RYAN REYNOLDS DIVES INTO THE UNTOLD STORY OF PARKINSON'S WITH A GROUP OF DEDICATED ADVOCATES
When my dad developed Parkinson's-related hallucinations and delusions, and he began seeing things that weren't there and believing things that weren't true, it was incredibly hard on him and our family. At the time, we didn't really know how to help him. Hallucinations and delusions are part of the untold story of Parkinson's, even though about half the people who develop the disease may experience them at some point over the course of their disease. And that's why I tell people if my family's experience sounds familiar, then don't wait, just talk to your doctor about it."
—Ryan Reynolds, actor and advocate
In a candid, roundtable conversation with a physician, two people living with Parkinson’s disease, and a care partner, Ryan explores the worry and isolation that can accompany Parkinson’s‑related hallucinations and delusions. These videos offer clinicians insight into why patients and care partners may stay silent—and the profound impact these symptoms can have on families—helping inform more open, meaningful conversations in the exam room.
HELP IDENTIFY PD PSYCHOSIS SYMPTOMS WITH A VALIDATED SCREENER
As part of routine appointments, have your patients or their caregivers complete the validated Self-Administered Screening Questionnaire for Parkinson’s Disease–Associated Psychosis (SASPAP). The SASPAP is a 4-question validated screening tool published in Movement Disorders.* Discuss the results and next steps to ensure these symptoms are identified before they progress.
En Español*©2023 International Parkinson and Movement Disorder Society (MDS). All rights reserved. Used with permission. This scale may not be copied, distributed or otherwise used in whole or in part without prior written consent of MDS.
50%
Over the course of their disease, about 50% of people with Parkinson’s disease (PD) may experience hallucinations and delusions.1
90%
Despite the prevalence of hallucinations and delusions, up to 90% of patients and care partners do not proactively report these symptoms to their physicians.2,3
HALLUCINATIONS AND DELUSIONS CAN MANIFEST IN MULTIPLE WAYS
Hallucinations4-6
Vision
Auditory
Olfactory
Gustatory
Tactile
Delusions5-7
Jealousy
Persecutory
Reference
Hallucinations and delusions worsen the outlook for patients with PD:
- Higher incidence of falls and fractures8
- Increased hospital admissions and nursing home placements9,10
- Increased mortality risk10,11
Caregivers of patients with PD psychosis experience greater burden and distress:
- Higher incidence and increased severity of depression12,13
- Increased risk for chronic illness14
- Feelings of isolation12
HALLUCINATIONS AND DELUSIONS CAN HAVE A SIGNIFICANT IMPACT ON PATIENTS AND CAREGIVERS
References: 1. Forsaa EB, Larsen JP, Wentzel-Larsen T, Alves G. A 12-year population-based study of psychosis in Parkinson disease. Arch Neurol. 2010;67(8):996-1001. 2. Fénelon G, Mahieux F, Huon R, Ziégler M. Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain. 2000;123(Pt 4):733-745. 3. Chaudhuri KR, Prieto-Jurcynska C, Naidu Y, et al. The nondeclaration of nonmotor symptoms of Parkinson’s disease to health care professionals: an international study using the nonmotor symptoms questionnaire. Mov Disord. 2010;25(6):704-709. 4. Fenelon G, Mahieux F, Huon R, Ziegler M. Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain. 2000;123(4):733-745. doi:10.1093/brain/123.4.733. 5. Voss T, Bahr D, Cummings J, Mills R, Ravina B, Williams H. Performance of a shortened Scale for Assessment of Positive Symptoms for Parkinson’s disease psychosis. Parkinsonism Relat Disord. 2013;19(3):295-299. doi:10.1016/j.parkreldis.2012.10.022. 6. Ravina B, Marder K, Fernandez HH, et al. Diagnostic criteria for psychosis in Parkinson’s disease: report of an NINDS, NIMH work group. Mov Disord. 2007;22(8):1061-1068. doi:10.1002/mds.21382. 7. Andreasen NC. Scale for the Assessment of Positive Symptoms (SAPS). Iowa City, IA: University of Iowa; 1984. 8. Forns J, Layton JB, Bartsch J, et al. Increased risk of falls and fractures in patients with psychosis and Parkinson disease. PLoS One. 2021;16(1):e0246121. doi:10.1371/journal.pone.0246121. 9. Aarsland D, Larsen JP, Tandberg E, Laake K. Predictors of nursing home placement in Parkinson’s disease: a population-based, prospective study. J Am Geriatr Soc. 2000;48:938-942. 10. Wetmore JB, Li S, Yan H, et al. Increases in institutionalization, healthcare resource utilization, and mortality risk associated with Parkinson disease psychosis: retrospective cohort study. Parkinsonism Relat Disord. 2019;68:95-101. doi:10.1016/j.parkreldis.2019.10.018. 11. Forsaa EB, Larsen JP, Wentzel-Larsen T, Alves G. What predicts mortality in Parkinson disease?: a prospective population-based long-term study. Neurology. 2010;75(14):1270-1276. 12. Mantri S, Klawson E, Albert S, et al. The experience of care partners of patients with Parkinson’s disease psychosis. PLoS One. 2021;16(3):e0248968. doi:10.1371/journal.pone.0248968. 13. Aarsland D, Larsen JP, Karlsen K, Lim NG, Tandberg E. Mental symptoms in Parkinson’s disease are important contributors to caregiver distress. Int J Geriatr Psychiatry. 1999;14(10):866-874. 14. Schrag A, Horvis A, Morley D, Quinn N, Jahanshahi M. Caregiver-burden in parkinson’s disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat Disord. 2006;12(1):35-41.