Cognition is a broad term that encompasses everything from general knowledge and memory to problem solving, decision making, and comprehension. But how does Parkinson’s affect one’s cognition? The Parkinson Alliance, through its latest survey, answers that question from the patient’s perspective. Over 1,500 people with Parkinson’s participated in the survey, including nearly 400 who had DBS surgery. The survey report provides a better understanding of this complex topic, and offers recommendations pertaining to cognitive functioning in individuals with PD. You can read the complete report here.
One area that participants noted cognitive changes was in memory and how the duration of their disease and age affected perceived memory. In fact, there are “normal” types of memory problems that happen to all people, regardless if they have PD or not.
Harvard Medical School has a fascinating article entitled, “Improving Memory: Understanding age-related memory loss” in their Patient Education Center. In part, it addresses some memory issues that are normal. These include transience, or the tendency to forget facts or events over time; absentmindedness; blocking, such as something being on the tip of your tongue; misattribution, such as when you have the right memory but the wrong source (e.g., we saw that movie on Tuesday, when it was Wednesday); suggestibility, which relates to the vulnerability of your memory to the power of suggestion; bias; and persistence, meaning those memories that one cannot forget like those someone with PTSD may experience. Most fascinating was the lengthy section on why memory fades and what you can do to help keep your brain healthy. These recommendations, for example, include getting a good night’s sleep, staying socially active, continuing to learn, and managing your stress, among other things.
People with PD, however, do tend to have more problems with working memory (such as not remembering where keys are placed) and retrieval (such as not remembering an appointment). The University of California, San Francisco, offers an educational video entitled, “Coping with the Cognitive and Behavioral Symptoms of Parkinson’s Disease” on their Parkinson’s Disease Clinic and Research Center website. The video was presented by Dr. Katherine Possin at a conference on PD. The good news is that these types of memory problems can be helped with different copying strategies, which she details. For example, some strategies include writing things down, using a calendar, using an electronic reminder, and setting up a daily routine, among other things.
Also of note in our survey report is that the vast majority of participants indicated they had not been prescribed medications for cognition difficulties. However, many of those who have been prescribed medications reported a perceived benefit. But, non-medication based therapies are also useful in improving cognition as are physical exercise, reading, social relationships, learning a second language, listening to music, interacting with pets (such as service dogs), and learning to play an instrument.
If you are newly diagnosed, I recommend that you request a neuropsychological evaluation test to obtain a baseline of your cognition. Also be sure to monitor and treat sensory changes, for example your vision and hearing.
Read Cognition & Parkinson’s Disease: The Patient’s Perspective. Please let us hear from you on this topic.
— Margaret Tuchman and her blogging partner Gloria Hansen