by Zina Kroner, DO
More recently, doctors are being urged to treat dementia more aggressively in Parkinson's patients, as it would optimize quality of life for the patients and their caregivers. It is established that one third of patients with Parkinson’s disease experience dementia. Cognitive impairments are the hallmark features, including decreased attention span, executive functioning and memory deficits. Obtaining a legitimate diagnosis of dementia can be quite tricky in that symptoms may widely fluctuate and therefore the diagnostic instruments that physicians use to diagnose Parkinson’s dementia may not always give reliable results. Research is conflicting at this point as to which is the best medical agent to use in this population.
There are multiple safe nutritionally oriented treatments that patients may engage in to help prevent early onset dementia as it is related to Parkinson’s disease. First and foremost, optimization of diet is critical. There is much research to suggest that a diet that is high on the glycemic index scale can exacerbate dementia. Insulin resistance, associated with a diet that is chronically high on the glycemic index, has been associated with Alzheimer’s disease. The connection has been labeled type 3 diabetes by some. (See my published article under the References section of my website on this topic).
Low Glycemic Index, No Pesticides, No MSG
Eating organic, MSG and pesticide free foods that can exacerbate both Parkinson’s as well as dementia is important. Remember that MSG can trigger glutamate receptors in Parkinson’s and non-Parkinson’s patients alike. Following a Mediterranean style diet that is high in unheated extra virgin olive oil, fish and poultry, nuts, vegetables, low glycemic index fruits, whole grains that are gluten free and unprocessed foods is key.
Just Do It
Adding a daily exercise component is imperative. Exercise can trigger dopamine levels to rise, help with coordination, drive down cortisol, improve insulin resistance, and help with mental acuity. These are all essential when hoping to help prevent dementia and improve Parkinson’s symptoms. Exercise should include weight bearing exercise as well as core bodywork.
The adrenal hormone DHEA has been shown to boost dopamine levels. There is also a significant amount of research pointing to DHEA helping with improvement in memory in dementia patients. DHEA is ever present in brain tissue and helps to offset the negative effects of cortisol. It is, however, a precursor to many of the other hormones and needs to be used judiciously and under medical supervision.
Follow an Anti-Inflammatory Program
Low grade chronic inflammation may be a precursor to neurodegenerative disease. An excellent anti-inflammatory program, including diet and supplements may help to quiet the inflammation down.
Polyphenols, excellent antioxidants found in green tea, have recently been studied to see if they modify the course of Parkinson’s. The Chinese study enrolled 410 untreated people with Parkinson’s disease and were randomized to receive 0.4g, 0.8g, or 1.2 g of green tea polyphenols daily. As a reference, 2 cups of green tea contain approximately 300mg of polyphenols. At 6 months a significant improvement was noted in each dosage category based on the Unified Parkinson's Disease Rating Scale. At 12 months, however, unexplainably, the scores did not differ from placebo. Improvements were more profound for those with a greater severity of disease. There were no notable side effects except for insomnia for those not accustomed to green tea intake.
The reduction of oxidative stress on neurologic tissue in Parkinson’s as well as dementia patients is important. Utilization of polyphenols, vitamin C, tocotrienols, bioflavanoids, proanthocyandins from grape seed extract, coenzymeQ10, and curcumin may have a beneficial effect.