Understand dementia caused by Parkinson's disease and its manifestations?

In recent years, many patients will consult Parkinson's common sense problems through the Internet. We invite the most authoritative expert group of doctors in Beijing to discuss and study these issues. Now I will answer my friends with Parkinson's disease one by one. The details are as follows: Parkinson's disease is a common nervous system disease in middle-aged and elderly people, and its main pathological feature is the lack of a substance called dopamine in the brain. In the late stage of Parkinson's disease, some patients often have dementia symptoms, which are called Parkinson's dementia. The incidence of dementia in patients with Parkinson's disease is significantly higher than that in patients with other diseases of the same age, and about 24%~3 1% of patients with Parkinson's disease will develop dementia; Among all kinds of dementia, dementia caused by Parkinson's disease accounts for about 3% ~ 4%; The incidence of Parkinson's disease dementia in people aged 65 and above is about 0.2%~0.5%. But neuropsychological tests have confirmed that about 70% of Parkinson's patients are accompanied by dementia. With the increase of age, the incidence of dementia is also increasing. By the age of 85, the incidence of dementia among patients with Parkinson's disease is about 65%. The incidence of Parkinson's disease dementia in patients over 70 years old is three times that of patients younger than this age group. In a word, it is believed that dementia is more obvious during the period of 2 months to 5 years before the death of Parkinson's disease patients. Just like Parkinson's disease, the cause of Parkinson's disease and dementia is still not completely clear. It may be related to environmental toxins and genetic factors. There are many changes in neurotransmitters in patients with Parkinson's disease and dementia, including dopamine, acetylcholine, norepinephrine and serotonin. Although some people think that the decrease of the latter two may be related to cognitive impairment and depression, more attention is paid to the serious loss of the first two neurotransmitters, especially the substantia nigra neurons in the brain, which leads to the obvious decrease of dopamine in the brain. The main manifestations of dementia in Parkinson's disease are dyskinesia, dementia and neuropsychiatric symptoms. Compared with Parkinson's disease, dyskinesia and gait abnormality are more common in dementia patients with Parkinson's disease, but tremor is relatively rare, so these patients have relatively poor curative effect on levodopa, a drug for Parkinson's disease. Mental retardation of Parkinson's disease has been confirmed by many studies, but the intelligence of patients with Parkinson's disease in the early stage does not necessarily change. With the progress of the disease, mental retardation gradually appeared. The concrete manifestations are the decline of abstract thinking ability, poor insight and judgment, obstacles in understanding and summarizing, lack of comparative analysis of similarities and differences of things, decline of verbal expression and acceptance of things, and decline of comprehensive learning ability. Memory disorder is manifested as the decline of language memory; Visual memory and motor memory disorders, as well as obvious damage to long-term memory; Impaired logical memory; Impaired instantaneous memory; Computing power is declining. Due to the inability to concentrate, memory declines, and the ability of digital mental arithmetic is obviously impaired. Visual spatial skill deficiency Parkinson's disease has obvious visual spatial skill impairment, which hinders the processing of disproportionate visual information. Even if the intelligence is normal in the early stage of the disease, the perception of visual space may change. Specifically, the ability to observe problems and long-term visual memory decline, image memory decline, lack of foresight, foresight and planning, structural comprehensive ability decline, visual analysis comprehensive ability, visual movement coordination ability and abstract space combination skills decline. Mental retardation Parkinson's disease dementia is obviously slow at the beginning of mental activity and intellectual activity, which is characterized by prolonged time, slow response and slow thinking. Hallucinations and illusions Visual hallucinations are vivid colors and vivid images of animals or people, which can be spontaneous or induced by anti-Parkinson's drug treatment. Hallucinations are often accompanied by visual hallucinations, which can take different forms, especially persecution, theft and feeling that strangers live in their own rooms. In addition, about 20% patients suffer from depression. The patient's interest in the surrounding things decreases, which is manifested as indifference, depression, slow response, irritability and euphoria. Head CT scan showed that Parkinson's disease dementia had atrophy of brain, brain stem and basal ganglia. This CT change of diffuse brain atrophy can explain the manifestations of mental retardation in patients with this disease.