The Other Dimension of Parkinsons


Windsor Reflections at Lakewood Ranch

Posted on

Apr 01, 2022


Florida - Sarasota, Bradenton & Charlotte Counties

Share This
For more information on the author, Windsor Reflections at Lakewood Ranch, CLICK HERE!

Lets start with what most of us know about Parkinson's disease (PD). Comparatively common in older adults, its a neurological disorder estimated to affect nearly 2% of those over age 65, estimated by the National Parkinson's Foundation to be one million Americans in 2020.Public figures, such as the popular actor Michael J. Fox, who has PD, have increased the publics awareness and understanding of the disease.

Now lets consider the side of PD less talked about: Parkinson's Disease Dementia (PDD). Usually, the condition is depicted as auditory and visual hallucinations of imagined occurrences, delusion, and paranoia that follow the more visible motor dysfunction typical of Parkinson's. In fact, the dementia component of PD usually does not appear earlier than a year or more after the diagnosis. The average time from onset of Parkinson's to signs of dementia may be around ten years if certain studies are correct. The phenomenon may also be more common than most people think. That's why, to recognize April as Parkinson's Awareness Month, were focusing on the dementia phase of the disease.

Recognizing PDD
The University of California, San Francisco, Weill Institute for Neurosciences Memory and Aging Center outlines the symptoms of PDD:1

Trouble focusing, remembering things or making sound judgements
May develop depression, anxiety or irritability
May hallucinate and see people, objects or animals
Sleep disturbances

The Alzheimer's Organization states that an estimated 50 to 80 percent of those with Parkinson's eventually experience dementia as their disease progresses. There's no single test or combination of tests that can give a conclusive diagnosis of PDD, which may partly account for the wide range in the statistics. An original diagnosis of Parkinson's will be based on movement irregularity, with PDD symptoms at least a year off. This puts greater importance on working closely with a physician for an early diagnosis. Sadly, the deterioration of brain cells by PDD can't be stopped or slowed. Drug therapy can alleviate some of the symptoms.

The Difference Between Parkinson's Dementia and Others
The difference among various dementias can be confusing, and dementia should never be self-diagnosed instead of consulting with a neurology specialist. First, consult your primary physician. The International Parkinson and Movement Disorder Society provides a directory of movement disorders specialists to search for a specialist in your area.

Dementia with Lewy bodies(DLB) is a spectrum of dementia-related to Parkinson's, which is also characterized by the formation of Lewy bodies, clumps of protein that form in the brain. PDD symptoms resemble DLB, which also causes changes in thinking, behavior, and movement. The difference between PDD and DLB is that with DLB behavior and cognition impairment symptoms occur first, whereas Parkinson's will present as movement impairment with dementia appearing later.2While the cause of PDD is unknown, scientists think the progression of Lewy body protein build-up first affects motor control, and eventually, enough nerve cells die that the first signs of dementia appear.

Different clumps of protein form in a brain affected by Alzheimer's Disease (AD). Another difference between Alzheimer's and similar dementia is that Parkinson's tends to affect attention and executive function more than memory .An essential and hopeful distinction: although the symptoms are similar, people with PDD are not at risk of developing Alzheimer's Disease, according to the Pacific Brain Health Center. Nor is long-term memory likely to be as affected. The characteristic loss of recognition of loved ones and a general awareness that affects Alzheimer's patients is not typical of PDD.3

Aging and Parkinson's
Johns Hopkins Medicine states: The older you are, the greater your risk of developing Parkinson disease.4The Michael J. Fox Foundation, in its downloadable brochure Navigating Cognitive Changes in Parkinson's, also notes "Cognitive changes from Parkinson's often are different or more than you'd expect with age." The example they offer is a helpful illustration of the difference between ordinary changes in memory function due to age and those caused by Parkinson's. Ordinarily, you'll forget where you left your keys, and this may become more common as you age. By contrast, forgetting what your keys are used for or how to use them signifies a more severe dysfunction related to dementia.

Caregiving at Home
People with PD may get along well with home caregiving with the help of a spouse for years. The onset of PDD can change this significantly, primarily in disrupting the ability to communicate. Be prepared that the disorientation will change a persons behavior. They may not be able to be left alone and may become moody, impulsive, and annoyed.

A few simple communication techniques are recommended for the caregiver:

Establish a daily routine. Having meals, exercise, and activities at roughly the same time every day avoids annoyance and anxiety in your loved one.
Simplify living areas. Reduce distraction and shadows.
Keep the home brightly lit.
Remain calm and empathetic. Remember, it's the disease and not a conscious decision that creates erratic behavior.
When evaluating the move to an Assisted Living or Memory Care community, consider that all the above features are incorporated into a well-designed, quality care residence.

Try to establish a gentle regimen for your loved one with PDD. It will be difficult to change old habits, and those that are not harmful might be comforting. But some boundaries may need to be set to add years of a higher quality of life. These are things to encourage the person with PDD to do:

Be socially active Engaging with friends exercises your cognitive skills, remembering names, etc.
Get involved in the community Maintain a sense of self-worth.
Exercise regularly Exercise also releases natural brain chemicals that can improve emotional well-being.
Eat a healthy, balanced diet High protein meals can benefit your brain chemistry.
Train your brain Play brain games online puzzles are great or playing cards with your caregiver.
Reduce stress
Sleep well
Take care of medical conditions Diabetes, high blood pressure, and high cholesterol
can damage your brains blood vessels and lead to
thinking and memory problems.
Check on mood and motivation.
Review your medications Certain prescriptions and over-the-counter medications can confuse some people. Consult your physician.
Drink in moderation
Don't smoke Smoking is related to Alzheimer's and other cognitive disorders.

Caregiver stress shows up on your face and in your manner in subtle ways that nonetheless are easily picked up by your loved one. Give yourself a break. Dementia will place demands on your relationship, and this is natural. You should get enough sleep and regular nutrition. Seek counseling from your specialist to help you stay on even keel.

Assisted Living, Memory Care and Nursing Homes
There are no long-term care communities exclusively for people with Parkinson's. Assisted Living and Memory Care communities are typically equipped for their particular needs because of the prevalence of the disease. There will very likely become a point where loved ones will not care for themselves in significant ways, such as getting dressed and preparing food. Dementia, of course, will further inhibit their abilities. Assisted Living is a good option for earlier PD stages. Still, the onset of dementia, which can take years, will require Memory Care for optimum therapy and assistance with daily living. It is worth considering whether an inevitable move from Assisted Living to Memory Care is desirable or if Memory Care is the best initial choice. Memory Care residences should include specific physical design to aid dementia patients in navigating to and from and within their rooms or apartments. Staff should be highly trained and compassionate. Programming should rely on the best medical practice and cognitive science. Either Assisted Living or Memory Care, or a nursing home, will provide meals, assistance with daily living routines, and emergency care. The costs and level of care among the three vary widely. Interview the residence director and health care director to assess the level and quality of care the residence can provide.

For More Information About Parkinson's:
If you or your family has questions about Parkinson's disease and Parkinson's Disease Dementia, want information about treatment, or need to find support, consult your primary care physician and contact any of the following organizations:

The American Parkinson Disease Association.

National Institute of Neurological Disorders and Stroke

Michael J. Fox Foundation for Parkinson's Research

Parkinson's Foundation

Other Articles You May Like

Time for tax-loss harvesting?

As you know, the gig economy has been booming over the past several years. If youre thinking of using your skills to take on a side gig, what should you do with the money youll make?Theres no one right answer for everyone, and the decisions you make should be based on your individual situation. And of course, you may simply need the extra income to support your lifestyle and pay the bills. But if you already have your cash flow in good shape, and you have some freedom with your gig money, consider these suggestions: Contribute more to your IRA. If you couldnt afford to contribute the maximum amount to your IRA, you may find it easier to do so when you have additional money coming in from a side gig. For the 2023 tax year, you can put in up to $6,500 to a traditional or Roth IRA, or $7,500 if youre 50 or older. (Starting in 2024, this extra $1,000 catch-up contribution amount may be indexed for inflation.) The amount you can contribute to a Roth IRA is reduced, and eventually eliminated, at certain income levels. Look for new investment opportunities. If youre already maxing out your IRA, you might be able to find other investment possibilities for your side gig money. For example, if you have young children, perhaps you could use some of the money to invest in a 529 education savings plan. A 529 plan offers potential tax advantages and can be used for college, qualified trade school programs, and possibly some K-12 expenses. Please keep in mind that potential tax advantages will vary from state to state. Build an emergency fund. Life is full of unexpected events and some can be quite expensive. What if you needed a major car repair or required a medical procedure that wasnt totally covered by your health insurance? Would you have the cash available to pay these bills? If not, would you be forced to dip into your IRA or 401(k)? This might not be a good move, as it could incur taxes and penalties, and deprive you of resources you might eventually need for retirement. Thats why you might want to use your gig earnings to help fund an emergency fund containing several months worth of living expenses, with the money kept in a liquid, low-risk account. To avoid being tempted to dip into your emergency fund, you may want to keep it separate from your daily spending accounts.   Pay down debts. Most of us will always carry some debts, but we can usually find ways to include the bigger ones mortgage, car payments and so on into our monthly budgets. Its often the smaller debt payments, frequently associated with high-interest-rate credit cards, that cause us the most trouble, in terms of affecting our cash flow. If you can use some of your side gig money to pay down these types of debts, you could possibly ease some of the financial stress you might be feeling. And instead of directing money to pay for things you purchased in the past, you could use the funds to invest for your future.As weve seen, your side gig money could open several promising windows of opportunity so take a look through all of them. Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. Edward Jones, Member SIPC

Time for tax-loss harvesting?

Its been a bumpy year for the financial markets which means that some of your investments may have underperformed or lost value. Can you use these losses to your advantage?Its possible. If you have some investments that have lost value, you could sell them to offset taxable capital gains from other investments. If your losses exceed gains for the year, you could use the remaining losses to offset up to $3,000 of ordinary income. And any amount over $3,000 can be carried forward to offset gains in future years. This tax-loss harvesting can be advantageous if you plan to sell investments that youve held in taxable accounts for years and that have grown significantly in value. And you might receive some gains even if you take no action yourself. For example, when you own mutual funds, the fund manager can decide to sell stocks or other investments within the funds portfolio and then pay you a portion of the proceeds. These payments, known as capital gains distributions, are taxable to you whether you take them as cash or reinvest them back into the fund. Still, despite the possible tax benefits of selling investments whose price has fallen, you need to consider carefully whether such a move is in your best interest. If an investment has a clear place in your holdings, and it offers good business fundamentals and favorable prospects, you might not want to sell it just because its value has dropped. On the other hand, if the investments youre thinking of selling are quite similar to others you own, it might make sense to sell, take the tax loss and then use the proceeds of the sale to purchase new investments that can help fill any gaps in your portfolio. If you do sell an investment and reinvest the funds, youll want to be sure your new investment is different in nature from the one you sold. Otherwise, you could risk triggering the wash sale rule, which states that if you sell an investment at a loss and buy the same or a substantially identical investment within 30 days before or after the sale, the loss is generally disallowed for income tax purposes.Heres one more point to keep in mind about tax-loss harvesting: Youll need to take into account just how long youve held the investments youre considering selling. Thats because long-term losses are first applied against long-term gains, while short-term losses are first applied against short-term gains. (Long-term is defined as more than a year; short-term is one year or less.) If you have excess losses in one category, you can then apply them to gains of either type. Long-term capital gains are taxed at 0%, 15% or 20%, depending on your income, while short-term gains are taxed at your ordinary income tax rate. So, from a tax perspective, taking short-term losses could provide greater benefits if your tax rate is higher than the highest capital gains rate.Youll want to contact your tax advisor to determine whether tax-loss harvesting is appropriate for your situation  and youll need to do it soon because the deadline is Dec. 31. But whether you pursue this technique this year or not, you may want to keep it in mind for the future because youll always have investment tax issues to consider.   Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL  This article was written by Edward Jones for use by your local Edward Jones Financial Advisor.Edward Jones, Member SIPC

Do your investments match your goals?

As you go through life, youll have various financial goals and to achieve them, youll need to invest. But just recognizing the need to invest is not as useful as matching specific types of accounts or investments with specific goals. How can you make these connections?Lets look at some common goals and how they could possibly be met with appropriate accounts and investments: Saving for a down payment on a house  When youre saving for a down payment, you want a certain amount of money available at a certain time so, for this goal, you wont want to take too much risk. Consequently, you might consider investing in certificates of deposit (CDs), which will pay you regular interest payments and return your principal when the CDs mature. CDs are issued in a range of maturities, from one month to 10 years. Other vehicles you might consider are money market accounts or other cash equivalents.   Saving for a childs education  If you have children, and youd like to help them pay for some form of higher education, you may want to consider a 529 education savings plan. Any earnings growth in a 529 plan is federally tax free, provided the withdrawals are used for qualified education expenses, and you may also receive state tax benefits. A 529 plan can be used for college, approved trade school programs, student loan repayments and some K-12 costs. And if the child youve named as a beneficiary chooses not to continue their education, and doesnt need the money in a 529 plan, you can generally switch beneficiaries to another immediate family member.  Saving for retirement  This is the one goal that will remain consistent throughout your working years  after all, you could spend two or even three decades in retirement, so youll need to accumulate as many financial resources as you can to pay for those years. Fortunately, you likely have access to several good retirement-savings vehicles. If you work for a business, you might have a 401(k) plan, which offers you the chance to put away money on a tax-deferred basis. (If you have a Roth option in your 401(k), your withdrawals can be tax free, although, unlike a traditional 401(k), your contributions wont lower your taxable income.) If you work for a public school or a nonprofit organization, you may be able to participate in a 403(b) plan, which is quite similar to a 401(k), and the same is true if you work for a state or local government, where you might have a 457(b) plan. And even if you invest in any of these plans, you can probably also contribute to an IRA, which gives you another chance to invest on a tax-deferred basis (or tax-free basis, if youre eligible for a Roth IRA). Try to take full advantage of whatever retirement plans are available to you.Here's one final point to keep in mind: While some investments and accounts are appropriate for certain goals, they may not necessarily be suitable for your individual situation  so keep all your options in mind and take the steps that are right for you.  Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. Edward Jones, Member SIPC