Some aspects of Parkinson’s disease are not popular conversation topics in the PD community. They are the shadow issues too delicate to cast light on routinely. Think cognitive loss and dying.
The Parkinson’s disease Foundation called my attention to a new study of cognitive loss in PD. University of Pennsylvania researchers followed 141 PD patients who had normal cognition at the beginning of the study. They found that 47.4% of the patients progressed to what’s called mild cognitive impairment after six years. MCI is a loss of some thinking, memory, language and judgment capacity.
The real attention getter in this study is that every participant who was diagnosed with MCI during the study progressed to dementia within five years. Hope is what drives us in our struggle with PD. But we can’t let that necessary hope blind us to the reality of significant cognitive dangers down the road.
DEATH AND DYING
I came across a provocative essay that appeared in the New York Review of Books this year. Marcia Angell, the former executive editor of the New England Journal of Medicine, wrote it. It was a long review of a moving book that I have read but not commented on in this blog.
When I read the book, it sparked my interest in the palliative care movement. The reason was Gawande powerfully documents through individual case studies how very often medicine ill serves patients at the end of life. Where comfort measures are called for, intense, costly, ultimately futile rescue efforts are often inflicted on patients who would prefer prefer otherwise. Both the book and the essay are worth your attention. Book details:
Being Mortal: Medicine and What Matters in the End
by Atul Gawande
Metropolitan, 282 pp., $26.00
NICOTINE PD PARADOX
Nicotine occupies a strange role in Parkinson’s. My interest as a cigar smoker is large in this issue. For some unknown reason nicotine appears to protect against PD onset and might even slow the progress of the disease. The prospect that a known carcinogen might just be helpful in PD it is almost laughable. The review article on the subject is provocative.
I’m entering my third week of the exercise program Rock Steady Boxing, which I have described an earlier blog post. I continue to be very impressed with the able physical therapists and the results I am experiencing.
Over the last two weeks I’ve experienced only one PD “down” day. You know, those blah days when it feels like you have the flu. Before the boxing program, I was experiencing those bad days about one day in five. Rock steady is available only in Largo in the Bay Area at present. That makes for a long Drive for Hillsborough PD patients, especially in rush hour. Program Director Tara Schwartz tells me she hopes to have a second program located either in or much closer to Hillsborough County by the end of 2016. That’s very good news indeed.