Parkinson’s disease is one of the most common
degenerative diseases of the nervous system.
It is most common in people over 65 years of age
and can affect younger people as well.
Patients under 40 are classified as “young onset Parkinson’s”
and make 10-15% of all cases.
In Parkinson's, specific neurons in the brain start to malfunction.
They make less of a chemical called dopamine
that is involved in generating movement.
Scientists do not yet know exactly
what leads to the death of these dopamine-producing neurons.
In most cases, they believe Parkinson's is due to
a combination of genetic changes and environmental factors,
with young onset patients
perhaps having a stronger genetic contribution.
Parkinson's symptoms can be broadly divided into two types:
motor – or movement – related
and non-motor symptoms.
Non-motor symptoms might show up earlier
but can occur throughout the disease.
Non-motor Parkinson's symptoms can include:
• Loss of the sense of smell;
• Sleep problems;
• Constipation; and
• Depression.
Some non-motor Parkinson's symptoms
may be associated with Parkinson's medications.
These can include:
• Daytime sleepiness;
• Hallucinations – or seeing things that aren’t really there;
• Drops in blood pressure; and
• Psychosis – or losing touch with reality temporarily.
Tell your doctor if you have any of these symptoms.
Changing medications may help.
Tremor is not always present
but can be the most noticeable motor symptom of Parkinson's disease in many cases.
The tremor is usually in the hands at rest,
but can also be present in the legs or even the chin.
The resting tremor of the hands is often described
as “pill rolling” with the thumb and other digits involved.
Other motor symptoms include slow movements (or bradykinesia),
stiffness,
reduced facial expression,
changes in posture,
and trouble with walking and balance.
Motor symptoms usually start on one side of the body
and can spread to the other as the disease advances.
There are a variety of rating scales
that Parkinson's specialists sometimes use to track changes over time.
Doctors sometimes divide Parkinson’s disease into five stages.
Progression is typically slow but can vary from patient to patient.
In stage 1, mild symptoms,
usually including tremor and other motor symptoms
affect one side of the body and produce little disability overall.
In stage 2, symptoms make daily activities more difficult.
Movement problems are on both sides of the body.
Posture and walking can be affected and disability is mild.
In stage 3, movements are moderately slower.
Balance is more affected
which puts patients at greater risk of falling.
Dressing, bathing, and doing other daily activities
have become significantly more difficult.
In stage 4, significant mobility issues
require the use of a walker to move around.
Patients need considerable help doing daily activities
and are unable to live independently.
In stage 5, balance and movement problems are severe enough
that the person needs a wheelchair and nursing care.
They may also have noticeable mental changes,
delusions, or hallucinations.
Learning about the stages of Parkinson’s can be frightening.
However not everyone with Parkinson’s will progress to stage 4 or 5.
It's important to remember that Parkinson's affects everyone differently,
and you may or may not have all the possible symptoms.
Doctors treat Parkinson’s disease with medications to relieve symptoms.
Starting these medications does not slow the progression
but can provide benefit to patients that improve
and maintain their quality of life for many years.
Advanced therapies such as
surgical implantation of a deep brain stimulator
may also help in select cases as well.
If you suspect Parkinson’s,
a careful examination by a specialist in Parkinson’s disease
and other movement disorders is essential.
You can search for Parkinson’s “Centers of Excellence”
which are located in most major cities in the US.
It’s also important to learn your treatment options.
With today’s medications and treatments,
the outlook for people with Parkinson’s
is much better than in the past.
You and your doctor can create a personalized treatment plan together.