COPING WITH COGNITIVE DECLINE
Try to play “The Second Innings” of your life harder than how hard you played your first. You might have retired , but this phase is crucial too. You need to be active both mentally and physically to be fine in the coming years. All of a sudden after retirement you will be having the entire day to yourself where you could do the things which you never could give time. This is not the time to sit back and spend your whole day on your rocking chair.
Parkinsons and Aging have some characteristics in common like high risk of fall, gait disturbances, memory issues, thinking problems, apathy, anxiety and many more. These all impairments are somewhere linked to cognitive functions.With ageing mild cognitive impairment sets in, which is also seen in the cases of early parkinsons. Doing regular physical and mental exercises in this phase of your life have shown very positive results in cognitive well being of an elderly individual.
MILD COGNITIVE IMPAIRMENT (MCI) has been diagnosed in major cases of parkinsons, from which patients have high probability of getting progressed to dementia within 4 years of diagnosis known as Parkinsons disease Dementia (PDD).
What all does MCI affects:
- Attention
- Executive functioning like planning,flexibility, inhibition and decision making
- Language like sentence comprehension and naming difficulty
- Walking and balance
- Freezing episodes while walking
- Dual tasking like walking and speaking on the phone.
Early detection is very necessary to stop or decline the process of cognitive impairment into dementia. Caregivers are the first source of information. They should be understanding that any abnormal behaviour from a loved one is not on purpose. The parkinsons or ageing might be doing it to them. Please report any sign or symptom to the health care provider and they will guide you further.
Meanwhile lets see a few changes in the lifestyle which you could modify apart from the medical treatment.
5 Options which you need to start implicating:
- Newspaper :
Reading newspaper is an better option than listening to news on the television in parkinsons patients with MCI. They have difficulty in attention, grasping knowledge, confusion with too many things happening too fast. This will lead to anxiety thinking why am I suddenly facing such difficulty.
Let it work at their own pace and switch to the traditional reading .
- Ask them to plan a fixed time of the day , fix a place and select a section in the newspaper which they will be reading everyday. PD patients have difficulty in planning a day, prioritizing things, decision making . You can have an alarm set for paper reading. Help them to simplify things and make them quiet straight forward.
- Reading needs maintaining focused attention which lacks in PD patients. This activity will work on knowledge base, processing speed, grasping power and parallel thinking
- In reading we have to hold onto multiple bits of information as we read a paragraph which becomes challenging for the patient.
- Start with a smaller content and try to discuss what they read it will be helpful
- There should not be any distractions in the room , like T.V , pets . PD patients have difficulty to tune out stimuli that are irrelevant to the task/process ( cognitive Inhibition)
- Gradually for practicing dual tasking you can give some light background music and a reading task
- Take breaks and take it easy.
If you see in the newspaper there are various kinds of puzzles which have proven to be helpful for better cognition . A puzzle a day can be fruitful. Puzzles like sudoku, jig saw, hangman , crossword and word search
Benefits :
- Helps focused Attention
- Delays dementia
- Visual perception (e.g., recognizing objects, patterns, and orientation of lines)
- Cognitive flexibility (e.g., switching attention between different strategies, between different puzzle pieces, and between puzzle shape, image, and color)
- Perceptual reasoning (e.g., integrating different perceptual information to develop strategies and plans how to solve the puzzle)
- Working and episodic memory (e.g., keeping the association between spatial location and visual patterns/images of puzzle pieces in working memory and long-term memory).
These all are the areas of cognition where parkinson’s patients have shown to have problems.
- BOOKS :
Reading a book would work on a similar basis as reading a paper with some additional benefits. As books mostly have a storyline it would be beneficial for working memory which helps in linking events , also it would have impact on cognitive flexibility (switch between thinking about two different concepts) and attention.
- PHYSICAL EXERCISE :
Physical activity has benefits associated with dual tasking, memory and language.
We will see some examples of exercise where you will be performing dual tasks. With parkinsons performing two activities together becomes an hindrance. For example if they wish to walk they need to focus and plan each step they put, if we try to have a conversation with them they might lose focus on walking and have chances of fall. So let’s do these exercises while sitting.
- Have a undistracted environment for exercise always
- Exercise 1 : sit comfortably on a chair. You need to do spot marching while sitting. While performing you need to start subtracting 5 from 100 and keep going …like 95 , 90, 85, 80……. To start with 5 is a easier number you can select one for yourself
- Exercise 2: sit comfortably and do spot marching . Select any mathematical table eg. 4. Ask someone to call out numbers from 1 to 40. While performing the marching you need to clap whenever the number from the table of 4 will be called out. Eg. 4,8,12,16………so on.
- You can create your own exercise and start practicing.
- MOBILE APPLICATIONS :
In this age of technology mobile applications have been very user friendly and feasible . There are various applications which have come up and work on each aspect of cognition. They have protocols for various neurological diseases specially for parkinsons. I will list down some names which you might find useful :
- CogniFit
- Lumosity
- https://www.neuronup.com/en
- https://apps.apple.com/us/app/mind-app-for-alzheimers-parkinsons-essential/id799194074
-
Elevate – Brain Training
- LEISURE ACTIVITIES :
Getting involved in leisure activities in mid-life have proven to decline cognitive impairment. Mental activity is associated with global cognition, language, and executive function; physical activity was associated with memory and language; and social activity was associated with global cognition. So Get involved in any activity which you like . Learn any new activity . Learn a new card game, a recipe, a new form of language, new art form. Learning anything new and practicing it ,is going to put your cognitive skills at work!!
Any approach to show positive effects takes time . Have patience. Follow it for at least 3 months . It is not a quick fix. Hope this article was helpful. Please feel free to contact us !!!
References:
- Patrick Fissler,Jigsaw Puzzles As Cognitive Enrichment (PACE) – the effect of solving jigsaw puzzles on global visuospatial cognition in adults 50 years of age and older: study protocol for a randomized controlled trial,2017; 18: 415.
- Angela Federico,Screening for Mild Cognitive Impairment in Parkinson’s Disease: Comparison of the Italian Versions of Three Neuropsychological Tests,08 Nov 2015
- JG. Goldman,Mild Cognitive Impairment in Parkinson’s Disease, Minerva Med. 2011 Dec; 102(6): 441–459.
- Ioannis Pachoulakis,Kinect-Based Exergames Tailored to Parkinson Patients,Volume 2018 |Article ID 2618271
- Lin Liu,Characteristics of language impairment in Parkinson’s disease and its influencing factors,2015 Jan 27
- Valerie E. Kelly,A Review of Dual-Task Walking Deficits in People with Parkinson’s Disease: Motor and Cognitive Contributions, Mechanisms, and Clinical Implications,2012
- Patrick Fissler,Jigsaw Puzzling Taps Multiple Cognitive Abilities and Is a Potential Protective Factor for Cognitive Aging,Front. Aging Neurosci., 01 October 2018
|
|
|||