Written by Connie Carpenter Phinney 

For this month’s meetup, we were pleased to again welcome Dr. Mark Mapstone as a special guest. Dr. Mapstone is a professor of neurology at UC Irvine and the chief of neuropsychology.

In addition to his clinical practice, Dr. Mapstone is an active researcher. His research focuses on developing understanding of blood biomarkers so that conditions like Parkinson’s might be detected before symptoms begins. He also has interest in understanding how the brain produces behavior and thinking abilities.

Dr. Mapstone is a member of our Science Advisory Board and a frequent guest on our Care Partner Meetup. He most recently joined us in August. If you missed it you can read my notes from that session and watch a recording.

This month, our panelists included DPF Care Partner Ambassadors Gail Gitin and Pat Donahoo. We were also joined by Polly Dawkins. 

If you haven’t already signed up to attend our sessions live, you can do so today.

Questions from the Meetup

Since the conversation during the meetup centered around a handful of questions, these notes will highlight those questions and expand on aspects of them.

Please note that some quotations below have been edited for clarity and brevity. 

Dementia and Executive Function

We asked Dr. Mapstone, “Why are care partners not told early on that a person with Parkinson’s will most likely have some form of dementia due to the demands of the disease on his or her brain–and why are we not told that this will likely relate more to executive function and decision-making?”

Dr. Mapstone said, “There are still folks who hold on to this idea that Parkinson’s disease is primarily a motor disorder, where we get the tremor the stiffness, rigidity, the slowness of movements known as bradykinesia, and the gait problems.”

He went on to say, “What we’re focusing on today is more the cognitive and behavioral aspects of Parkinson’s. These are becoming more appreciated but they don’t quite get out there to everybody at the same rate. There are early adopters and people who are on the front lines who see this because they’re with people with Parkinson’s all the time. They know the cognitive impacts. Clearly as a care partner for a person with Parkinson’s disease, you are also on the front lines, and you see this day to day.

Dr. Mapstone also acknowledged that a small percentage of people with Parkinson’s will have minimal or even no impact on their cognitive function throughout the course of their life with Parkinson’s, but that most will experience cognitive impacts and the most common impact is to executive function. He described executive function as the cognitive process that results from the frontal lobes of the brain, which is highly specialized for planning, decision making, and control of some of our primal instincts.” Dr. Mapstone used the example of having the self control to not say inappropriate things in public or control one’s urge to eat too many cookies. This kind of self-control may be degraded or slowly eroded by Parkinson’s. 

These challenges represent a kind of dementia, which Dr. Mapstone noted “refers to a loss of something that was there before” and occurs slowly over time. Dementia affects daily function and can have many causes, of which Parkinson’s disease is one. Of course Alzheimer’s disease is another, but there are many others, including reversible forms of dementia like those caused by sun stroke or Vitamin B-12 deficiency. Dr. Mapstone also acknowledged that a per