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April is Parkinson’s Awareness Month. Nearly 90,000 people in the United States are diagnosed with Parkinson’s each year. Scientists believe a combination of environmental and genetic factors are to blame. There is currently no cure for this disease, so raising awareness is crucial for early diagnosis and treatment, improving quality of life for those living with Parkinson's, and funding research for a cure.

James Parkinson is credited as having first identified the symptoms of Parkinson’s disease more than 200 years ago. Since then, we have made considerable progress towards understanding what causes the motor symptoms we most associate with this disease. We now recognize a spectrum of non-motor symptoms as part of Parkinson’s that were not originally associated with that disease.

But what is Parkinson’s? You may have heard of people with Parkinson’s having dementia-like symptoms; is it a form of dementia?

Parkinson’s is a neurodegenerative disorder of the nervous system. It was originally described based on a set of motor symptoms such as tremor while at rest, increased muscle tone and rigidity, and slowness of movement. Over time, Parkinson’s patients may develop problems walking, talking and swallowing. They may experience fatigue, sleep disorders, as well as memory and cognitive problems.

Here are some early signs of Parkinson’s. Remember, no single one of these symptoms means you should worry. But if you have multiple symptoms, talk with your doctor.

1. Tremors, often in the hands or fingers.
2. Small handwriting.
3. Loss of smell.
4. Trouble sleeping.
5. Trouble moving or walking, including stiffness and balance problems.
6. Constipation.
7. A soft or low voice.
8. Facial Masking, meaning a reduction of facial expressions.
9. Dizziness or fainting.
10. Stooping or hunching over.

To help Parkinson’s patients manage their symptoms, here are some tips:

• Build Your Care Team: Taking a patient-centered approach to healthcare is essential. No two Parkinson’s patients are the same, so it’s important to build a healthcare team that understands and helps manage your symptoms and quality of life.
• Exercise: People with Parkinson’s who exercise for 2.5 hours per week experience a slowed decline in quality of life. Aerobic activity, stretching, strength training, and balance/agility/multi-tasking exercises can keep you moving well.
• Medication: Since most Parkinson’s symptoms are caused by a lack of dopamine in the brain, many Parkinson’s drugs are aimed at either temporarily replenishing, or mimicking the action of, dopamine.
• Diet & Nutrition: Food! What you eat, how much and when, can impact how you live well with Parkinson’s.

Due to the common memory and cognitive problems, which affect about half of all Parkinson’s patients, the term “Parkinson’s disease dementia” has been adopted. The term dementia means that a person has “permanent cognitive changes that are significant enough to impact daily living.” The combination of movement and cognitive impairments can be particularly challenging and may limit a Parkinson’s patient’s ability to participate in social settings and perform basic activities.

Changes in the structure and chemistry of the brain can cause memory and thinking problems in Parkinson’s patients. Alpha-synuclein, a protein that is central to Parkinson’s, forms sticky clumps, called Lewy Bodies, that can disrupt normal brain functioning and lead to dementia. Because of this, the term “Lewy Body dementia” may sometimes be used.

Lewy Body occurs first in higher brain regions, causing problems with attention, memory and hallucinations, before the common motor symptoms of Parkinson’s may even develop.

Lewy Body dementia includes two different types of related dementias, distinguished by which symptoms start when:

1. Parkinson’s disease dementia: diagnosed when a person living with Parkinson’s experiences significant cognitive decline after a year or more of motor symptoms.
2. Dementia with Lewy Bodies – diagnosed when cognitive decline is the earliest symptom, or when cognitive decline and motor symptoms begin and progress together.

A lot of people ask me what the difference is between Alzheimer’s and Parkinson’s or other dementias. As I learned a few years ago when obtaining my dementia advisor certification, “all Alzheimer’s is dementia but not all dementias are Alzheimer’s.” The advanced cognitive changes that impact daily living in both Alzheimer’s and Parkinson’s mean they are BOTH different types of dementia.

• Alzheimer’s causes declines in memory, thinking and reasoning skills. Alzheimer’s is diagnosed by physicians, neurologists, neuropsychologists, geriatricians, and geriatric psychiatrists.
• Parkinson’s disease dementia tends to be less disabling than Alzheimer’s disease. People with Alzheimer’s disease have language difficulties earlier than people with Parkinson’s, and they are unable to form new memories unlike in Parkinson’s.
• While Alzheimer’s disease is the most well-known form of dementia, there is also vascular dementia, Lewy Body dementia, and frontotemporal dementia. Some patients develop multiple types of dementia, which is known as “mixed dementia.” There are also rare types of dementia, caused by diseases and medications.

The Parkinson’s Foundation offers resources to aid in a patient’s Parkinson’s journey:

1. Helpline: Call PF’s Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions, provided by nurses, social workers and health educators.
2. Newly Diagnosed Guide: Designed to help people with Parkinson’s and their loved ones get started on their PD journey, learn more about PD and prepare for a doctor's appointment.
3. Genetic Testing and Counseling Study: PD GENEration: Mapping the Future of Parkinson’s Disease is a global research study that provides genetic testing and counseling at no cost for people with Parkinson’s.
4. PF Library: Explore books, podcasts, fact sheets, videos, and more.
5. Hospital Safety Guide: This guide is a resource for people with Parkinson's and their care partners, filled with useful tools to prepare for a hospital stay, either planned or unplanned.

I would be remiss in highlighting Parkinson’s Awareness Month if I did not also mention the Guide Program, of which Care Advantage is the personal care provider for Medicare in Virginia! The “Guiding an Improved Dementia Experience” (GUIDE) Model is a pioneer program announced by the Centers for Medicare & Medicaid Services (CMS) in 2024, designed to support people living with dementia and their caregivers. The goal is to improve the quality of life for those affected by dementia while also easing the burden on caregivers.

Thinking about Parkinson’s, and often the related dementia symptoms, the Guide Program could provide much needed respite benefits for Parkinson’s patients and their families!

To qualify for the Guide Program, a patient must be:

• Showing signs of a decline in mental functioning or formally diagnosed with a disease that impacts cognitive abilities.
• Receiving support from family or friends that could benefit from relief.
• Enrolled in Medicare Parts A and B with Medicare as primary payer (patients enrolled with Medicare Advantage plans, Pace, or hospice are not eligible).

To learn more about Care Advantage’s role in the Guide Program and how your loved one might qualify, please call our Client Services at 866.323.9464 or visit us at www.careadvantageinc.com.