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What Is The Prognosis For The Inability To Walk, Talk Or Swallow When Diagnosed With Dementia With Parkinson's Disease?

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Posted on Thu, 10 Mar 2022
Question: My husband has dementia with Parkinson ( probable Lewy bodies) and he cannot walk, talk, or swallow. It all happened within the last 4 months. I am lost as to what to do. What do you recommend for this condition?
doctor
Answered by Dr. Dr. Erion Spaho (12 hours later)
Brief Answer:
Both, neurological and psychiatric evaluation are necessary.

Detailed Answer:

Hello,

The dementia of Parkinson's disease may respond to drugs used in other types of dementias such as Alzheimer's (Donepezil, rivastigmine).

Drugs used for Parkinson's may worsen the memory problems, and may cause psychotic symptoms, so, a review of the doses of these drugs is also necessary.

For depression or mood issues, if these are present, antidepressants and mood-stabilizing drugs such as Nortriptyline, Citalopram may be needed.

If there are present psychotic symptoms, antipsychotics such as Clozapine may be necessary.

All these treatment possibilities and drugs adjustments should be done after evaluation of both, a Neurologist and a Psychiatrist.

Hope you found the answer helpful. Let me know if I can assist you further.
Greetings.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (11 hours later)
Thanks for your response. My husband does not talk, walk or, move on his own even in bed.He stares in space and he can't get a word out. I was concerned that you said Sinemet for Parksinson's may make the dementia worse. What tests should my husband take to be evaluated? He took a short memory test last year and he didn't know the year or month and he couldn't perform a simple math problem. He couldn't recall the words given to him after a short period of time had passed. I am worried that he's shutting down. Is this typical of dementia and Parkinson's patients?
doctor
Answered by Dr. Dr. Erion Spaho (13 hours later)
Brief Answer:
Suspected last stages of Parkinson's.

Detailed Answer:
Hello again.

Dementia is a well known feature of the last stages of the Parkinson's disease, typically starting around 10 years after the Parkinson's diagnosis.

It is true that Sinemet may worsen the dementia symptoms, and, if it is possible, lowering the dose may be necessary.

Neuropsychological tests are those that assess the dementias as the diagnosis, since your husband did not well last year, it is not necessary to redo the test.

Regarding the symptoms, is not only dementia, but advanced stages of Parkinson's that may be responsible, in such cases the prognosis is very reserved.

Discuss with your husband's Neurologist about the drugs adjustments that can be done.

Hope this helps.

In good health.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (11 hours later)
My husband is now under hospice care and the Sinemet was increased to 4 times a day. ( 10/100 mg) Am I to understand that this increase may make the dementia worse? His tremors have greatly decreased but he's just staring in space. I am concerned that he is over- medicated with muscle relaxant ( Baclofin), anti-anxiety ( Seraquel ), Parkinson's ( Sinemet 10/100 mg) and Namzaric. IS it typical of advanced stage dementia that the patient looses awareness of surrounding by staring in space, and fails to eat, swallow, walk etc?
doctor
Answered by Dr. Dr. Erion Spaho (22 hours later)
Brief Answer:
Sinemet may be lowered.

Detailed Answer:

Hello,

Levodopa may cause some of the symptoms of dementia as adverse effects, or may worsen the pre existing ones.

In such cases, since actually is improved tremor too, decreasing the doses may be necessary.

Antidepressants also may be lowered since there are no evident mood changes.

Yes, advanced stages of dementia may cause loose of awareness and abilities to move, feed, etc.

Hope this helps.
Take care.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Is The Prognosis For The Inability To Walk, Talk Or Swallow When Diagnosed With Dementia With Parkinson's Disease?

Brief Answer: Both, neurological and psychiatric evaluation are necessary. Detailed Answer: Hello, The dementia of Parkinson's disease may respond to drugs used in other types of dementias such as Alzheimer's (Donepezil, rivastigmine). Drugs used for Parkinson's may worsen the memory problems, and may cause psychotic symptoms, so, a review of the doses of these drugs is also necessary. For depression or mood issues, if these are present, antidepressants and mood-stabilizing drugs such as Nortriptyline, Citalopram may be needed. If there are present psychotic symptoms, antipsychotics such as Clozapine may be necessary. All these treatment possibilities and drugs adjustments should be done after evaluation of both, a Neurologist and a Psychiatrist. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.