#25 Understanding Mild Cognitive Impairment and Dementia (Interview with Dr. Keith Josephs, Mayo Clinic Movement Disorder Specialist, Behavioral Disease Specialist, and Research Scientist)

On this episode, I discuss what a caregiver needs to know when confronted with psychosis exhibited by their loved one. It is important for caregivers to understand some of the common and reversible causes of psychosis related to Parkinson's disease. The psychosis may manifest as visual, auditory, or tactile hallucinations. In some cases, delusional thoughts and paranoia may be present during the psychotic episode. When a loved one experiences psychosis, you must know what kind of medical attention your loved one will require and be armed with the knowledge of treatment options. I discuss numerous medication options to treat psychosis. You must be aware of potential side effects as well as the black box warning on these medications. Finally, I discuss some of the treatments in the research pipeline and how to find out more information about these medications in clinical trials. The Parkinson's Disease Caring podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

In this episode, I introduce the topic of psychosis as it relates to Parkinson's disease. I review some of the important information about the different forms of psychosis including illusions, hallucinations, and delusional thoughts. This episode will set the stage for the upcoming month of episodes diving deep into this topic. We will discuss the biology of psychosis, the various causes of this problem in PD, and the available treatments. Our discussion on treatments will include both pharmacological therapy as well as non-pharmacological therapy. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

One of the greatest challenges for a caregiver of a loved one with Parkinson's disease is managing episodes of psychosis. On today's episode, I interview a caregiver named Sharon. Sharon is a caregiver for her husband with a 14 year history of PD. In the recent years, he has experienced a decline in cognitive function as well as episodes of psychosis that included visual and tactile hallucinations as well as delusional thoughts. Sharon shares some of these experiences with us and explains how she handled the episodes. She offers great advice for all caregivers not only witnessing psychotic episodes but also cognitive decline. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

In this episode, I discuss the current recommendations for treatment of Mild Cognitive Impairment of Parkinson's disease as well as the Dementia of Parkinson's disease. The discussion includes both pharmacological recommendations as well as non-pharmacological recommendations based upon the available medical literature. We discuss the recent publication of the Movement Disorder Society recommendation for treatment of Mild Cognitive Impairment and Dementia of Parkinson's disease. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

My guest interview is Dr. Keith Josephs, Professor of Neurology and Research Scientist at the Mayo Clinic in Rochester, Minnesota. Dr. Josephs is a world expert on Parkinson's disease and related Atypical Parkinson disorders as well as Alzheimer's disease and other dementia illness. We discuss where Parkinson's disease starts in the peripheral system of the body as well as in the brain. He shares his thoughts about the research looking into the types of pathological changes that happen in the brain causing dementia. We discuss if dementia could be a result of mixed pathological changes such as a mixture of Parkinson's disease and Alzheimer's disease or other conditions. He helps us better understand the difference between Lewy body disease and Parkinson's disease dementia. Dr. Josephs also discusses psychosis, depression, and other non-motor symptoms related to Parkinson's disease. He shares with us some of the current research projects that he is personally working on at the Mayo Clinic. Finally, he shares some of his thoughts about a new treatment recently approved by the FDA for Alzheimer's disease. After this episode, you will have a much better understanding of what is happening in the brain to cause your loved one to experience changes in cognitive ability due to Parkinson's disease and have hope for the future. 

This month, we will turn our attention to cognition in people with Parkinson's disease. In this introduction episode, I talk about the clinical diagnosis of Mild Cognitive Impairment of Parkinson's disease and what this actually means. I discuss how this condition may progress throughout the course of the illness. I discuss Dementia of Parkinson's disease and the prevalence rate of this condition.This month, we will focus on the neuropathology of cognitive changes of Parkinson's disease and focus on treatments for various problems related to cognition. We will also discuss in future episodes the research pipeline on novel therapeutics in clinical trials that may improve cognitive performance. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. Please email [email protected] if you would like to suggest topics for future shows or to ask questions related to these topics.  

In this episode, we conclude the month long topic of swallow impairment in Parkinson's disease. I share treatment recommendations with you from two interviews conducted with local speech and language pathologist who specialize in swallowing therapy. Juliana and Tiffany share practice and very useful advice that care partners and caregivers will benefit from to help their loved one. I also present the recommendations from a multidisciplinary consensus panel that published their treatment recommendations for Swallowing impairment in September of 2021. I offer a final conclusion on swallowing impairment. I hope that this information will be useful for you and your loved one with Parkinson's disease. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

In this episode, I discuss the process of swallowing and areas of dysfunction of swallowing in Parkinson's disease. I explain the three phases of swallowing and many of the problems that occur in each stage related to Parkinson's disease. Then I describe testing available to assess for swallowing dysfunction. To further explain the diagnostics available for swallowing impairment, I interviewed Juliana Harl, a Speech-Language Pathologist in practice who specializes in Parkinson's disease. She reviews various testing options and what she looks for in her assessments. She also provides recommendations that caregivers may use at home to help assess their loved one with Parkinson's disease to empower you to raise a concern regarding swallowing function to your loved one's health care provider. Join us next week for the final episode on swallowing impairment when we discuss treatment options as well as nutritional support. The Parkinson's Disease Caring Podcast is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information. 

In this episode, I introduce the topic for the month of January on this podcast. The topic is swallowing dysfunction of Parkinson's disease. The medical term for swallowing impairment is dysphagia. This month we will dive deep into this topic reviewing the potential problems that may occur for people with Parkinson's disease. I introduce the topic today. In the following shows, we will discuss in great detail the testing options, treatment options, and nutritional support for swallowing impairment in Parkinson's disease. Swallowing impairment is under reported by patients and sometimes can be silent. Healthcare providers may under utilize diagnostic testing resulting in less people receiving the exact diagnosis and treatment protocol. Care partners and Caregivers can be great advocates for their loved one to receive testing when appropriate and treatment to prevent common complications of swallowing impairment. Ultimately, we desire to prevent aspiration pneumonia which is the most common cause of death in Parkinson's disease. 

Thank you for supporting the Parkinson's Disease Caring Podcast in 2021! We are looking forward to a great year ahead. The format of the Podcast will change slightly this year. Each month or two, the podcast will focus on a clinical problem that is commonly reported in the PD clinic. I will dedicate the weekly shows to this topic and dive deep into the information you need to know related to this topic. I will add interviews with patients, care partners, caregivers, and other experts to provide you with detailed information on the diagnostic information as well as treatment protocols for you to consider with your loved one and their health care provider. The Parkinson's Disease Caring Podcast  is produced and hosted by Dr. Kevin Klos. Please visit www.pdcaring.com for more resources and information.