What Is Parkinson’s Disease? Risks, Symptoms And Treatment
What Is Parkinson’s Disease? Risks, Symptoms And Treatment.
Some of the earliest warning signs and symptoms of Parkinson’s are tremors, loss of mobility, and poor balance — all of which are motor symptoms. But nonmotor symptoms, including change in speech and personality, increased urinary frequency and urgency, and cognitive impairments, are also symptoms of the disease.
Parkinson’s is a progressive disease of the central nervous system. The condition is caused by a loss of cells in the area of the brain that produces dopamine. It’s usually diagnosed in people who are in their early 60s. People who are diagnosed before age 50 are said to have early onset Parkinson’s.
About 2 percent of the approximately 1 million Americans with Parkinson’s are under age 40. That number may be higher because the disease is often underdiagnosed in younger people. And about 60,000 Americans are diagnosed with Parkinson’s disease each year, according to the Parkinson’s Foundation.
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People with the disease have a deficiency of dopamine, a brain chemical that helps control movement, according to Dr. Danny Bega, a neurologist at Northwestern University Feinberg School of Medicine in Chicago.
The symptoms of Parkinson’s disease are often the same, regardless of the age of diagnosis. That said, symptoms do vary from person to person.
Recent research suggests that nonmotor symptoms often happen first in younger patients. This includes:
- Tremors (a slight trembling or shaking), usually in a hand, finger, foot or leg, or the chin, typically while at rest. Tremors may also be an early sign of Parkinson’s.
- Muscle stiffness and rigidity of the arms, legs or body. For example, arms may not swing freely when the person is walking or feet may seem stuck when the person is walking or turning.
- Slowed movement, including being slow to initiate movements, like getting out of a chair; slow involuntary movements, such as blinking; or slow at performing routine movements like buttoning a shirt. Facial muscles can also be affected, causing a lack of expression known as “facial masking.”
- Balance, gait and posture problems. A shuffling gait, with short steps and a stooped posture, is characteristic of people with Parkinson’s and may throw off balance and increase the risk of falls.
Symptoms typically develop slowly over time, making them hard to detect in the early stages of the disease. In addition, the progression of symptoms and their intensity can vary from one person to another.
Parkinson’s causes more than motor problems; there can also be nonmotor symptoms that are unrelated to movement, Bega said. These symptoms can affect a person’s quality of life and everyday function, and they may include:
- Mood disorders. Depression and anxiety are common in people with Parkinson’s.
- Cognitive changes affecting memory, thinking, judgment and the ability to think of words. These usually occur in the later stages of Parkinson’s.
- Smell disturbances. A reduced sensitivity to smell or a loss of smell is an early symptom of Parkinson’s.
- Swallowing difficulties. The ability to swallow slows down as the disease progresses. Saliva may accumulate in the mouth and cause drooling.
- Chewing and eating problems. Late-stage Parkinson’s may affect muscles in a person’s mouth, making it harder to chew. This can lead to choking and weight loss.
- Speech changes. A person may speak more softly or sound monotone.
- Writing changes. Handwriting may look smaller, and words may be crowded together.
- Sleep problems. Insomnia, daytime fatigue and vivid dreams may all be linked with Parkinson’s.
- Food moves more slowly through the digestive tract, making regular bowel movements difficult.
- Lightheadedness when standing up after sitting or lying down, caused by a sudden drop in blood pressure in people with Parkinson’s.
Causes Of Early Parkinson’s Disease
The cause of Parkinson’s disease is not yet known, according to the Mayo Clinic. But researchers suspect that PD is caused by a combination of genetic and environmental factors, or some combination of the two may play a role.
This condition occurs when cells are lost in the part of the brain that produces dopamine. Dopamine is responsible for sending brain signals that control movement.
Certain genes are associated with early onset Parkinson’s. According to the National Parkinson Foundation, studies show that 65 percent of people with Parkinson’s who experience onset before age 20 may do so because of a genetic mutation. This organization also suggests this mutation affects 32 percent of people who experience onset between age 20 and 30.
Environmental causes of the condition may include exposure to chemical toxins such as certain insecticides, fungicides, and herbicides. The U.S. Department of Veterans Affairs recognizes Parkinson’s as a disease caused by exposure to Agent Orange. Agent Orange is a synthetic chemical herbicide that was used to spray vegetation and trees during the Vietnam War.
The disorder can also be diagnosed in younger people, but it’s rare. Only 5 to 10 percent of people have “early-onset” disease, meaning people are diagnosed before age 50.
Other Risk Factors For Parkinson’s Disease Include:
- Being male: Men are 1.2 to 1.5 times more likely than women to develop Parkinson’s, for reasons that are not yet known, Bega said.
- Heredity: Some genetic mutations may contribute to the development of Parkinson’s and can slightly increase a person’s risk. But most cases of the disease are not caused by inheriting genes linked to it. Only about 10 percent of people with Parkinson’s are genetically predisposed to the condition, according to the American Parkinson Disease Association.
- Exposure to toxins: Studies have shown that environmental factors — such as exposure to pesticides, herbicides (like Agent Orange) and drinking well water — may be tied to an increased risk of Parkinson’s, but that risk is relatively small, Bega said.
- Repeated head injuries: When these injuriestrigger a loss of consciousness, they have been linked with an increased risk of Parkinson’s.
Diagnosis Of Parkinson’s
There is no specific test, such as a blood test or MRI, that can be used to diagnose Parkinson’s. Instead, the diagnosis is based on a constellation of findings from a thorough examination.
Doctors may also perform a thorough neurological exam, which can help exclude other disorders that may cause symptoms. For example, a stroke may trigger balance problems, or a tremor could be a side effect of taking certain medications.
A DaTscan to visualize your brain’s dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, don’t diagnose Parkinson’s. However, they may be used to rule out other conditions.
Treatment For Parkinson’s Disease
Many medications are available to treat the symptoms of Parkinson’s disease, but none of them can slow the disease’s progression.
Levodopa, a dopamine-promoter drug, in combination with the drug carbidopa, is the most commonly prescribed treatment for controlling Parkinson’s motor symptoms. Carbidopa helps prevent nausea and vomiting associated with taking levodopa by itself.
Studies have suggested that being physically active may slow the progression of Parkinson’s symptoms.
Deep brain stimulation (DBS) is also considered a good option for people with early onset Parkinson’s. This is because people with early onset Parkinson’s are less likely to have other diseases that may cause complications.
DBS is a surgical procedure in which electrodes are placed in specific areas of your brain. These electrodes are connected to a generator. The generator is programmed to send electrical pulses to your brain.
The procedure may help alleviate the following symptoms:
- slowed movement
- difficulty walking
Parkinson’s Life Expectancy
Parkinson’s disease is not fatal. However, Parkinson’s-related complications can shorten the lifespan of people diagnosed with the disease.
Having Parkinson’s increases a person’s risk for potentially life-threatening complications, like a fall, blood clots, lung infections, and blockages in the lungs. These complications can cause severe health issues. They can even be fatal.
It’s unclear how much Parkinson’s reduces a person’s life expectancy. One study looked at the 6-year survival rates of nearly 140,000 people who had been diagnosed with Parkinson’s. In that six-year span 64 percent of people with Parkinson’s died.
What’s more, the study found that 70 percent of people in the study had been diagnosed with Parkinson’s disease dementia during the span of the study. Those who were diagnosed with the memory disorder had lower survival rates.
Caring For Someone With Parkinson’s Disease
Caring for a loved one with early onset Parkinson’s can be difficult. If you’re a caregiver for someone with this condition, it’s important that you remember your own emotional and physical health.
Not only are you dealing with a difficult diagnosis, you’re also managing an increased number of responsibilities. Burnout is common in caregivers, so make sure you’re checking in with your own needs.
The Michael J. Fox Foundation Center for Parkinson’s Research recommends these tips for caregivers:
Join a support group: Participating in a support group can offer you an outlet for your fears, concerns, and frustrations. You may also learn about new medications, research, and coping tips.
Expand your medical team: Add as many experts to your healthcare team as you need to support you and your loved one. This includes therapists, nutritionists, and movement specialists.
Stay organized: Maintain a calendar to track doctor appointments, medication refills, and your own obligations.
Stay informed: Educate yourself so you know what to expect. This can help you plan ahead so you’re not caught off guard by new symptoms.
Watch for depression: Stay closely tuned to the moods of your loved one. Watch out for the first signs of depression and get help if needed. Signs include:
- angry outbursts
- appetite changes
- sleep problems
- cognitive problems
Don’t overlook your own needs: You can’t take care of others if you don’t take care of yourself. Maintain a healthy diet and exercise regularly (even if it’s just taking a walk). Figure out what helps you de-stress. You may enjoy journaling, meditation, or yoga. Identify family members or friends who will step in when you need a break.
Preventing Early Onset Parkinson’s Disease
There isn’t a conclusive way to prevent Parkinson’s at any age. There are steps you can take that may help reduce your risk, however:
Drink caffeine: A study published in the Journal of Alzheimer’s Disease found that caffeine can help restore early motor and nonmotor symptoms tied to Parkinson’s.
Take anti-inflammatory drugs: A meta-analysis published by the American Academy of Neurology determined that anti-inflammatory drugs known as NSAIDs may help prevent Parkinson’s.
Watch your vitamin D levels: Many people with Parkinson’s don’t get enough American Academy of Neurology. Vitamin D supplementation may help reduce your risk.
Stay active: Exercise improves muscle stiffness, mobility, and depression in Parkinson patients. It may also help reduce the risk of getting the disease.
Parkinson’s often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.
To improve walking
- Walk carefully.
- Pace yourself — try not to move too quickly.
- Let your heel hit the floor first.
- Check your posture and stand up straight. This will help you to shuffle less.
To avoid falling
- Don’t walk backwards.
- Try to not carry things while walking.
- Try to avoid leaning and reaching.
- To turn around, make a U-turn. Don’t pivot on your feet.
- Remove all tripping hazards in your house such as loose rugs.
When getting dressed
- Allow yourself plenty of time to get ready. Avoid rushing.
- Select clothes that are easy to put on and take off.
- Try using items with Velcro instead of buttons.
- Try wearing pants and skirts with elastic waist bands. These may be easier than buttons and zippers.
Yoga uses targeted muscle movement to build muscle, increase mobility, and improve flexibility. People with Parkinson’s may notice yoga even helps control tremors in some affected limbs.
One of the hottest areas of Parkinson’s research involves the protein alpha-synuclein. In autopsies, many brain cells of people who’d had Parkinson’s disease American Academy of Neurology, which are unusual clumps of alpha-synuclein.
These clumps of protein in the brain are the pathological hallmark for Parkinson’s and may be one reason the brain is not working properly in those with the condition. If researchers can prevent the protein from clumping into Lewy bodies, by either clearing them out or stopping their spread within brain cells, then that may lead to a method of stopping the disease’s progression, said the Michael J. Fox Foundation for Parkinson’s Research.
Additional resources learning about Parkinson’s disease:
- Learn more about Parkinson’s disease from the Mayo Clinic.
- Everything You Want to Know About Parkinson’s Disease