Mild cognitive impairment

Slowness of thinking or loss of ability to process information is referred to as bradyphrenia. It mirrors the slowness of movement in the body (bradykinesia)
seen in Parkinson’s.

Difficulty multitasking, paying attention and concentrating are often the most common cognitive changes in early Parkinson’s.

This in turn can lead to problems with memory and recalling new information. These changes can make communication challenging due to word-finding, inability to follow group conversations, or remembering names. It may result in the desire to disengage from social situations.

It is also common for people with Parkinson’s to experience cognitive fatigue due to having to concentrate harder when doing things quickly.

Difficulty starting activities or tasks can be likened to the physical difficulty in initiating movement. This may appear as if the person has less energy (fatigue) or motivation (apathy).

Difficulty in multi-tasking can lead to challenges in at work or at home.

You may get overwhelmed by busy environments. Bradyphrenia may affect safety when walking in busy places. It is also an issue when driving due to a delay in reaction time, which is why Parkinson’s is a reportable medical condition to your driving authority (see Driving & Parkinson‘s infosheet).

However, this does not mean you have to give up driving altogether, provided your symptoms are not impacting your abilities. Your GP or neurologist will assess this and you can get an assessment from an OT to help your confidence and driving abilities.

In some cases, cognitive changes may become severe and have a significant impact on daily living.

Practical tips

While there is no way to stop cognitive changes that come with age or progression of Parkinson‘s, an OT and psychologist can help arm you with tips and tools to manage these symptoms.

Neuroplasticity

Exercise can not only help slow the progression of Parkinson’s, but it also helps boost memory and thinking skills.

Just like you need exercise for your body, your brain needs exercise too! Brain training has been shown to increase neuroplasticity. Do some puzzles, lego building, play cards, read a book, do trivia, sing or just try something new.

Concentration and bradyphrenia

• Do one task at a time (ask for no interruptions especially if important).
• Do important tasks when you are rested and your medications are ‘on’.
• Avoid distractions (e.g. radio or television) when focusing on a task.
• Make sure you (and others) allow yourself extra time to complete things, recall words or names.
• Deliberately concentrate as you do the task, for example, talk to yourself “Did I pack my keys?”
• Plan tasks ahead with plenty of time to avoid rushing and added pressure.

Short-term memory changes

• Use diaries, lists, prompts or alarms.
• Ask for meetings to be recorded and AI transcripts to be circulated.
• Ask the person you are talking to for confirmation if you feel you have forgotten something important.
• Use a ‘memory corner’ at home where important items such as keys or phone are always placed.
• Try to establish a daily routine, write it down and stick to it.
• Use a Webster Pak, Tab Timer or phone alarm to remind you to take your meds on time every time.

Difficulty starting activities

• Schedule each day out hour by hour.
• Set goals for the day and use checklists to stay on track.
• Include enjoyable activities in your routine like hobbies and interests.
• Get involved in group activities.

Experiencing cognitive changes or aware of them in a loved one?

It is vital that any concerns or questions are discussed with your treating medical specialist or GP. It can be useful to have a neuropsychology assessment to measure the type and extent of the cognitive changes experienced if any – n.b. this may require a medical referral.