pros & cons of being tested for Parkinsons when already have dementia

terlibrarian

My mother is in her early 80s.  She has been diagnosed with vascular dementia.  She has an appointment in July with neurology to be tested for Parkinsons.  What benefit is this?  When I search online for treatments of Parkinsons, I find recommendations of exercise and good diet.  But my mother refuses this "nonsense."  My father is worried that if she gets a diagnosis of Parkinsons in her medical record it will affect their medical insurance.  My mother's gerontologist is carefully monitoring her medications to reduce falls, which are happening about once every 3 weeks now (this frequency has slowed down, thankfully, from the beginning of the dementia diagnosis).  My mother doesn't have the tremors associated with Parkinsons.  I would like to hear about your experience. 

Thank you, Teresa

terei

Until the doctor could explain to me specifically what benefit the diagnosis  would be, I would not have any unnecessary tests done on a PWD.

M1

There are dopamine medications that are very specific for Parkinson's. They might help prevent falls. That would be the reason to test. 

Unless they are not on Medicare, a diagnosis will not affect their medical premiums.

jfkoc

One can have Parkinson's with dementia. It is an entirely different illness from VD. In addition to possible dementia it effects the autoimmune system and had motor as well as non-motor symptoms.

Parkinsons as a separate disease has it's own treatment protocol.

Please be certain that the neurologist she is seen by regularly sees patients with Parkinson's. The best would be a motion disorder speialist.

I would want to fully understand why her Dr wants her tested as well as fully learning about the disease and treatment. 

My husband was diagnosed with MCI>Parkinson's>Lewy Body Dementia. He never had a tremor! Diagnosis, while diffiult, is important especially when it comes to the use of drugs.

I assume that at your mother's age she receives Medicare. That is what my husband relied on plus supplemental Plan F. None of his diagnosis effected his premium.You and your father should carefully review .her insurance.

This is a good read to get you started. You can also talk to these people.

https://www.parkinson.org/

Jo C.

It seems that my prior response has somehow become lost. 

Per medical writing, about 30% of people with Parkinson's do not present with tremor.  There are writings regarding, "non-tremor dominant Parkinson's",  Google will have information re this.

There is no one specific test for Parkinson's, it is diagnosed by the Neurologist's exam and often by doing a SPECT Scan.   Nothing is invasive, and nothing is painful nor is it highly time consuming.   Yet; the findings will make a huge difference in the treatment plan and the very quality of life for the person if diagnosed with Parkinson's.

Why would this be imporant?   Because Parkinson's has a long list of the damage and very severe symptoms it can cause and there are specific medications to slow this down, and also to treat the symptoms.  Here is a link to a simple writing re "Parkinson's is not just about shaking."   Remember, not all people with Parkinson's will have tremor.

https://parkinsonsnewstoday.com/2019/01/09/abcs-parkinsons-not-just-about-shaking-n/

Another reason for having this ruled in or out as a diagnosis is to obtain an accurate diagnosis for type of dementia.  This is crucial.

There are multiple different types of dementia of which Alzheimer's Disease is only one type.  In Parkinson's, the most common type of dementia is Lewy Bodies Dementia, (LBD).  Accurate diagnosis for type of dementia is critical because medications to treat one type of dementia can be contraindicated in another; Lewy Bodies Dementa is one of these. 

Problems with falling is part of Parkinson's due the changes that disease brings; so it really would be best to know with certainty what your mother does have so her treatment can be relevant and helpful. As for diet and exercise; yes, this does help, but is not primary treatment. There are many different meds used in Parkinson's depending on what is presenting symptomatically to relieve those grievoous issues as much as possible. It is just like heart disease and many other diseases; while diet and exercise is part of the "program," it is not the primary treatment.  Mayo Clinic as a good presentation re Parkinson's you may find informative re the meds used to treat Parkinson's.

As far as your father's concern regarding insurance impact; M1 is accurate. There would be no impact upon Medicare, HMO coverage, or private medical insurance coverage.  Not one whit.   If the issues is one of Long Term Care Insurance premiums, in many plans they may not discriminate or raise premiums based on a person's diagnoses once one has joined the plan.

NOTE:  If the worry is regarding Long Term Care Insurance, the diagnosis of dementia would carry as much weight as Parkinson's as dementia is progressive and requires long term care in the home or in a care facility.  Same dynamics.

I hope all goes well and that you are able to find out just what is presenting so that your mother will have the best treatment plan.  Dementia has about an eight year life expectancy on the average; however, as we here all learn, nothing seems to be "average."  Each person will be differant in their own unique journey.  My own step-father had a nearly 20 year span with Alzheimer's before his death from a different cause.

Do let us know how things are going, we will be thinking of you and your parents and we truly do care. 

From one daughter to another,

J.

Rescue mom

For whatever it’s worth: extended family members diagnosed with Parkinson’s. Caregivers say their medications, prescribed by a doc for Parkinson’s, made a big difference in how the patient felt and performed. When he did not take the meds, he  was noticeably off, the meds helped a lot. But you have to have a Dx to get the meds.

Had friends with Parkinson’s, some had tremors, others did not. 

A Dx won’t affect any regular health insurance and not Medicare. As already said, it’s not so different for insurance purposes from a Dx of dementia, which already exists. It might have some impact on long term care insurance, but at their age and medical history it’s highly unlikely they could get that now regardless.

John2.0.1

My mom has Parkinson's. She does not have tremors. She has stiffness. She has great difficulty moving her legs and arms and her several of her fingers don't move any more.

The right meds help - she's on Rytary which helps her ability to move her arms and legs. Without it she's literally be immobilized.

JJAz

HAVE HER EVALUATED!  My husband was diagnosed with Alzheimer's and had good care from a specialty Alzheimer's clinic.  When he sick with a cold he took OTC medication that we didn't know was dangerous for Parkinson-Plus patients.  It sent him into a tail spin, and he never recovered.  THEN, he was diagnosed with Parkinson-Plus.  Too late.  There are a lot of meds that are dangerous and some that are helpful for Parkinsons-Plus.  She deserves good medical care.