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Everything You Need To Know About Parkinson’s Disease

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Parkinson's disease is a degenerative brain condition that often occurs with age. 

Understanding how to manage Parkinson’s is essential, especially if you are caring for a loved one suffering from the disease. Learning more about Parkinson’s will enable you to provide better care for the individual as they cope with the symptoms of this misunderstood condition.

This article will examine the causes of Parkinson's disease, how to recognize the signs, and the treatment options available to your loved one.



What is Parkinson's Disease?

 

Parkinson‘s disease is a progressive nervous system disorder most often associated with tremors, slowing of movement, and walking problems.

Parkinson's disease occurs when nerve cells in a particular part of the brain, the substantia nigra, die. These dopamine-producing brain cells are responsible for movement, and when they are damaged or die, the movement disorder that is Parkinson's disease develops. The symptoms of Parkinson's disease include balance problems, tremors, stiffness, and slowed movements.

In some cases, it may be genetic, but not all. Symptoms start gradually and increase as the disease progresses over time.

There is currently no known cure for Parkinson‘s disease. There are, however, many treatment options to help your loved one manage their condition and improve their quality of life.

In some cases, your loved one’s healthcare provider may suggest surgery to regulate an area of the brain to improve their symptoms.

Parkinson's disease and similar conditions may be grouped under the umbrella term Parkinsonism. In this category, other conditions with similar symptoms of Parkinson's disease are multiple system atrophy or corticobasal degeneration.

 

How Common Is Parkinson’s Disease?

 

According to the Parkinson’s Foundation, nearly one million Americans have Parkinson's disease, with an average of 60,000 people in the U.S. diagnosed annually. Globally, more than 10 million people are living with Parkinson's disease.

Parkinson's disease is far more prevalent among white men over 50. Research is looking into why this disease affects more men than women.


What Causes Parkinson’s Disease?

 

Research into the causes of Parkinson's disease is still ongoing. According to the NIH, it is believed that Parkinson's disease is caused by a combination of genetic and environmental factors.

Genetic: There are genetic mutations associated with a higher risk of Parkinson's disease. In most cases, though, no apparent single genetic mutation is found. Further research around the genetics of Parkinson's disease will, in time, help researchers discover its causes, which will help them understand how to prevent, cure, or treat Parkinson's.

In young people diagnosed with Parkinson's, there is more likely a genetic mutation as the cause and often a family history of the disease.

Non-Genetic: Research indicates that idiopathic (non-genetic) Parkinson's disease develops due to problems related to how the patient's body processes alpha-synuclein, a protein. With Parkinson's disease, these proteins are misshapen, known as protein misfolding, and cannot be used appropriately by the body, and this causes alpha-synuclein protein build-up.

These tangled protein bundles are called Lewy bodies. It's the Lewy bodies that cause brain damage and cell death. Protein misfolding is also related to other disorders, including Alzheimer's disease.

Other Causes: Exposure to pesticides or experiencing a head injury has been shown to increase the risk of Parkinson's disease.

 

Is Parkinson’s Disease Preventable?

 

Because the cause of Parkinson's remains unknown, there remains no clear way to prevent Parkinson’s disease.

Some research shows a correlation between performing regular aerobic exercise and reducing the risk, as well as consuming caffeine. However, not enough is yet known to suggest physical activity or caffeine consumption as ways to prevent Parkinson's disease.

The Michael J. Fox Foundation for Parkinson's Research is the world’s largest non-profit fundraiser for Parkinson’s pharmaceutical treatments. The Foundation also funds research to find a cure for Parkinson’s disease.



Risk Factors For Parkinson’s Disease

Being a white man over 50 is the single greatest risk factor for Parkinson's disease. It is most often diagnosed around the age of 60, though there are rare cases of a young person under 40 years of age experiencing early onset.

In addition to age, other risk factors for Parkinson's disease include:

 

Genetics  

    • If your loved one has many close relatives with Parkinson’s disease, chances are greater of developing the disease.

 

Gender  

    • Women are less likely to develop Parkinson’s disease than men.

 

Environmental Factors 

    • Long-term exposure to environmental toxins such as herbicides and pesticides.



Signs and Symptoms of Parkinson's Disease

 

No one sign of Parkinson’s disease is definitive for diagnosis, as these symptoms may have other causes, such as neurological disorders. The severity of these symptoms is highly individual. Parkinson's disease symptoms progress and worsen over time.

If you notice two or more of the following signs, it may be a good time to talk with your loved one’s healthcare provider.

Look for these common signs of Parkinson’s disease in your loved one:

  • Tremor (usually noticeable in the hands or fingers at first)

  • Bradykinesia (slowed movement)

  • Rigidity (stiff muscles)

  • Stooped back

  • Problems with walking or balance

  • Facial masking (lack of facial expression)

  • Micrographia (handwriting has become much smaller)

  • Lost sense of smell

  • Slowed or  Softer Speech

  • Dizziness due to blood pressure changes

 

Non-movement, or non-motor symptoms, may occur in your loved one even before movement symptoms and may affect daily living and quality of life.

Some non-motor Parkinson’s disease symptoms include:

  • Constipation

  • Depression

  • Memory loss or dementia

  • Sleep problems

  • Sexual dysfunction

 

Keep in mind that many of the symptoms of Parkinson’s disease can indicate an entirely different diagnosis. Speak with your loved one’s healthcare provider to discuss your concerns if you suspect Parkinson’s disease.

 

How Is Parkinson’s Disease Diagnosed?

 

No blood tests, lab tests, or neurology scans are used to diagnose Parkinson's disease. Instead, your loved one's physicians will diagnose the disease based on their family history, medical history, and physical examination.

Tests may be prescribed, however, to rule out other conditions with shared symptoms.

As a caregiver, your role in noticing and reporting symptoms to your loved one’s healthcare provider will help them make a definitive diagnosis.

For a second opinion, consult with a movement disorder specialist about a diagnosis of Parkinson's. A movement disorder specialist is a neurologist specializing in Parkinson's disease and other movement disorders.

In some cases, if your loved one's healthcare provider is unsure whether a Parkinson's tremor is an essential tremor (another movement disorder), a brain imaging test called a DaT scan is used to capture images of the dopamine system in the brain.

The Michael J. Fox Foundation has sponsored a study to gather and compile data to find a biomarker. Parkinson's research is working to find a biomarker that will allow researchers to create a test that indicates a patient's risk factors or disease progression.



Treatment Options For The Symptoms Of Parkinson’s Disease

 

While there remains no cure for Parkinson's disease, there are medications and therapies designed to improve quality of life and reduce symptoms. 

As the disease progresses, it will be important for your loved one to be under treatment by a movement disorder specialist or a neurologist with specialized training.

 

Drug Therapy

Treatment of Parkinson's disease is highly individualized, as not all people will develop the same symptoms on the same timeline. Often, treatment begins with drug therapy to reduce daily living symptoms.

Levodopa may be prescribed to help manage the symptoms of Parkinson's disease, especially in cases where symptoms interfere with work or social situations.

Unfortunately, levodopa can cause dyskinesia, which refers to involuntary fidgeting, head bobbing, or swaying. Younger patients may consider beginning drug therapy with an MAO-B inhibitor, a dopamine agonist, or an anticholinergic drug.

 

Deep Brain Stimulation

In cases where pharmaceuticals are ineffective or cause intolerable side effects, deep brain stimulation may be considered a treatment option.

 

Exercise

Some research suggests that exercise can help. Talk with your loved one’s healthcare team to determine a safe regimen for physical activity.

 

As a caregiver, it is recommended that you attend doctor's appointments with your loved one to get your questions answered, take down notes, and report any changes to symptoms you have observed.

 

Robert C. Fisher

A Nurse Director at a large medical center in Boston, MA, who holds a Master’s in Nursing Leadership and Administration and an MBA in Healthcare Management.

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