Dementia, a global decline in behavior, intellect, memory, mood,
personality, speech, and thinking affects approximately 30% of people
with PD predominantly people 70 years or older. Dementia, like PD
itself, is a slowly evolving condition. Often, in retrospect, certain
changes in behavior, intellect, memory, mood, personality, speech,
and thinking were apparent but not appreciated at the time.
Sometimes, the beginning of dementia is the appearance of
hallucinations or delusions after starting a new PD drug. Anti-
cholinergic drugs, amantadine, selegiline, dopamine agonists, and
carbidopa/levodopa (with or without Comtan) in that order may bring
out hallucinations and delusions. The hallucinations and delusions
called a psychosis usually disappear when the drug is reduced or
stopped. A psychosis is not dementia but it can be a beginning, a
warning of the development of dementia.

The following Questionnaire was developed as a means of detecting the
beginning of dementia. The Questionnaires is a guide, it has not been
scientifically validated. The Questionnaire should first be completed
by you. The same Questionnaire should be then be completed by your
spouse or care-giver. As certain changes in behavior, intellect,
memory, mood, personality, speech, and thinking may NOT be apparent
to you but may be apparent to the spouse or care-giver.

Thinking Questionnaire

Score 1 or 2 points next to either Yes or No.


Awareness of Difficulty

1. Are you aware you're having difficulty thinking? Yes (2 points) No
(0 points)

2. Are you aware of a change in your behavior or personality? Yes (2)
No (0)


Sleep Changes:

3. During the day do you fall asleep often, such as while eating? Or
speaking? Yes (0) No (1)

4. At night, while asleep, do you have nightmares? Or scream? Yes (0)
No (1)


Cognitive Impairment (Difficulty doing things you previously could do)

5. Do you have difficulty in balancing your checkbook? Or making
change? Yes (0) No (1)

6. Do you have difficulty in telling time on a non-digital clock? Yes
(0) No (1)


Hallucinations

7. Do you now see animals or objects no one else sees? Yes (0) No (2)

8. Do you now see people who you know are dead? Yes (0) No (2)


Psychic or Mental Energy, Apathy

9. Do you lack a desire or energy to do things? Yes (0) No (1)

10. Do you now NOT take pleasure in doing things? Yes (0) No (1)


Depression

11. Do you feel sad, depressed, down? Yes (0) No (1)


Dis-inhibition (Inappropriate behavior, not previously shown)

12. Do you kick or throw things? Or shout angrily? Yes (0) No (1)

13. Do you hit people? Yes (0) No (1)


Mood Swings (Swings more often and more extreme than in the past)

14. Do your moods change rapidly from calm to angry? Or happy to sad?
Yes (0) No (1)


Anxiety

15 Are you more anxious, more stressed, than in the past? Yes (0) No
(2)


Panic

16. Do you suddenly feel overwhelmed, feel you can't do anything? Yes
(0) No (1)

17. Do you suddenly become overcome with fear? Yes (0) No (1)


Obsessions (Thoughts which control your mind)

18. Do you have thoughts or desires that you can't get out of your
mind? Yes (0) No (1)

19. Do you constantly thing of sex? Yes (0) No (1)


Compulsions (Actions which you can't control)

20. Do you gamble or shop beyond your means? Yes (0) No (1)

21. Do you engage in cross-dressing, excessive phone or video sex?
Yes (0) No (1)


Personality changes (paranoia, delusions, changes you never had
before)

22. Do you believe people are saying bad things about you? Yes (0) No
(1)

23. Do you believe people are stealing from you? Yes (0) No (1)

24. Do you believe people are planning to hurt you? Yes (0) No (2)

25. Do you believe your spouse or partner is having an affair? Yes
(0) No (1)

Scores of 20 to 30 are probably normal (no dementia)

Scores of 19 or less may be abnormal