Affinity Health, a leading provider of high-quality health coverage, examines whether Parkinson’s disease inevitably leads to dementia.

Parkinson’s disease (PD) is a progressive neurological condition that gradually strips individuals of their motor skills. For those living with PD, however, challenges are not limited to physical ones.

A significant proportion of patients also experience cognitive deterioration and, in some instances, dementia.

“The association between Parkinson’s disease and dementia is not fully understood,” says Murray Hewlett, CEO of Affinity Health.

“According to the National Institutes of Health, numerous factors influence the progression of cognitive symptoms in PD patients.”

The Link between Parkinson’s Disease and Dementia

According to studies, around 80% of people with this disease are at risk of developing dementia as they face challenges related to their illness. This is believed to be due mainly to abnormal protein deposits known as Lewy bodies in the brain. These bodies are made up of a protein called alpha-synuclein. For reasons not yet fully understood, this protein clumps together and builds up in the brain cells of people with PD.

The formation and accumulation of Lewy bodies are the primary drivers of the motor symptoms associated with PD, such as tremors, muscle stiffness, and slowness of movement (bradykinesia).

Lewy bodies can also spread to other brain regions, including those responsible for memory, learning, and executive function, leading to cognitive decline.

When Does Cognitive Decline Begin?

Cognitive problems experienced in PD often come before full-blown dementia. Some patients begin noticing memory lapses, trouble concentrating or difficulty deciding things early on their journey.

With time, cognitive problems can escalate, leading to a diagnosis of dementia.

Ageing and duration of illness are major risk factors for developing dementia in people with PD. The longer someone lives with PD, the more likely they will experience cognitive decline. As we age, our brains become more vulnerable to various forms of cognitive impairment, further increasing the likelihood of dementia in older PD patients.

Stages of Parkinson’s Disease

Typically, PD goes through a predictable sequence of events comprising five stages. Cognitive impairment can occur at any sequence stage, alongside motor skill decline.

Stage One

Symptoms are mild and do not significantly interfere with one’s ability to perform normal daily activities. Usually, tremors and other movement-related symptoms are confined to one side of the body. Subtle changes can be seen in posture, manner of walking, and facial expressions. Subtle changes in attention, processing speed, and executive function may be observed, but these changes are often dismissed as part of the normal ageing process.

Stage Two

As the illness progresses, symptoms deteriorate further. This will typically include tremors, rigidity, and other movement problems that start affecting both sides of the body or midline (such as the neck and trunk). Walking becomes more difficult. Individuals may experience difficulties with tasks that require multitasking, problem-solving, and decision-making.

Stage Three

The middle stage is characterised by balance loss. Falls become more common while motor symptoms worsen. Individuals may experience more significant impairments in attention, memory, and executive function. Difficulty with planning, organising, and problem-solving becomes more apparent, and these deficits can interfere with the individual’s ability to perform complex tasks.

Stage Four

It becomes difficult for someone affected to live independently. Although walking without help or standing unsupported is possible, they generally require a cane or walker to assist. Attention and concentration become increasingly impaired, and the individual may have difficulty with language, visuospatial skills, and overall cognitive flexibility.

Stage Five

By this stage, PD has impacted motor skills to the point where individuals affected are mostly bedridden or confined to a wheelchair. They require around-the-clock care. Individuals in this stage often have significant impairments in all cognitive domains, including memory, language, problem-solving, and visuospatial skills.

It should be noted that PD progression varies among individuals, and the time between stages may differ. Some people progress more rapidly through stages, while others may remain in a particular stage for longer.

Dealing with the Emotional Impact of PD

The thought of losing both physical and mental abilities can be overwhelming for people with PD and their families. While there is no cure for PD, there is hope. Researchers are exploring gene therapies, stem cell treatments, and neuroprotective agents that may slow or halt PD progression.

They are also working hard to decipher the relationship between PD and dementia so that they can approach new interventions that could manage or even prevent a decline in cognition. Meanwhile, present-day treatment in the form of medications and cognitive rehabilitation may help improve the quality of life for those living with PD.

About Affinity Health

Affinity Health is South Africa’s leading health coverage provider, offering you a range of options at affordable rates, including access to the widest national provider network. We understand the importance of having medical insurance that meets your needs, budget, and lifestyle. Our healthcare products are designed to protect you and your family when it matters the most. We strive to give our clients peace of mind and the highest standard of service. For more information, follow us on Facebook, Twitter, and Instagram.