George H.W. Bush, the 41st President of the United States died on November 30, 2018, at the age of 94. He was diagnosed with vascular parkinsonism in 2012 which affected his walking and caused him to require a wheelchair for his mobility over the past few years. His passing puts a spotlight on this disease, which can be confused with Parkinson’s disease (PD).
Vascular parkinsonism is a brain disorder that mimics some of the features of PD, particularly the characteristic gait and balance symptoms. Vascular parkinsonism is thought to be due to an accumulation of small strokes in the parts of the brain that control movement. Lewy bodies, the key pathological hallmark of PD, are not present in vascular parkinsonism. People with vascular parkinsonism are less likely to be responsive to Levodopa and other PD meds than people with typical PD, but some are responsive, so it is common practice to try PD meds even if vascular parkinsonism is suspected. Treatment also focuses on preventing any further strokes with management of high blood pressure, high cholesterol, and diabetes and maximizing mobility with physical therapy.
A neurologist or movement disorder specialist can identify the distinctions between these diseases in order to make the proper Parkinson’s diagnosis.