Neurodegenerative Diseases: Parkinson’s and Alzheimer’s Diseases

Abstract

Neurodegenerative diseases increase in prevalence with aging. This chapter begins with a discussion of Parkinson’s disease. Optimally individualized treatment includes dopaminergic medications, physiotherapy, and multidisciplinary care. Evidence for integrative approaches is limited. Advances in genetics and biomarkers hold promise for subtype-specific, precision treatment in the near future. The second part of this chapter focuses on Alzheimer’s disease. Standard evaluation includes assessment for possible contributing factors that may worsen cognition, and management includes optimizing factors that may improve cognitive function. No disease-modifying medical approaches yet exist, but increasing emphasis on interventions to limit chronic inflammation and optimize brain metabolism remain fundamental in the integrative approach to Alzheimer’s disease. The new metabolic approach first described by Dr. Dale Bredesen is summarized and the importance of multidisciplinary care, with emphasis on early transition to palliative care when appropriate, is reviewed.