Parkinson's Disease
What is Parkinson’s disease?
Parkinson’s disease (PD) is a progressive, degenerative brain condition. While the most common symptoms are related to movement, PD can cause other symptoms. The risk of PD increases with age as it mostly affects people over 65 years of age. However, young people can be diagnosed with the condition. It’s estimated that 80,000 Australians have PD.
The disease is named after Dr James Parkinson who first described the disease in 1817 in his book An Essay on the Shaking Palsy. While there is currently no cure, symptoms can be managed. Research into PD continues around the world with a focus on treatments and discovering the exact cause of the condition.
Motor symptoms of Parkinson’s disease
These are the most noticeable symptoms that doctors often use to diagnose MD. They include:
Resting tremors
Slowed movement (bradykinesia)
Rigid muscles
Stooped or poor posture
Poor balance
Slow, shuffling walk
Loss of automatic movements such as blinking or smiling
Reduced facial expressions
Non-motor symptoms of Parkinson’s disease
Often called the ‘invisible symptoms’ of PD, these can affect almost every body system and occur at any stage of the disease. They include:
Fluctuating blood pressure, especially low blood pressure
Constipation
Sexual dysfunction (i.e. erectile dysfunction in men and pain or loss of libido in women)
Excessive perspiration
Frequent urination, incontinence or difficulty emptying the bladder
Fatigue
Disturbed sleep
Loss of smell
Drooling due to excess saliva
Swallowing difficulties
Changes to vision (i.e. dry eyes, double vision)
Changes in speech (i.e. loss of volume, slurring and monotone voice)
Changes in writing (i.e. writing becomes smaller as it becomes harder to write)
Mild to moderate weight loss
Apathy or depression
Mood disturbances
Memory or concentration problems
Hallucinations and/or paranoia in people who have lived with the condition for some time
Stages of Parkinson’s disease
Symptoms of Parkinson’s disease develop slowly, but they typically progress in patterns that are defined in stages.
Stage one
Early stages of the disease involve mild symptoms that don’t usually interfere with daily activities. Sometimes, the symptoms are missed altogether. Usually, tremors or movement symptoms affect only one side of the body. Changes in posture, walking and facial expressions begin to happen. It’s usually family or friends who notice symptoms first.
Stage two
Symptoms worsen with tremors and rigidity now affecting both sides of the body. It may be more apparent that the person has difficulty with their posture or when walking. Their speech may also be affected.
Stage three
In this stage (considered mid-stage), slowness of movement is more pronounced and it’s common for the person to have falls. Symptoms now impact daily activities such as eating or dressing.
Stage four
As the disease progresses, symptoms become more severe and debilitating. It may be necessary to use a walker. The person will need help with daily activities and will be unable to live on their own.
Stage five
This is the most advanced stage of the disease. Stiffness in the legs may cause ‘freezing’ which makes it impossible to stand or walk. Often the person requires a wheelchair and around-the-clock help to prevent falls. It’s very common for people in this stage to experience hallucinations, delusions, confusion and dementia.
What causes Parkinson’s disease?
Parkinson’s disease causes certain nerve cells in the brain to gradually break down and die. This causes a decrease in the neurons that produce a chemical called dopamine. When dopamine levels drop, abnormal brain activity occurs which is what causes the symptoms. However, in 95% of cases, it’s unclear what causes this to happen. This is known as Idiopathic Parkinson’s disease.
While researchers are still working to discover the cause of PD, it’s clear that there are certain risk factors which are:
Age — the older you are the more likely you are to develop the disease
Gender — men are 50% more likely to develop it than women
Environment — there is a higher incidence in rural areas and it’s believed that this is associated with increased exposure to herbicides and chemicals
Genetics — approximately 15% of people with PD have a family history of the disease
Head injury — head injuries including concussions can increase the risk of developing PD.
How is Parkinson’s disease diagnosed?
There is no definitive test to diagnose PD and it may take some time to diagnose the condition.
A neurologist (doctor specialising in nervous system conditions) will diagnose the disease based on:
Your medical history
A review of signs and symptoms
A neurological examination
A physical examination.
Any imaging tests are usually performed to rule out other conditions, as imaging doesn’t help diagnose PD.
Sometimes the doctor may give you a PD medication to determine if your symptoms improve. If so, this may be used to confirm a diagnosis.
Treatment and management of Parkinson’s disease?
Unfortunately, there is no cure for PD. Treatment aims to control symptoms and may include:9
Medications — Most medications for PD either increase or are a substitute for dopamine, which can help reduce symptoms. Medications can be given in tablet form, via injection or through a tube directly into the small intestine.
Surgery — In some cases, deep brain stimulation surgery can reduce tremors, although this treatment isn’t suitable for everyone.
Other lifestyle measures are also recommended, which include:
Eating a healthy diet, particularly focusing on fibre and water to ease constipation symptoms
Regular movement to help increase muscle strength and balance and mobility
Can you prevent Parkinson’s disease?
Unfortunately, researchers are still unsure what causes PD and why it progresses differently in each person. This uncertainty means that prevention strategies are unclear. However, research into the disease continues around the world.
When should you see a doctor?
If you have any of the symptoms associated with PD you should see your doctor. Other conditions have similar symptoms so it’s always a good idea to get them checked. With the right diagnosis, you’ll receive the right treatment.
Your local MediADVICE pharmacist is available to help you manage your health. Speak to your MediADVICE pharmacist about your symptoms so we can recommend products and medications that may be suitable for you, or refer you to a doctor if necessary.
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