Parkinson’s disease (PD) is widely recognized for its impact on movement—tremors, stiffness, and slowness—but its effects on cognition are often overlooked. Many individuals with PD experience changes in memory, problem-solving, and overall thinking abilities, which can profoundly affect daily life. Understanding these cognitive changes is essential for patients, caregivers, and families to prepare for challenges and maintain quality of life.
Cognitive Changes in Parkinson’s Disease
1. Change in Executive Functioning: The Struggle to Plan and Organize
One of the earliest and most common cognitive symptoms in Parkinson’s disease are changes in executive functioning. This refers to difficulties with:
- Planning and organizing tasks
- Problem-solving and decision-making
- Switching between tasks
- Maintaining focus and attention
These challenges arise due to changes in the frontal lobe and disruptions in dopamine, a key neurotransmitter that supports brain function in PD[1].
2. Slowed Thinking (Bradyphrenia)
People with PD often describe their thought processes as slower or “foggy.” This condition, known as bradyphrenia, makes it harder to process information quickly, follow conversations, or react in real-time[2]. It does not necessarily mean intelligence is affected, but rather that mental processing takes longer.
3. Memory Issues and Parkinson’s Disease
Memory problems in Parkinson’s disease differ from those in Alzheimer’s disease. People with PD typically experience difficulties with:
- Retrieving information rather than storing new memories
- Word-finding challenges (struggling to recall the right word)
- Remembering to complete tasks (prospective memory)
While these memory issues are usually mild in early PD, they can worsen over time, particularly in individuals who develop Parkinson’s disease dementia (PDD)[3].
4. Visual-Spatial Difficulties
Many people with PD have trouble judging distances, recognizing objects, or navigating familiar environments. This can lead to increased falls, difficulty driving, and problems with everyday tasks such as dressing or setting a table[4].
5. Mood and Cognition: The Overlap with Anxiety and Depression
Cognitive symptoms often interact with mood disorders. Depression and anxiety, common in PD, can make cognitive symptoms appear worse. Individuals may struggle with:
- Motivation and initiation of tasks
- Sustained attention
- Emotional regulation
Addressing mood disorders can sometimes improve cognitive function, highlighting the importance of a comprehensive treatment approach[5].
Parkinson’s Disease Dementia: When Cognitive Decline Progresses
In the later stages of Parkinson’s, about 50-80% of patients develop Parkinson’s disease dementia (PDD)[6]. Symptoms include:
- Severe memory loss
- Confusion and hallucinations
- Increased difficulty with reasoning and problem-solving
Risk factors for PDD include older age, more severe motor symptoms, and longer disease duration. While there is no cure, medications such as cholinesterase inhibitors (e.g., rivastigmine) may help manage symptoms.
Coping Strategies and Support
While cognitive changes in PD can be challenging, there are strategies to help maintain mental sharpness and independence:
- Cognitive exercises – Brain training activities, puzzles, and reading can help slow decline.
- Medication management – Some PD medications can improve alertness, while others may contribute to confusion. Regular medication reviews are essential.
- Routine and structure – Keeping a consistent daily schedule helps reduce confusion and improve memory.
- Physical activity – Exercise has been shown to support brain health and slow cognitive decline[8].
- Professional support – Formal care providers like ones medical care team, supportive services, and Geriatric care managers, like those at Vital Aging NYC, provide expert guidance to help families navigate cognitive and medical challenges in PD.
Final Thoughts: Planning for the Future
Understanding how Parkinson’s disease affects memory and thinking is crucial for individuals and caregivers. With proper support, lifestyle modifications, and medical management, it is possible to maintain cognitive function and enhance quality of life for as long as possible.
If you or a loved one is facing cognitive challenges with Parkinson’s disease, Vital Aging NYC offers care management to ensure you receive the best support possible to supplement your medical care. Contact us today to explore how we can help.
References
- Emre M. (2003). What causes mental dysfunction in Parkinson’s disease?. Movement disorders : official journal of the Movement Disorder Society.
- Muslimović, D., Post, B., Speelman, J. D., & Schmand, B. (2005). “Cognitive Profile of Patients with Newly Diagnosed Parkinson Disease.” Neurology, 65(8), 1239-1245.
- Goldman, J. G., & Litvan, I. (2011). “Mild Cognitive Impairment in Parkinson’s Disease.” Movement Disorders, 26(10), 1814-1824.
- Uc, E. Y., Rizzo, M., Anderson, S. W., et al. (2005). “Visual Dysfunction in Parkinson’s Disease without Dementia.” Neurology, 65(12), 1907-1913.
- Aarsland, D., Påhlhagen, S., Ballard, C. G., Ehrt, U., & Svenningsson, P. (2012). “Depression in Parkinson Disease—Epidemiology, Mechanisms and Management.” Nature Reviews Neurology, 8(1), 35-47.
- Aarsland, D., Andersen, K., Larsen, J. P., Lolk, A., Nielsen, H., & Kragh-Sørensen, P. (2001). “Risk of Dementia in Parkinson’s Disease: A Community-Based, Prospective Study.” Neurology, 56(6), 730-736.
- Petzinger, G. M., Fisher, B. E., Van Leeuwen, J. E., et al. (2013). “Exercise-Enhanced Neuroplasticity Targeting Motor and Cognitive Circuitry in Parkinson’s Disease.” The Lancet Neurology, 12(7), 716-726.