Parkinson’s disease is the common neurodegenerative disorder and most common movement disorder in the elderly people. It is fairly prevalent in the elderly who feel it quite disabling. Parkinson being a complicated progressive neurological disorder – unravels rather slowly. The disease progresses stage wise – in the first stage, the symptoms manifest rather slowly and the person leads better quality of life. The symptoms may be subtle if present. In the next stage, the symptoms manifest gradually and affect day-to-day activities. The affected individual may find difficulty in performing their day-to-day activities with ease. In the third, i.e. mid Parkinson’s stage, movement becomes slow, falls become common as balancing becomes a problem. Simple daily tasks get affected – dressing, brushing, eating and moving. The fourth stage disease is associated with severe symptoms that make the affected individual dependent on other for performing daily activities and even walking also. The fifth stage disease makes the affected person completely dependent on others – as the person is unable to walk and move. It is therefore necessary to understand and diagnose Parkinson’s disease to achieve a successful treatment outcome.

Causes

In Parkinson disease, some neurons or nerve cells (the neurons that produce dopamine) in the brain break down and die. The cause is still unknown. However, studies have shown the involvement of both genetic and environmental factors. Certain drugs – antipsychotic and anti-emetics, repeated head injury, pesticides, environmental toxins and pollutants have been linked with the disease. Certain recent studies are claiming Parkinson’s disease to be a form of proteinopathy (abnormal folding of proteins that spread from neurons to neurons)

Risk Factors

The major risk factor for Parkinson’s disease is aging as the risk increases for individuals who or in mid or later years of their life, i.e., 60 years old or above. A strong family history is another risk factor. Men are more likely to develop Parkinson’s than women. Environmental factors may also play a role in the disease.

Primary Symptoms of Parkinson’s Disease

The primary symptoms are all related to motor function that involves both voluntary and involuntary movements. Massive destruction of dopamine-producing brain cells results in the progressive manifestation of primary symptoms.

Tremors (shaking of hands & arms, trembling in fingers and legs), shaking of head and jaw;

Tremors mostly occur in resting state and may get worst when the person is tired and stressed.

Stiffness of limbs increase during movement (rigidity) – pain in muscles and loss of hand movements can lead to micrographia – cramped handwriting (the letters become small and indecipherable) and eating difficulty.

Progressively voluntary movement slows down – and therefore – initiating and completing movement becomes difficult (Bradykinesia). Stiffness of facial muscles together with bradykinesia may cause mask-like (expressionless) appearance.

Postural instability with the loss of reflexes causes difficulty in adjusting posture – owing to which maintaining balance may become difficult – and therefore – leads to falls.

Persons with progressive Parkinson’s disease have Parkinsonian Gait – characterized by stooped posture (bending slightly forward), slow movement; stiffness of a body part; diminished arm swing; slowness of all movements (bradykinesia) foot scrapping the floor and falling unsteadily on the floor.

The speech also suffers as the volume becomes small and inaudible.

Secondary Symptoms of Parkinson’s Disease

The secondary symptoms may vary in severity and differ from patient to patient. They may result due to progressive loss of motor function and damage caused to the brain. The secondary symptoms may include stress, anxiety, depression, confusion, memory loss, excessive salivation, diminished sense of smell, difficulty swallowing, constipation, urinary urgency & frequency, slow speech, skin problems, erectile dysfunction, and increased sweating.

Diagnosis

An experienced neurologist can diagnose Parkinson’s disease based on the medical history of the patient and also after reviewing the signs and symptoms. In addition, the doctor performs both physical and neurological examination as well. But, as far as Parkinson’s disease is concerned, precise and prompt diagnosis, in the early stage will be immensely beneficial to the patient. This will be possible if the patient approaches and get examined by an experienced neurologist because certain other conditions like multi-system atrophy or normal pressure hydrocephalus, progressive Supra-nuclear Palsy, and other conditions look like Parkinson’s disease. 18F Flurodopa PET test is a special test for diagnosing Parkinson’s early. Furthermore, the MRI of the brain is recommended to ascertain any changes in the brain.

Treatment

There is no specific treatment to cure Parkinson’s disease, but the disease can be controlled and treated symptomatically. Your neurologist may prescribe certain medicines to control the symptoms. In addition to medicines, some lifestyle changes may also be recommended, such as aerobic exercises and physical therapy. Furthermore, regular follow up appointments are also necessary to manage the disease effectively

Can Parkinson be Prevented?

According to several research studies, regular exercise, walking, yoga, cycling and swimming help achieve significant improvement in the motor functions of the people suffering from Parkinson’s. Physical activity slows down the progression of the disease.