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I've noticed I cannot respond as fast to complex questions as I once did. I have more "tip of the tongue" experiences than ever. Are these symptoms of cognitive decline that go along with PD?

Non-motor symptoms such as you mentioned are seen in PD more than people realize. For some, the changes in cognition can be more troublesome and more problematic than the motor symptoms. Many people living with PD are not expecting to see such a change, especially in the early stages.

The terms "cognitive impairment" and "dementia" are frightening, but they are not interchangeable. They describe the extent of the decline in thinking and memory. In dementia, problems with memory and thinking are severe enough to interfere with daily activities such as driving, planning and cooking a meal, bathing, dressing, and grooming. Cognitive impairment may be more irritating or concerning but does not significantly impact how you live your life.

In both conditions, deficits in memory, attention, problem-solving, decision-making, and language are common. These are seen primarily as short-term memory loss, lack of concentration, difficulty making decisions, and visuospatial problems or having difficulty processing your surroundings or environment. The "tip of the tongue" experiences you mentioned and difficulty understanding complex sentences are common. The slower thinking is comparable to moving slower. This behavior is seen as a delayed response to verbal or behavioral stimuli, taking longer to complete tasks, and difficulty retrieving information from memory. In later stages, there may be increased confusion, visual hallucinations, delusions, agitation, and less ability to comprehend written or verbal commands.

The challenges above affect your day-to-day functioning, decrease your quality of life, cause poorer treatment outcomes, and can lead to depression and anxiety. When asked, care partners stated these symptoms increased their distress rather than motor symptoms. If you are experiencing any of the symptoms above, bring them to your neurologist's attention. Some strategies and medications can help.





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