Cognitive Concerns in Parkinson’s Disease: Early Signs, Risk Factors, and What Caregivers Should Know (Part 1)
When most people think about Parkinson’s disease, they often picture tremors, stiffness, or difficulty with movement. While those motor symptoms are widely recognized, Parkinson’s also has a significant and often under-discussed impact on cognition. Understanding these cognitive changes early can make a meaningful difference. It allows families to plan ahead, seek appropriate support, and maintain a higher quality of life for longer. At Town Square University Parkway, we believe education is one of the most powerful tools a caregiver can have.
This session, presented by Catherine McDermott, APRN, PMHNP-BC, focuses on helping caregivers and families better understand the cognitive side of Parkinson’s disease. Catherine is a board-certified Psychiatric Mental Health Nurse Practitioner specializing in geriatric psychiatry, cognitive impairment, and dementia care. With over 30 years of experience, she brings both clinical expertise and a compassionate, practical approach to supporting families navigating complex diagnoses.
Parkinson’s disease is far more than a movement disorder. While motor symptoms such as tremors, rigidity, and slowed movement are hallmark features, the disease also affects how a person thinks, processes information, and interacts with the world around them. This dual impact on both motor and cognitive function is what often makes Parkinson’s particularly challenging for individuals and their caregivers.
Cognition refers to a range of mental processes that allow us to function independently. These include memory, attention, executive function, and visuospatial awareness. Executive function, in particular, plays a critical role in daily life, as it allows individuals to plan, organize, make decisions, and complete tasks. In Parkinson’s disease, changes in attention and executive function often appear early, sometimes even before noticeable motor symptoms develop.
From a neurological perspective, Parkinson’s disease is driven by the progressive loss of dopamine-producing neurons in the substantia nigra, a region of the brain essential for movement and coordination. As the disease progresses, many individuals also develop Lewy bodies, which are abnormal protein deposits that interfere with normal brain function and contribute to cognitive decline.
It is important to recognize that cognitive symptoms are part of a broader group of non-motor symptoms associated with Parkinson’s. These may include mood changes such as depression and anxiety, sleep disturbances, and autonomic dysfunction affecting systems like blood pressure and digestion. Because these symptoms are less visible than motor changes, they are often overlooked, yet they can have a profound impact on quality of life.
Early cognitive changes in Parkinson’s disease are often subtle. Individuals may experience slowed thinking, difficulty multitasking, or challenges with planning and organization. There may be noticeable changes in attention, focus, or visual-spatial awareness, along with mild memory concerns. While these symptoms may initially seem minor, they can gradually progress and interfere with daily functioning.
As the disease advances, some individuals may develop dementia. One form associated with Parkinson’s is Lewy body dementia, which can be particularly complex to manage. This condition is often characterized by fluctuating cognition, where individuals may have periods of clarity followed by confusion, as well as visual hallucinations and REM sleep behavior disturbances. These symptoms can be distressing for both the individual and their caregivers and often require specialized care.
Early recognition of cognitive changes is critical. Identifying these shifts allows families to make informed decisions, adjust medications appropriately, implement safety measures, and access the support and resources needed to maintain independence for as long as possible. A proactive approach can significantly improve both outcomes and overall quality of life.
If you begin to notice changes in thinking, behavior, or daily functioning, the first step is to speak with a primary care provider. A comprehensive evaluation typically includes a detailed medical history, brain imaging such as an MRI, and formal neurocognitive testing. One of the most important, and often overlooked, steps in this process is a thorough medication review. In many cases, medications can contribute to cognitive symptoms, and adjustments can lead to meaningful improvement.
Parkinson’s disease is complex, and its impact extends far beyond movement. Gaining a deeper understanding of the cognitive side of the disease empowers caregivers to recognize changes earlier, seek appropriate care, and provide more effective support for their loved ones.
Education is essential. Support is critical. And no one should have to navigate this journey alone. We invite you to reach out, ask questions, or schedule a tour to learn more about how we can support you. Call the Club at 941-277-5048.