, neuropsychological testing will also look at issues of mood, emotions, quality of life and personality styles. A neuropsychological evaluation usually takes up to eight hours depending upon the complexity of the issue and the patient’s abilities and condition. A neuropsychological evaluation can assist in differential diagnosis, assessment of cognitive functioning, daily functioning and treatment. Many times insurance companies will cover part or all of the cost of the assessment.
Psychological symptoms are common in Parkinson’s disease and it is best thought of as a neuropsychological disorder. Psychological intervention in addition to medical intervention can greatly increase an individual’s quality of life when dealing with the challenges of Parkinson’s disease.
Dr. Gluss is a Licensed Clinical Psychologist (Psy21522), an executive coach, author and radio show host with an expertise in psychological assessment, understanding individual, group and organizational psychology.
For over 20 years Dr. Gluss has been applying his clinical skills as a psychologist to aiding individuals reach their maximum potential.
A native of Montreal, Dr. Gluss has worked in the United States and Canada. Some of his clients have included the Disney Corporation, Beutorac Wealth Management, Taylor Asset Management, the Vancouver Film School, and The Los Angeles Film School.