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 "Tackling dementia" in Parkinson's Disease 
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post "Tackling dementia" in Parkinson's Disease
An abstract was recently posted to PubMed about an article on PDD and DLB published in an English journal. This abstract leads me to believe that the full article is interesting. (Can anyone obtain the full article?)

I'm curious what you think about this statement: "Well lit rooms and the use of glasses and hearing aids can help to reduce hallucinations."

Robin




The Practitioner. 2011 Jan;255(1736):15-7, 2.

Tackling dementia in patients with Parkinson's disease.

Rolinski M, Ebmeier KP.
FFulbrook Centre, Oxford.

Abstract
Dementia more than one year after the onset of motor features associated with Parkinson's disease is defined as Parkinson's disease with dementia (PDD). If it develops within one year of the motor features, the term dementia with Lewy bodies (DLB) is used. Since clinical and pathological features are similar, it is generally accepted that both represent a continuum of the same disorder.

PDD together with DLB account for around one fifth of all cases of dementia in the elderly.

Studies suggest that most patients with Parkinson's disease would eventually develop dementia if they lived long enough. The diagnosis of PDD in the presence of long-standing pronounced motor features rarely poses a diagnostic dilemma. However, the diagnosis of DLB may be more difficult. It relies on the revised consensus clinical criteria which require the presence of at least two of the following three syndromes: persistent visual hallucinations, fluctuating defects in cognitive and functional ability, and parkinsonism. An early referral to a specialist clinic may not only help to confirm the diagnosis, but also to co-ordinate the group of professionals working with the patient.

Well lit rooms and the use of glasses and hearing aids can help to reduce hallucinations. Cholinesterase inhibitors used in Alzheimer's disease have a role in DLB and PDD. Trials show moderate improvements in cognitive function in patients treated with rivastigmine. The greatest impact, however, seems to be on the psychotic features of the disease. Patients with DLB are less likely to have a good motor response from L-dopa than patients with Parkinson's disease or PDD.

PubMed ID#: 21370709 (see pubmed.gov for this abstract only)


Mon Mar 07, 2011 2:01 am
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Joined: Fri Dec 31, 2010 3:07 pm
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Location: Minnesota
Post Re: "Tackling dementia" in Parkinson's Disease
That does sound interesting, Robin.

I have read that about well-lit rooms many times, but all of them were after Coy was no longer hallucinating so I don't have personal experience with it. I guess the theory is that shadows can trigger hallucinations in a softly lit room. I can understand how poor vision or poor hearing might also contribute to the problem, at least theoretically.

It would be interesting to hear if any of our members have personal experience with this.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Mon Mar 07, 2011 2:17 am
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Post Re: "Tackling dementia" in Parkinson's Disease
I think there is something to this, I'm going to pay more attention when Frank does hallucination. I know his outside hallucinations are probably shadows, and if the trees are moving he thinks someone is coming closer.
I put lights on in each room as it starts to get dusk, but that was because he can't figure out how to do it himself. Thinking back, when he hesitates to enter an area because someone is there, it is an unlite room.
Thank you,

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Gerry 67, cared for Frank 71, married 49 yrs; dx 2004, passed away October 26, 2011.


Mon Mar 07, 2011 8:54 am
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Post Re: "Tackling dementia" in Parkinson's Disease
That is so true with my Dad. His hearing is extremely bad and we have tried several times to get him to wear a hearing aid, but he refuses. I am convinced that a lot of the 'hammering', and all the other noises he hears are more pronounced because of his very poor hearing. I have also noticed that his hallucinations are definitely worse in the evening. He has often shouted at me to 'look at the devil going up the stairs'. His eyes would follow this creature going upstairs, and it is always around dusk, when shadows are falling. I will be more vigilant at that time of day and make sure the lights are on before the shadows fall. I wish we could get him to wear a hearing aid, but I'm afraid it only upsets him if we try too much to persuade him to try the aid.

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cared for Dad who passed away on January 28th 2013 R.I.P.


Mon Mar 07, 2011 9:15 am
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Joined: Fri Jan 15, 2010 9:33 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
I wish you a lot of luck with the hearing aid issue. My dad was extremely hard of hearing too, and he was bad enough about using his hearing aids BEFORE his big decline. Once that happened, getting him to use them was just an exercise in futility. We all gave up and just yelled, which was the only way he could hear us. Interestingly, there were times during the following year where his hearing became extremely acute - he was able to hear things he hadn't heard in 20 years! This is a strange disease indeed! Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Mar 07, 2011 11:48 am
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Post Re: "Tackling dementia" in Parkinson's Disease
My husband's hearing is also hyper-acute whereas his hearing had been marginal before Lewy. His hallucinations may be slightly more pronounced in evening but his hallucinations have never been as big a problem as his delusions, which are constant and cause him much anxiety.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Mar 07, 2011 12:14 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
Well, at least maybe I am not imagining that my mother's hearing has improved! By about two years before her diagnosis, her hearing was really getting bad and the audiologist said she had moderate hearing loss in both ears and recommended hearing aids, which she refused to try. Now, her hearing seems to be much better. Strange, indeed.

Julianne


Mon Mar 07, 2011 1:21 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
Frank could never adj a hearing aid, and I wouldn't be able to know the volume he was hearing. So I never considered them.

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Gerry 67, cared for Frank 71, married 49 yrs; dx 2004, passed away October 26, 2011.


Mon Mar 07, 2011 1:24 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
I find this abstract very interesting. Especially where they say if the Dementia is outside a year of onset of Parkson's it is PDD and if within a year it is LBD. I have read different opinions but my LO dementia didn't start until 2 years after diagnosed with parkinson's but they are calling it LBD. So, I'm confused. In regards to light in room to reduce hallucinations. I have tried this as my doctor told me the same thing. Keep the rooms well lit and it will reduce the hallucinations. I have tried to keep it light and I think it works somewhat. But she still sees people sitting in the van when we go outside to get in the van. Ihave to admit thoght, the headrests along witht the shape ofthe top of the seat, I can see where it could cause you to think there was someone inthe van.

Please clarify for me about the PDD vs LBD.

The addition of Namenda has produced amazing results. In view of the news of Bill Gates donation to charity, I have written him and asked him to consider directing some of that to the LBD foundation


Wed Mar 09, 2011 7:55 am
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Joined: Mon Mar 08, 2010 9:32 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
Robin, I found what appears to be the full abstract on Unbound MedLine. It says the same thing as what you quoted above.


Wed Mar 09, 2011 8:14 am
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Joined: Fri Aug 11, 2006 1:46 pm
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Post Re: "Tackling dementia" in Parkinson's Disease
I did quote the entire abstract from PubMed (pubmed.gov). Did you find the full article on Medline?


Wed Mar 09, 2011 12:03 pm
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