Wellness Tips for Parkinson's

If you’ve been diagnosed with Parkinson’s, you can help keep yourself in safe and healthy ways by taking certain precautions.

Physical therapy is almost always beneficial.

Group wellness programs, group exercise, yoga, tai-chi, and support groups which include the involvement with others can help with the isolation and depression some people with Parkinson’s feel. Exercise can ease symptoms.

Research shows that patients with Parkinson’s disease who exercise regularly do better than those who don’t. Any degree of exercise helps!

EXERCISE TIPS

Check with your doctor before starting an exercise regime.

• Practice physical and occupational therapies from certified therapists.
• Exercise your face, jaw and eyes whenever possible.
• Perform bending, stretching, and breathing exercises often and regularly.
• Exercising in bed may be easier than on the floor.
• Even if it means having to hold onto something, build your walking skills.
• Exercising in the water is easier on the joints. Many fitness centers, hospitals, colleges, and YMCAs or YWCAs have water exercise programs.

SAFETY TIPS

Ask your doctor for a prescription/referral for a home safety evaluation by an occupational therapist.

• Install grab bars in the tub and shower.
• Use a bath chair or stool in the shower.
• Keep floors smooth but not slippery.
• Stockpile supplies in easy to reach cabinets.
• Make sure stairwells are lit.
• Get nightlights for bathrooms and hallways.
• Keep walking areas free of clutter.
• Wear low heeled, comfortable shoes. Avoid walking in slippery socks and slippers.
• Make sure carpets are fully tacked to the ground, and avoid throw rugs.

DIET AND EATING TIPS

• To avoid choking and encourage digestion cut foods into smaller portions.
• Remain upright for 30 minutes after eating.
• For upset stomachs linked to medication, try eating a small amount of non-protein based food before taking medication.
• If protein blocks your body’s ability to absorb levodopa (Sinemet), you may need to avoid taking this medication within 30 minutes before to 1 hour after eating meat or other high-protein foods.

PARKINSON’S AND DEMENTIA

Dementia is a less common feature of Parkinson’s disease. Approximately 20% of people with Parkinson’s disease will develop Parkinson’s disease Dementia (PDD). A person with Parkinson’s who experiences hallucinations and more severe motor control problems are at risk for dementia. For those people with Parkinson’s who go on to develop dementia, there is usually at least a 10 to 15 year lag time between their diagnosis and the onset of dementia.

Signs of dementia would include:

• Memory problems
• Distractibility
• Slowed thinking
• Disorientation
• Confusion
• Moodiness
• Lack of motivation
• Hallucinations

Parkinson’s disease Dementia (PDD) is different from a similar disorder, known as Dementia with Lewy Bodies (DLB). DLB is characterized by fluctuations in alertness and attention, recurrent visual hallucinations, and Parkinsonian motor symptoms like rigidity and the loss of spontaneous movement. In this disorder, the cognitive problems, such as hallucinations, tend to occur much earlier in the course of the disease and often precede the difficulties with walking and motor control.

Is the dementia caused by Parkinson’s disease or something else? Indications that dementia may be caused by something other than Parkinson’s include agitation, delusions (strongly held false beliefs), language difficulties, and early onset of memory symptoms. If these factors are present, your physician can test for other possible causes of dementia, such as a Vitamin B-12 deficiency or an underactive thyroid gland. Depression is also common in people with Parkinson’s and can mimic dementia by causing similar symptoms.

Additionally, Alzheimer’s and Parkinson’s are both common in the elderly, especially in those over 85. Therefore, people with Parkinson’s who develop dementia may develop Alzheimer’s dementia as well. If a person with established Parkinson’s develops signs of Alzheimer’s dementia, he or she will probably benefit from medications for Alzheimer’s dementia as well. The similarities in symptoms between Parkinson’s, Diffuse Lewy Body, and Alzheimer’s disease, can make it difficult to determine the cause of the symptoms. Therefore, obtaining a thorough consultation with a neurologist is recommended to make a definitive diagnosis and establish an appropriate plan of care.

There are other, much less common disorders with features similar to Parkinson’s with dementia such as Multiple System Atrophy (MSA), Normal Pressure Hydrocephalus (NPH), Corticobasal degeneration (CBD) and Progressive Supranuclear Palsy (PSP) to name a few. If people do not respond to treatments for Parkinson’s disease or if they have unusual features, referral to a neurologist who specializes in Movement Disorders is often helpful.

The bottom line  Parkinson’s is a disorder of muscle and movement control that should be quite manageable and controllable for a lengthy period of time. About 20% of patients develop dementia, including loss of memory and other cognitive functions. If patients with Parkinson’s develop behavioral or memory problems; a physician can help determine the cause of the problems and develop a treatment plan.