Mild Cognitive Impairment
As Parkinson’s disease (PD) advances, about 50% of people with PD will experience some cognitive decline. However, only 30% of people with Parkinson’s will develop Parkinson’s related dementia in the advanced stages of the disease.
What causes mild cognitive impairment (MCI)?
A drop in dopamine, which regulates the body’s movements, can cause mild and circumscribed cognitive changes. Scientists are currently examining changes in two other neurotransmitters called acetylcholine and norepinephrine as possible causes of decline or changes in mental control, self-regulation and memory loss (PDF, 2017).
What might it look like?
The following are some of the symptoms affiliated with MCI:
- Forgetting things more often
- Forgetting important events such as appointments or social engagements
- Losing trains of thought or experiencing problems following storylines in conversations, books or movies
- Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task or interpreting instructions
- Experiencing difficulty navigating familiar environments
- Becoming increasingly impulsive or showing increasingly poor judgement
- Family and friends noticing any of the above behaviours (Mayo Clinic Staff, 2017)
A MCI diagnosis may be made when an individual is able to perform all their usual activities successfully, without more assistance from others than they previously required. However, regular follow up is recommended to ensure that there is no progression of any impairments (UCSF Memory and Aging Center, 2017). Fernandez et al. (2005) state that: “when differences in cognitive decline are subtle, like that in PD patients with MCI, appreciating cognitive changes that may be due to medications is essential. Appropriately timing neuropsychological testing to on and off medication periods needs to be recorded for appropriate cognitive monitoring and MCI diagnosis”.
Treating MCI in Parkinson's
If you report changes of cognition to your doctor, your doctor should rule out causes of MCI other than Parkinson’s, such as vitamin deficiency, depression or fatigue. Parkinson’s does not typically cause a sudden change in cognition and, if someone experiences this, the cause is likely something else, like a medication side effect.
Drug therapies available for cognitive changes that have been professionally diagnosed as symptomatic of Parkinson’s include rivastigmine, donepezil, and galamantine. Individuals experiencing attention difficulties due to daytime sleepiness may benefit from stimulants (PDF, 2017).
Remember...
- MCI is not exclusive to people with Parkinson’s disease, although PD (or PD medications) are sometimes a direct cause of MCI.
- MCI does not decrease the worth or intelligence of an individual.
- MCI should be closely monitored.
Sources
Family Caregiver Alliance et. al. (2011). Mild Cognitive Impairment. Retrieved from https://www.caregiver.org/mild-cognitive-impairment-mci
Mayo Clinic Staff. (2017). http://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/dxc-20206111
Parkinson’s Disease Foundation, Inc. (PDF). (2017). Cognitive Impairment. Retrieved from http://www.pdf.org/cognitive_impairment_pd
This content was published in the September 2017 edition of our monthly support group newsletter, GroupLink. The content was accurate as of this publication date.