Parkinson's Disease - Complications

Complications

Parkinson's disease (PD) is not fatal, but it can reduce longevity. The disease progresses more quickly in older patients, and may lead to severe incapacity within 10 - 20 years. Older patients also tend to have muscle freezing and greater declines in mental function and daily functioning than younger people. If PD starts without signs of tremor, it is likely to be more severe than if tremor had been present.

Parkinson's disease can seriously impair the quality of life in any age group. In addition to motor symptoms (motion difficulties, tremors) Parkinson’s can cause various non-motor problems that have physical and emotional impacts on patients and their families.

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Swallowing Problems

Swallowing problems (dysphagia) are sometimes associated with shorter survival time. Motor impairment of the muscles in the throat not only impairs chewing and swallowing, which can lead to malnourishment, but also poses a risk for aspiration pneumonia.

Emotional and Behavioral Problems

Depression is very common in patients with Parkinson's. The disease process itself causes changes in chemicals in the brain that affect mood and well-being. Anxiety is also very common and may present along with depression.

Some drug treatments (levodopa combined with a dopamine agonist) can cause compulsive behavior, such as gambling, shopping, and increased sexuality. Patients who have pre-existing tendencies to novelty-seeking behavior, or a family or personal history of alcohol abuse, may be more likely to develop compulsive gambling. Deep brain stimulus (DBS) surgery may also increase the risk for compulsive gambling in patients who have a history of gambling.

Cognitive and Memory Problems

Impaired Thinking (Cognitive Impairment). Defects in thinking, language, and problem solving skills may occur early on or later in the course of the disease. These problems can occur from the disease process or from side effects of medications used to treat Parkinson’s. Patients with PD are slower in detecting associations, although (unlike in Alzheimer's disease) once they discover them they are able to apply this knowledge to other concepts.

Dementia. Dementia occurs in about two-thirds of patients with Parkinson’s, especially in those who developed Parkinson’s after age 60. Dementia is significant loss of cognitive functions such as memory, judgment, attention, and abstract thinking. It is most likely to occur in older patients who have had major depression. PD marked by muscle rigidity (akinesia), rather than tremor, and early hallucinations also increase the risk for dementia. (Visual hallucinations can also occur as a side effect of dopamine medication.) Unlike in Alzheimer's, language is not usually affected in Parkinson's-related dementia.