My understanding and experience of the mental changes/dementia due to PD are related 
to the decrease in dopamine within the nigro-striatal-cortical connections to the 
frontal lobe.  The mental changes occur as the disease progresses.  It seems to cause 
a decreased emotional investment in the movement I may be assessing (i.e. gait).  
Therefore, this has been discussed as being one of the reasons for the lack of 
initiation in P w/ PD.

Also, long-term use of L-Dopa can lead to schizzophrenic type dementia.

My approach to EVERY person with AD or PD is individualized and never based soley on 
the diagnosis....certainly establishing where the person is in regards to mental 
status is the start, for this will let me know if I should use cerebral or primitive 
mechanisms in my approach to treating the movement deficit.

Seems like most of the people with AD that I have treated were in LTC facilities and 
were at the later stages.  I would use very common/familiar tasks (i.e. 
bicyle/dance/walk) for mobility training.  The person with PD may not respond as well 
given the side effects of meds and the freezing issues associated with movement in the 
later stages.  However, in early stages, I can use cueing and strength training to 
improve balance and gait.



David A. Lehman, PhD, PT
Associate Professor
Tennessee State University
Department of Physical Therapy
3500 John A. Merritt Blvd.
Nashville, TN 37209
615-963-5946
[EMAIL PROTECTED]



Hello:

What  differences  if  any do you all see in the way that Alzheimer's versus
Parkinson's diseases manifest themselves in your clients?

Are your treatment approaches different based solely on the disease?

Thanks,

Ron


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