Ngaba kukulahlekelwa yinkumbulo okubangelwa sisifo sikaParkinson? Masithethe ngeParkinson's Disease Dementia!

Ngaba usapho lwakho, mhlawumbi umama wakho, utata wakho, okanye umntu osondeleyo kuwe unesifo sikaParkinson? Ngaba umntu onjalo uye wazilibala kancinci kancinci izinto, wakufumanisa kunzima ukwenza izinto ezazilula ngaphambili, okanye ngaba ukhe waphawula utshintsho kwindlela acinga ngayo? Enyanisweni, kukho imeko yokukhumbula kunye nobukrelekrele enokubangelwa sisifo sikaParkinson. Namhlanje siza kuthetha ngale meko ibizwa ngokuba yi-`(Parkinson's Disease Dementia)`. Musa ukoyika, masiyiqonde ngokulula le nto.

Yintoni iParkinson's Disease Dementia?

Ngamafutshane, iParkinson's Disease Dementia (PDD) kukwehla kwamandla okucinga nokuqiqa okwenzeka kumntu onesifo sikaParkinson, ubuncinane emva konyaka efunyenwe esi sifo (ngesiqhelo ixesha elide).

Abanye abantu bayoyika xa besiva igama elithi "Dementia." Kodwa masiqonde ukuba yintoni. I-Dementia yimeko apho ukusebenza kwengqondo yomntu kuyehla kunokuba bekunjalo ngaphambili, nto leyo eyenza kube nzima ukwenza imisebenzi yemihla ngemihla. Ukuze oku kusebenza kwengqondo kuphazamiseke, ubuncinane ezimbini kwezi zilandelayo kufuneka ziphazamiseke:

• Inkumbulo
• Ukucinga ngokunengqiqo
• Ulwimi (ukuthetha, ukuqonda)
• Ukulungelelanisa izinto
• Ukuziphatha

Amaxesha amaninzi, ngaphambi kokuba kwenzeke oku kungalibali okukhulu, imeko ebizwa ngokuba yi-"Mild Cognitive Impairment (MCI)" inokwenzeka, ebonakala ngeengxaki ezincinci zenkumbulo okanye ukwehla kancinci kwisantya sokucinga. Oku kuthetha ukuba inkumbulo ayisebenzi kakuhle, nangona ingaphazamisi kakhulu imisebenzi yemihla ngemihla. Nangona kunjalo, ayizizo zonke iimeko ze-"MCI" eziya kwi-"Dementia". Phakathi kwe-10% kunye ne-20% yabantu abanesifo sikaParkinson banokuba ne-"MCI" kuphela ubomi babo bonke.

Njengoko usazi, isifo sikaParkinson sisifo esibangela ukuwohloka kwemithambo-luvo, okanye isifo sobuchopho esiye sinciphise iiseli zemithambo-luvo kancinci kancinci. Sichaphazela kakhulu iintshukumo zomzimba. Iimpawu ezifana nokuxhawula izandla kunye nokuhamba kancinci (bradykinesia) zezona ziqala ukubonakala. Nangona kunjalo, ngokuhamba kwexesha, esi sifo sinokuchaphazela neendawo zobuchopho ezilawula iingcinga nezenzo. Kulapho ke kuvela khona i-dementia.

Ixhaphake kangakanani le meko?

Umngcipheko wokuba nesifo sengqondo i-Parkinson's dementia uyahluka ngokweminyaka kunye nobude bexesha oye waba nesifo iParkinson's. Umzekelo:

• Phakathi kwe -16% kunye ne-20% yabantu abaneminyaka engama-60 ukuya kwengama-75 ubudala bebenesifo sikaParkinson kangangeminyaka emi-5 ukuya kwelishumi.
• Phakathi kwama -20% nama-30% abantu abaphakathi kweminyaka engama-60 nama-75 ubudala bebenesifo sikaParkinson kangangeminyaka eli-10 ukuya kweli-15.
• Le meko inokwenzeka kubantu abangama-50% ukuya kuma-60% abaneminyaka engaphezu kwama-75 ubudala abanesifo sikaParkinson kangangeminyaka engaphezu kwe-15.

Ziziphi iimpawu zeParkinson's Dementia?

Indlela esi sifo esichaphazela ngayo umntu ngamnye ingahluka, kodwa kukho iimpawu eziqhelekileyo:

• Ubunzima bokugxila: Ubunzima bokugxila kwinto enye, kulula ukuphazamiseka.
• Ukulahlekelwa yinkumbulo: Ubunzima bokukhumbula izinto ezintsha, kwaye ngamanye amaxesha ude ulibale nezinto ezindala.
• Iingxaki zokuqonda ulwazi olubonakalayo: Umzekelo, ukuba nobunzima bokufumana into enye kwindawo enabantu abaninzi.
• Nokuba ngumsebenzi olula kunokuba nzima ukuwuceba, ukuwuqala, nowokugqiba.
• Ubunzima bolwimi: Amagama ayaxutywa, amagama ezinto ayalibaleka, kwaye izivakalisi ezinzima ziba nzima ukuziqonda.
• Intetho ayicaci, njengokungathintitha.

Ukongeza, utshintsho lokuziphatha lunokwenzeka:

• Utshintsho kwimeko yengqondo: ukwanda kosizi (ukudakumba), ukucaphuka rhoqo (ukucaphuka), kunye nexhala.
• Ukungakhathali: Ukungafuni kwenza nto, ukuziva ukruqukile yinto yonke.
• Ingqondo: Ukubona izinto ezingezizo zokwenyani (ingakumbi ukubona izinto ezingekhoyo), okanye ukukholelwa izinto ezingezizo zokwenyani (ingakumbi ukucinga ngezinto ezingaqhelekanga).

Ukuba wena okanye umntu omthandayo unale mpawu, kubaluleke kakhulu ukubona ugqirha ukuze akunike icebiso. Ungayiqonda imeko kwaye uthathe amanyathelo afunekayo ngaphandle kokukhathazeka.

Kutheni i-Parkinson's dementia ikhula?

Isizathu esiphambili soku kukuqokelelana kweeproteni ezingaqhelekanga ezibizwa ngokuba yi-`(Lewy bodies)` engqondweni. Ezi `(Lewy bodies)` ziingqumba ezincinci ezenziwe ngeproteni ebizwa ngokuba yi-`(alpha-synuclein)`. Xa ezi ziqokelelana ngaphakathi kweeseli zemithambo-luvo `(neurons)` zobuchopho, ezo seli ziyabola kwaye ziyafa.

Kwisifo sikaParkinson, ezi `(Lewy bodies)` ziqala ukufakwa kwiindawo zengqondo ezilawula intshukumo, ingakumbi kwindawo ye`(basal ganglia)`. Yiyo loo nto iingxaki zokuhamba ezifana nokungcangcazela nokuhamba kancinci ziqala ukwenzeka. Ekuhambeni kwexesha, ezi `(Lewy bodies)` zinokusasazeka kwiindawo eziphezulu zengqondo ezilawula izinto ezifana nokucinga, inkumbulo, kunye nolwimi. Kulapho ke `(Parkinson's Disease Dementia)` zenzeka khona.

Le meko ifana kakhulu nolunye uhlobo lwe-dementia olubizwa ngokuba yi-Lewy body dementia (LBD). Enyanisweni, ezinye izazinzulu zikholelwa ukuba zombini ezi zifo zibangelwa lutshintsho olufanayo lobuchopho olubandakanya iproteni ye-alpha-synuclein. Umahluko omkhulu kukulandelana kweempawu. Siza kuthetha ngaloo nto kungekudala.

Ngubani osengozini enkulu yokuhlaselwa yile meko?

Izinto ezimbini eziphambili ezibangela umngcipheko wokuphuhlisa i-Parkinson's dementia zezi:

1. Ukukhula kweminyaka: Le ngozi iyanda ngokuhamba kweminyaka.

2. Ukwanda kwexesha lesifo sikaParkinson: Okukhona isifo siqhubeka ixesha elide, kokukhona umngcipheko wokuba nesifo sengqondo esixhalabisayo uyanda.

Ukongeza, uphando lufumanise ukuba abantu abaneempawu ezithile zesifo sikaParkinson nabo banamathuba amaninzi okuba ne-dementia. Ezi mpawu ziquka:

• Ukuba neempawu ezinzima zemisipha: Ukuba uneempawu ezinzima ezifana nokungcangcazela kunye nobunzima bokuhamba.
• Ekuqaleni kwesifo sikaParkinson , iingxaki zenkqubo yemithambo-luvo ezizimeleyo (umzekelo, i-orthostatic hypotension, ukungakwazi ukuzibamba komchamo) zinokubakho.
• Iingxaki zokunyakaza zichaphazela amacala omabini omzimba ngokulinganayo (iimpawu zentshukumo ezilinganayo).
• Amayeza esifo sikaParkinson aqulethe i-dopamine awasebenzi njengoko bekulindelwe.
• Ukuba nengxaki ebizwa ngokuba yi-"REM sleep behavior disorder" (apho udlala khona into oyiphuphayo).

Uyibona njani le nto kanye kanye?

Ngelishwa, akukho vavanyo luthile olunokuqinisekisa ngoko nangoko ukuba kukho isifo iParkinson's Disease Dementia. Ugqirha wenza uxilongo ngokuqwalasela izinto ezininzi:

• Babuza ukuba iimpawu zakho ziqale nini kwaye zitshintshe njani.
• Buza ngembali yakho epheleleyo yezonyango.
• Ndiza kujonga ukuba zeziphi amayeza ozisebenzisayo ngoku.
• Buza ukuba kukho umntu onayo le zifo kusapho lwakho.

Ukongeza, ezinye iimvavanyo zingenziwa ukunceda ekuxilongweni. Umzekelo, uvavanyo lwegazi, uvavanyo lokujonga ingqondo (ezifana ne-CT scans, i-MRI scans), kunye novavanyo lwe-neuropsychological oluvavanya izakhono zokucinga.

Njengoko benditshilo ngaphambili, iimpawu kunye nezizathu zeParkinson's Disease Dementia (PDD) kunye neLewy Body Dementia (LBD) ziyafana kakhulu. Ngoko ke, kukho indlela encinci esetyenziswa ngoogqirha ukwahlula phakathi kwezi zimbini:

• Ukuba iimpawu ze-dementia (ezifana nokulahlekelwa yinkumbulo) zivela ubuncinane ngonyaka (ngesiqhelo iminyaka eliqela) emva kokuqala kweengxaki zokuhamba kwesifo sikaParkinson (ezifana nokungcangcazela, ukuhamba kancinci), ibizwa ngokuba yiParkinson's Disease Dementia (PDD).
• Ukuba iimpawu ze-dementia zibonakala ngaphambi, ngexesha, okanye kungakapheli unyaka ukususela ekuqaleni kwe-Parkinson's movement disorders, ibizwa ngokuba yi-`(Lewy body dementia - LBD)`. Ezinye izigulane ze-`(LBD)` zisenokungabi nazo iingxaki ze-Parkinson's movement disorders.

Zithini iindlela zonyango zoku?

Umbuzo abantu abaninzi abawubuzayo kukuba ingaba likho na unyango loku, okanye lunganyangeka na. Ukuthetha inyani, akukho nyango lunokuthintela okanye lubuyisele umva ukuqhubela phambili kwesifo sikaParkinson's Disease Dementia. Yinyani ebuhlungu leyo.

Kodwa ungalahli ithemba! Kukho amayeza kunye nonyango olunokunceda ukulawula okanye ukunciphisa ezinye zeempawu. Umzekelo:

• `(Ii-Cholinesterase inhibitors)`:Amayeza akule klasi, afana ne-donepezil (Aricept®), i-rivastigmine (Exelon®), kunye ne-galantamine (Razadyne®), anokubonelela ngokukhululeka kwezinye iimpawu, ingakumbi ukubona izinto ezingekhoyo, utshintsho kwindlela yokucinga, kunye notshintsho kwindlela yokuziphatha.
• Ii-Selective serotonin reuptake inhibitors (SSRIs) kunye nee-serotonin kunye ne-norepinephrine reuptake inhibitors (SNRIs): La ngamayeza adla ngokunikwa abantu abadandathekileyo. Anokunceda ekulawuleni utshintsho lweemvakalelo ezifana nokudakumba, umsindo, kunye noloyiko.
• Unyango lokuziphatha kwengqondo (CBT): Olu luhlobo lwe-psychotherapy, oluluhlobo lwe-talk therapy. Lunokunceda ekulawuleni izinto ezifana neengxaki zokuziphatha kunye noxinzelelo.

Iqela lakho lezonyango liza kuthetha nawe lize ligqibe ukuba loluphi unyango olukulungeleyo. Kodwa khumbula into enye. Amanye amayeza angenza iimpawu ze-dementia zibe zimbi ngakumbi. Umzekelo, i-carbidopa-levodopa, iyeza elisetyenziswa rhoqo ukunyanga iingxaki zokuhamba zesifo sikaParkinson, linokunyusa ukubona izinto ezingekhoyo kunye nokudideka kwabanye abantu abane-dementia yesifo sikaParkinson. Ngoko ke, musa ukuqala okanye uyeke ukuthatha naliphi na iyeza ngaphandle kwengcebiso kagqirha wakho.

Kusenokubakho iimvavanyo zonyango eziqhubekayo zonyango olutsha lweParkinson's Disease Dementia. Ungabuza ugqirha wakho ngaloo nto.

Iqhubeka njani le meko? (Ingqikelelo)

Uqikelelo lomntu onesi sifo luxhomekeke kwizinto ezininzi. Nangona kunjalo, njengesifo sikaParkinson, isifo sikaParkinson i-Dementia sidla ngokuba mandundu ngokuhamba kwexesha. Nangona unyango lunokubonelela ngokukhululeka kwiimpawu, umgangatho wobomi unokuncipha.

Oku kunganda ngokukhawuleza kangakanani?

Izinga lesifo sikaParkinson esiba mandundu ngalo liyahluka kakhulu kumntu nomntu, njengoko isifo sikaParkinson siqhubeka. Iqela lakho lezonyango lingakunika wena nosapho lwakho umbono wento eninokuyilindela ngokusekelwe kwimeko yenu ethile.

Ngaba oku akunakuthintelwa ukuba kwenzeke?

Ngelishwa, okwangoku akukho nto inokwenziwa ukuthintela iParkinson's Disease Dementia ukuba ingakhuli. Kwakhona, akukho ndlela yokunciphisa umngcipheko wokuba nayo.

Singamnceda njani umntu onesifo sengqondo sikaParkinson?

Ukuba umntu omthandayo unale meko, ukongeza ekusebenzeni neqela lezonyango ukuze limnike unyango olungcono, kukho nezinye izinto ezininzi onokuzenza:

• Funda kangangoko unako malunga neParkinson's Disease Dementia: Okukhona usazi ngakumbi ngayo, kokukhona kuya kuba lula kuwe ukujongana noko kuza kwenzeka. Kwaye, uya kukwazi ukummela ngcono umntu omthandayo.
• Yenza kube lula imeko-bume yakhe:Susa izinto ezingafunekiyo endlwini uze uzigcine zilungile. Oku kunokunciphisa ukudideka kwengqondo abakufumanayo. Ukuba nokukhanya okuncinci ebusuku kunokunceda ekunciphiseni ukubona izinto ngendlela engafanelekanga.
• Misela inkqubo eqhelekileyo: Ukuba nenkqubo eqhelekileyo, njengokutya, ukuhlamba, kunye nokulala ngexesha elifanayo yonke imihla, kunokunceda abantu abaneParkinson's Disease Dementia bazive bekhululekile kwaye bekhuselekile.
• Joyina iqela lenkxaso: Yenza umntu omthandayo kunye nawe ubandakanyeke kumaqela enkxaso yezigulane zeParkinson kunye neentsapho zazo. La maqela anokubonelela ngolwazi oluxabisekileyo, iingcebiso kunye namava. Oku kunokuba namandla amakhulu ngeli xesha lohambo.

Ingaba isifo sengqondo sikaParkinson sahlukile kwezinye izifo zengqondo eziqhelekileyo?

Zininzi izizathu ze-dementia, kwaye iimpawu zahlukile. Isifo sika-Alzheimer lolona hlobo luqhelekileyo lwe-dementia. Ngokutsho kwezazinzulu, iimpawu ze-Parkinson's disease dementia zahlukile kancinci kwezo ze-Alzheimer's disease dementia. Umzekelo:

• Abantu abanesifo sikaParkinson banamathuba amaninzi okuba nokungabi namdla kunye nobunzima bokugxila kunabo bane-Alzheimer's.
• Abantu abane-Alzheimer's disease dementia banokuba neengxaki zolwimi ngaphambili kunabo bane-Parkinson's disease dementia. Kwakhona, abantu abane-Alzheimer's banengxaki yokukhumbula izinto ezintsha kunabo bane-Parkinson's disease dementia.

Ngaba kukho amanqanaba ahlukeneyo e-Parkinson's dementia?

Oogqirha baye bamkela iindlela zokwahlula isifo sikaParkinson ngokwamanqanaba ahlukeneyo. Nangona kunjalo, akukho ndlela ithile yokwahlula isifo sikaParkinson ngokwezigaba. Oku kungenxa yokuba indlela esichaphazela ngayo wonke umntu kunye nesantya esiba mandundu ngayo siyahluka kakhulu. Ngenxa yoko, kunzima koososayensi nakoogqirha ukusihlukanisa ngokwamanqanaba athile.

Okokugqibela, izinto ekufuneka uzikhumbule

Akulula ukufunda ukuba unesifo sikaParkinson, imeko echaphazela inkumbulo yakho kwaye inokuchaphazela amandla akho okusebenza. Kuqhelekile ukuba uzive ulusizi, uphoxekile, kwaye woyika oko kuza kwenzeka kwixesha elizayo. Khumbula ukuba awuwedwa ngeli xesha. Fumana inkxaso oyifunayo kubantu obathandayo, kusapho, kubahlobo, ingakumbi kwiqela lakho lezonyango.

Khumbula, nangona unyango lungenakuyinyanga ngokupheleleyo le meko, lunokunceda ekulawuleni iimpawu kunye nokuphucula umgangatho wobomi ukuya kuthi ga kwinqanaba elithile. Ngoko ke, musa ukuphelelwa lithemba kwaye qhubeka nolu hambo ngenkxaso oyifumanayo.

Isifo sikaParkinson , i-dementia, ukulahlekelwa yinkumbulo, izifo zobuchopho, imizimba kaLewy, izifo ze-neurological, ukhathalelo lwabantu abadala