Not Just a Movement Disorder: Cognitive Changes in PD

January 2, 2008

By Marsh, M.D.

Winter 2007-2008

Distractibility, disorganization, forgetfulness, and difficulties

with planning: it frequently comes as a surprise to people with

Parkinson's disease (PD) and their families that " cognitive changes " —

alterations in memory, attention, and thinking — are often part of

PD. After all, in 1817, when Parkinson first described

the " shaking palsy " he said that, " the senses and intellect were

uninjured. " While he was correct in most of his assertions, Dr.

Parkinson did miss the mark with this claim.

Cognitive changes can impact people's everyday lives as much, and

sometimes more than, the physical effects of PD. While physicians

are increasingly recognizing the importance of addressing cognitive

and other nonmotor symptoms, many still primarily focus on treating

physical (motor) symptoms. This means that cognitive changes may go

under-treated or untreated. It is critical that we, as physicians,

understand how to prevent and treat cognitive difficulties. It is

equally crucial that people with PD and their families understand

what types of changes to look for in order to communicate concerns to

their physicians. Increased awareness and treatment of cognitive

difficulties can lead to improved quality of life for people with PD

and their families.

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