Cognitive changes can affect communication in Parkinson’s

(Adapted from an article Parkinson Society Canada submitted to the Canadian Association of Speech-Language Pathologists and Audiologists)  
Researchers Angela South (r.) and Jacob Penner in the MRI Research Suite at the Robarts Research Institute, University of Western Ontario.

Researchers Angela South (r.) and Jacob Penner in the MRI Research Suite at the Robarts Research Institute, University of Western Ontario.

New research into the non-motor symptoms of Parkinson’s is revealing that people with Parkinson’s disease experience subtle changes in thinking ability and language right from the start. In fact, for approximately 5% of people, cognitive changes precede the onset of motor symptoms. These changes may affect all areas of language, including comprehension and expression in both verbal and nonverbal communications.

Affected areas include:

  • Attention. Because people have difficulty filtering out non-salient information, they may have trouble communicating when there are multiple distractions or multiple speakers. This may affect the ability to understand information and take in a large volume of information.
  • Language structure. The difficulty of processing and producing complex syntax both written and auditory and difficulty with drawing inferences can affect conversation and reading. As a result, people with Parkinson’s may use simplified sentence structures and less “rich” communication.
  • Memory. Retrieving information can be more of a problem than storing information, so people with Parkinson’s can benefit from strategies that make it easier to retrieve information and break it into smaller units.
  • Emotional processing. There is evidence that the masked facial expression in Parkinson’s is not just a matter of rigidity and stiffness in the facial muscles; it has a cognitive component, as well. People have difficulty both expressing and understanding emotions, particularly negative emotions such as sadness and anger, in a variety of ways, including facial expression, changes in tone of voice, inflection and volume, and words relating to emotional concepts.
  • Executive function. Problems in this area exist from the early stages and may appear as a delayed ability to organize language, integrate information, and identify and modify language strategies.
  • Word finding. People have problems with generating words. They may also have more difficulty with verbs than nouns. As a result, a person’s language may sound vague or rambling. One person with Parkinson’s said, “I find I have to use a lot of words to convey what I’m thinking.”
  • Social communication skills. In conversation, people may have difficulty with turn-taking, initiating topics, maintaining topics and drawing references.
  • Mood. Depression and apathy are common in Parkinson’s and they can reduce cognitive performance. However, “If someone is slow to communicate and has emotional processing impairments, this may be perceived as depression when it may, in fact, be a function of communication changes related to cognition and language skills,” says Angela South, a speech-language pathologist and PhD Student at the University of Western Ontario in London, Ontario. South’s research on cognitive-linguistic deficits in Parkinson’s and the impact on the communication dynamic between individuals and their family care partners is funded, in part, by a Graduate Student Award from Parkinson Society Canada. This work may assist speech-language pathologists in improving communication outcomes for people with Parkinson’s from the early stages of the disease and as the disease progresses.

Read Effective Communication Cognitive Impairment in Parkinson’s for more information and helpful tips for people with Parkinson’s and care partners.

4 Responses to “Cognitive changes can affect communication in Parkinson’s”

  1. 1 Freda Wesselson April 5, 2011 at 11:11 am

    My husband ,Rudolph Wesselson started having tremors in his hands in 1995 and started having LevaDopa meds in 1997. Lately he is getting confused at times. Doesn’t know where the bedroom is etc. In Jan 2011 he was diagnosed with a bladder infection that led to more tests and resulted in having an enlarged prostate caused by cancer and spread to bone cancer.(thankfully he has no pain,gets hormone treatment ) Resulted in having a urinal bag.He has a hard time realizing what the hose is for and remembering to move it from the walker to his chair. etc.He is seeing things that are not there,cows in a field, a farmer spreading manure. Is this a “parkinson dementia “or just because he is getting older (81 this summer.)Sometimes eating bread with a spoon not realizing that that is odd. We’re part of a Parkinson support group and he has twice a year an appointment with a neurologist.Rolph likes to quit the dr. app.

  2. 2 Angela April 8, 2012 at 9:12 pm

    Hi Freda,

    I would suggest contacting your Parkinson specialist. Infections, including UTI’s can also affect cognition, usually transiently. This may be part of his PD, part of a process unrelated to PD that is affecting his cognition, or the result of infection. It is not, per se, related to age. The visual changes you describe are also concerning. If he is awake when he is seeing these images, they may be hallucinations. I suggest seeing a neurologist specializing in PD as soon as you are able. If you are not currently connected with a specialist then please follow-up with your family physician as soon as you are able.

  3. 3 Martha Anne King January 5, 2013 at 9:56 pm

    Have you done any further research in this area?

  4. 4 Parkinson Society Canada January 10, 2013 at 12:22 pm

    Thank you for your interest in the research Parkinson Society Canada (PSC) funds. Cognitive changes continues to be an important area of funded research through our National Research Program (our latest ‘Research Highlights’ will be out shortly). We are also funding a new researcher looking at improving speech in PD (Dr. Shirley Fecteau). You may also find of interest our webinar ‘Cognitive Impairment and Parkinson’s Disease’ and our Guide to the Non-Motor Symptoms of Parkinson’s Disease.

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All material related to Parkinson's disease contained in Parkinson Post is solely for the information of the reader. It should not be used for treatment purposes. Specific articles reflect the opinion of the writer and are not necessarily the opinion of PSC.

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