Parkinson’s disease is a progressive disorder of the nervous system. It affects a person’s movement, facial features, and speech. There is no cure for Parkinson’s, but people with the condition can learn to manage its symptoms and prevent complications. As caregivers it's important to know the signs and how to handle changes. In this post, we tell you all you need to know about recognizing and treating Parkinson’s disease.
What is Parkinson's Disease?
Parkinson's is a disease of the nervous system. It occurs when nerve cells in the brain fail to function normally, or die off. Parkinson’s symptoms tend to come on slowly and gradually get worse as the condition progresses. Often, people first notice a minor tremor in one hand or the loss of facial expression. Symptoms then progress so that movement is inhibited and speech becomes soft and slurred.
According to the Parkinson’s Disease Foundation, almost one million people in the United States will have Parkinson’s by the year 2020—that’s more than the numbers living with ALS, multiple sclerosis, and muscular dystrophy combined.
The risk is greatest in older adults, although younger people can also develop the condition. When the disease affects someone aged 21 to 50, it is called early-onset Parkinson's disease.
Some diseases like Parkinson’s, which are all movement disorders, include:
- Arteriosclerotic parkinsonism
- Essential tremor
- Lewy-body disease
- Multiple system atrophy
- Normal pressure hydrocephalus
- Post-traumatic parkinsonism
- Progressive supranuclear palsy
- Viral parkinsonism
Parkinson's Disease Stages
Although the signs and symptoms of Parkinson’s are different for everyone, the disease tends to follow typical patterns of progression.
- Stage One. In the beginning, symptoms are mild and do not generally impact a person’s everyday life. The symptoms usually affect only one side of the body.
- Stage Two. Symptoms begin to get worse, and affect both sides of the body. Although the person retains their independence, they may struggle with daily tasks.
- Stage Three. At this stage, symptoms significantly impair a person’s activities. Falls are more common than before due to loss of balance and slow movements.
- Stage Four. Now, symptoms become severe and limit a person’s life. People at stage four are unable to live alone and require help with activities and movement.
- Stage Five. At this advanced stage, Parkinson’s is debilitating. It is impossible to stand or walk, and it is necessary to have full-time care for all tasks, from dressing to eating. Non-movement-related symptoms include hallucinations and delusions.
Parkinsonism vs. Parkinson's Disease
Parkinsonism is often confused with Parkinson’s disease. Parkinsonism is a syndrome where there are lesions in the basal ganglia, a group of structures found deep within the brain.
Parkinson’s disease is the most common neurodegenerative cause of Parkinsonism, making up 80 percent of cases of the syndrome.
Parkinson's Disease Causes
Parkinson's disease is the result of nerve cell (neuron) death in the brain. Its symptoms occur because the neurons that produce dopamine, an important brain chemical, die. Low dopamine levels affect normal brain activity.
The exact cause of Parkinson’s is unknown. However, experts believe that the onset of Parkinson's disease is related to one or more of the following risk factors:
In rare cases, certain genetic mutations can cause Parkinson's disease. When genetics are at fault, several members of the same family tend to develop Parkinson's disease.
Other gene variations may also play a role in Parkinson’s onset, but the risk is relatively small, even for people who do display such genetic markers.
Being exposed to certain toxins, along with other environmental factors, may increase an individual’s Parkinson’s risk. For example, continuous exposure to some herbicides and pesticides can be a factor, although this risk is quite small.
Presence of Specific Substances in the Brain
Some brain changes linked to Parkinson's disease include the presence of Lewy bodies, or clumps of specific substances in brain cells. In particular, a protein within Lewy bodies, called alpha-synuclein, is currently of interest to Parkinson's disease researchers.
Most people develop Parkinson’s disease at age 60 or older, and the risk increases with age, but younger adults are also at risk. Early-onset Parkinson’s affects four percent of those with the condition.
Parkinson's Disease Symptoms
This condition affects everyone differently, and not everyone will have the same symptoms and signs of Parkinson's disease. Also, people don’t always experience symptoms at the same level of intensity, or in the same order, as others with the condition.
Early signs of Parkinson's disease are often mild, and may not be recognized as anything serious until they progress. Generally, symptoms begin on one side of the body before affecting the other. Often, the side first affected remains the worst. Some of the most common signs and symptoms of Parkinson's include:
The first sign is often a tremor, or shaking, in a limb such as the hand or the fingers. Hands may tremor when you are not using them, or you may repeatedly rub your thumb and forefinger together, known as a pill-rolling tremor.
Also known as bradykinesia, slowed movements are another hallmark of Parkinson’s. Over time, the disease slows down a person’s movement, making simple tasks more drawn out and difficult. Eventually, the person will become bed-bound and require the use of a wheelchair.
Loss of Unconscious Movements
Losing automatic (unconscious) movements means that people with Parkinson’s are less able to perform actions such as blinking and smiling. Another common example is that they are no longer able to swing their arms while walking.
Rigid and stiff muscles occur throughout the body, leading to pain and reduced range of motion.
Difficulties with Posture and Balance
Parkinson’s causes people to lose their balance more frequently, leading to falls and other complications. Also, posture may become stooped, which can further limit mobility and cause pain.
Changes in Speech and Writing Abilities
If you have Parkinson’s, over time you may notice that your speech becomes slurred, softer, or more hesitant. It may sound more monotone than before. Writing is another form of communication that is affected, as people struggle to write due to muscle stiffness, tremors, and slowed movements.
Hallucinations and Delusions
In the advanced stages, people with Parkinson’s may experience non-motor symptoms such as hallucinations and delusions. These can be distressing for the person with the condition as well as their caregivers.
Parkinson's Disease Diagnosis
If you have any of the symptoms of Parkinson's disease, see your doctor right away. These symptoms may indicate another condition that is not Parkinson’s.
To diagnose Parkinson’s, a neurologist may carry out one or more tests, including:
- Full medical history
- Review of signs and symptoms
- Neurological examination
- Physical examination
- Dopamine transporter (DAT) scan
- Blood tests
- Imaging tests, such as an MRI, CT, or ultrasound of the brain
The neurologist may also ask you to take a specific Parkinson's medication to see if your symptoms improve. If they do, it indicates that you have Parkinson's disease.
Parkinson's Disease Treatment
Although there is no cure for Parkinson's disease, medications and lifestyle changes can make a big difference to your symptoms and quality of life. Work with your healthcare team to find the best plan for your needs. Some of the treatments they may recommend include:
Avoiding Falls and Injuries
Keeping a firm footing in the shower is essential to preventing falls. Try a shower grab bar for the stability you need. ( See Product )
In the mid to late stages of Parkinson’s, people tend to fall more easily thanks to poor balance, muscle rigidity, and slow movements. Even a small bump can cause you to lose your footing. To avoid falling, try to place your weight evenly on both feet, make U-turns instead of pivoting, and do not carry items when walking.
A toilet safety frame is all you need to transfer to and from the toilet in safety. ( See Product )
Fit your home with frames and mats to stop falls or to reduce the risk of injury if you do fall. For example, you may wish to place grab bars throughout your home, a toilet safety frame in the bathroom, and a padded fall mat by the bed.
Never underestimate the power of a soft cushion to absorb the impact of unexpected falls. ( See Product )
Adapting Daily Living Activities
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Daily tasks that we often take for granted, such as dressing and eating, become much more difficult as Parkinson’s symptoms progress. Work with an occupational therapist to find techniques that make these activities easier.
With a dressing stick, you'll never have to struggle getting on shirts and jackets. ( See Product )
You can also buy devices to assist you in your daily life, such as button hooks and dressing sticks for getting dressed and undressed, and a reacher grabber to help you carry out all sorts of tasks.
Reacher grabbers are the best way to put high or low items in arm's reach. ( See Product )
Get your own rollator walker to stay mobile, indoors and out. ( See Product )
Poor balance becomes a big concern as symptoms get worse. At some stage, you will need to use cane, walker, or rollator walker, before eventually progressing to a wheelchair in stage four or five.
Exercise for Parkinson's Disease
Exercise is important for everyone, and people with Parkinson’s disease are no exception. Regular physical activity can improve your strength, flexibility, balance, and mental health.
Try walking, swimming, aqua aerobics, and dancing. Stretching exercises, such as tai chi and yoga, may be especially helpful, according to some studies.
Diet for Parkinson's Disease
Eating a balanced diet may ease some of the symptoms of Parkinson's disease. Aim to consume a variety of fruits, vegetables, whole grains, lean proteins such as lentils or poultry, fatty fish, and nuts and seeds. A high-fiber diet can help prevent constipation, a common symptom among those with Parkinson’s disease. Don’t forget to drink enough water and other liquids each day to ensure healthy digestive functioning.
Alternative Therapy for Parkinson's Disease
Several alternative therapies can help Parkinson's disease symptoms and complications. Many people benefit from massage therapy to loosen up stiff muscles and encourage relaxation.
Parkinson's Disease Medications
Medications can be extremely helpful for some people with Parkinson’s—sometimes dramatically improving symptoms. Eventually, however, most drugs lose their effectiveness, but taking medications is still better than not taking any.
There are many different types of medicines to control Parkinson’s symptoms, as well as its complications. Speak to your doctor about what is right for you.
Deep Brain Stimulation for Parkinson's Disease
Deep brain stimulation (DBS) involves placing electrodes into the brain. These electrodes are connected to a generator in the chest. The generator sends electrical pulses to the brain to reduce Parkinson's disease symptoms.
There are some risks involved with surgery and the DBS system in general. Therefore, this treatment is typically reserved only for those with advanced Parkinson's disease that does not respond well to medication. However, it can be very effective at controlling symptoms in these people.
Discovering you or a loved one has Parkinson’s disease can be frightening. People experience a range of emotions in response to their initial diagnosis and at varying stages of the disease. Those who are feeling persistently sad or hopeful should see their doctor, as they may have depression, which can be treated with medications and talk therapy.
Both people with Parkinson’s and their caregivers should seek emotional support from others. Ask for help from family, friends, therapists, and doctors. Support groups are also available.
Parkinson's Disease Prognosis
For people with Parkinson's disease, life expectancy is similar to the general population, provided they receive prompt medical treatment. It’s important to see your doctor as soon as you notice symptoms because early intervention can prevent potentially fatal complications.
Parkinson's disease typically causes some complications, although these vary from person to person. Potential complications of Parkinson’s disease include:
- Dementia (in the later stages)
- Depression and anxiety
- Problems eating and drinking, due to muscle issues
- Sleep disorders, including insomnia or excessive daytime sleepiness
- Bladder problems, such as incontinence or difficulty urinating
- Sudden drops in blood pressure when standing up
- Loss of sense of smell
- Loss of sexual desire or trouble performing sexually
Some of these complications respond well to treatment. For example, you can take medications to address depression, anxiety, sleep disorders, constipation, pain, and loss of sexual function.
Prevention of Parkinson's Disease
Both the cause of Parkinson’s, and its methods of prevention, remain unknown. However, according to the latest Parkinson's disease research, regular cardiovascular activity may have a protective effect.
Also, some evidence suggests that consuming caffeine—in the form of tea, coffee, and green tea—may reduce the risk of Parkinson’s disease. This research is limited, and there is not enough evidence to recommend that people drink caffeine purely to protect against the condition.
Living with Parkinson's Disease
Parkinson’s disease poses unique challenges for those with the condition, along with their loved ones and caregivers. But the disorder does not affect longevity, and people with Parkinson’s disease can find ways to manage their symptoms and live rich lives despite their diagnosis.
Many treatment options control symptoms and prevent complications. Some of the best include medications, regular exercise, and various therapies. Specific devices and living aids help people to move around with ease, prevent falls, and assist in everyday tasks. Finally, don’t forget to seek support to deal with the emotional and psychological impact of living with Parkinson’s disease.