Shake, Rattle and Roll: The Less Visible Symptoms of Parkinson’s

When people think of Parkinson’s Disease (PD), they usually picture the physical manifestations of this movement disorder: tremor, shuffling steps, stooped posture, stiff and rigid movements, poor balance and dyskinesia.

When Joe, the author of the blog, Day by Day Adventures of the PD Warrior, wrote about the less visible symptoms of PD, the slow-moving wheels in my brain began churning.

This is a topic that I loathe to discuss: the loss of cognitive functioning due to PD.

I and others living with PD take pride in our intelligence and education. Most of the people I know with PD have at least a Master’s degree. A doctor from China said that all of his PD patients in China were nuclear physicists and that I was in good company. I didn’t feel reassured.

Margery H. Silver, Ed.D., is a neuropsychologist, and has a husband with PD. She wrote a terrific article entitled Cognitive Changes in Parkinson's. It is informative, practical and succinct including strategies for circumventing or managing these cognitive changes. Dr. Silver is also the co-author of Living to 100: Lessons in Living to your Maximum Potential at Any Age.

Dr. Silver categories the cognitive changes from PD as follows:
Bradyphrenia (slow thinking)
Attention and concentration
Executive functions
Memory
Visual-spatial abilities

Some of these cognitive changes from PD have impacted my behavior as follows:

Bradyphrenia (Slow Thinking)
My thinking is sometimes slow in answering a question, writing this blog, doing word jumbles, crossword puzzles, and playing Scrabble. I will eventually come up with an answer or solution, but it may take awhile. This is particularly frustrating because I previously prided myself on being an instant, quick to respond and decisive person.

Attention and Concentration
My ability to concentrate and to ignore distractions has decreased with PD. I can no longer simultaneously read and listen to music (instrumentals seem easier but songs with words are impossible). When I was working, it was difficult to deal with the constant interruptions by people who arrived in person or called by phone.

Executive Functions
I sometimes have difficulty with executive functions. They include my ability to initiate a task or activity on my own, to plan (for instance, what I will do during the day), to organize tasks and materials, to sequence (arrange items or things to do in order), to prioritize and to shift between activities and conversational subjects.

Memory
In Parkinson's disease, it is usually the retrieval of information that is impaired. I can usually get memories into storage (if I’ve paid attention), but I sometimes have difficulty recalling them. Occasionally, I have difficulty recalling a person’s name or grope for the correct word in conversation. Fortunately, memory has always been my strong suit and continues to serve me well.

Visual-Spatial Abilities
This term refers not to vision per se, but to how the brain interprets a visual image. I sometimes have difficulty judging distances and relationships between objects. In the past, I teased seniors who parked on sidewalks, but now I find myself parking on sidewalks, misjudging where the curb ends and the sidewalk begins.

Whew, I did it! I wrote about a topic that I was afraid to discuss. Thanks for listening and feel free to share your experiences about how PD has affected your cognitive abilities.