What are the main symptoms of Parkinson’s disease. How is Parkinson’s diagnosed. What causes Parkinson’s disease. Who is at risk for developing Parkinson’s. How does Parkinson’s progress over time. What treatments are available for Parkinson’s disease. How can Parkinson’s symptoms be managed.

Understanding Parkinson’s Disease: A Neurological Disorder

Parkinson’s disease is a progressive neurological disorder that affects movement, balance, and coordination. It results from the degeneration of dopamine-producing neurons in the brain, leading to a range of motor and non-motor symptoms. This complex condition impacts millions of people worldwide, making it essential to understand its nature, causes, and potential treatments.

The Underlying Causes of Parkinson’s Disease

What causes Parkinson’s disease? The exact cause remains unknown, but researchers have identified several factors that may contribute to its development:

• Loss of dopamine-producing neurons in the substantia nigra region of the brain
• Accumulation of alpha-synuclein protein in Lewy bodies
• Genetic mutations in specific genes like LRRK2, PARK7, and SNCA
• Environmental factors such as exposure to certain toxins or pesticides
• Age-related changes in brain chemistry and structure

While the precise mechanisms are still being studied, it’s believed that a combination of genetic predisposition and environmental factors play a role in the onset of Parkinson’s disease.

Recognizing the Symptoms of Parkinson’s Disease

What are the primary symptoms of Parkinson’s disease? The condition is characterized by four main motor symptoms:

1. Tremor: Involuntary shaking, often starting in the hands or fingers
2. Rigidity: Stiffness of muscles and reduced flexibility
3. Bradykinesia: Slowness of movement and difficulty initiating motion
4. Postural instability: Impaired balance and coordination

However, Parkinson’s disease manifests differently in each individual. Some people may experience tremors as their primary symptom, while others might notice changes in their gait or balance first. It’s important to recognize that symptoms often begin subtly and progress gradually over time.

Non-Motor Symptoms of Parkinson’s Disease

In addition to motor symptoms, Parkinson’s disease can cause a range of non-motor symptoms that significantly impact quality of life. These may include:

• Cognitive changes, such as memory problems or difficulty concentrating
• Mood disorders, including depression and anxiety
• Sleep disturbances, like insomnia or REM sleep behavior disorder
• Autonomic dysfunction, affecting blood pressure, digestion, and urinary function
• Loss of sense of smell (anosmia)
• Fatigue and reduced energy levels

Understanding these non-motor symptoms is crucial for comprehensive management of Parkinson’s disease and improving overall patient well-being.

Diagnosing Parkinson’s Disease: Challenges and Approaches

How is Parkinson’s disease diagnosed? Diagnosing Parkinson’s can be challenging, as there is no definitive test to confirm the condition. Instead, neurologists rely on a combination of clinical examination, patient history, and sometimes neuroimaging studies to make a diagnosis. The process typically involves:

1. Medical history review and symptom assessment
2. Physical and neurological examination
3. Evaluation of response to levodopa or other Parkinson’s medications
4. Neuroimaging studies, such as MRI or DaTscan, to rule out other conditions
5. Assessment of non-motor symptoms and their impact on daily life

It’s worth noting that early diagnosis can be particularly challenging, as symptoms may be subtle and overlap with other neurological conditions. This is why a comprehensive evaluation by a movement disorder specialist is often necessary for an accurate diagnosis.

Risk Factors and Demographics of Parkinson’s Disease

Who is most at risk for developing Parkinson’s disease? While the condition can affect anyone, certain factors may increase the likelihood of developing Parkinson’s:

• Age: The risk increases with age, with most cases diagnosed after 60
• Gender: Men are slightly more likely to develop Parkinson’s than women
• Genetics: Having a close relative with Parkinson’s may increase risk
• Environmental factors: Exposure to certain pesticides or industrial chemicals
• Head injuries: Repeated traumatic brain injuries may increase risk

It’s important to note that having one or more risk factors doesn’t guarantee that an individual will develop Parkinson’s disease. Conversely, some people with no known risk factors may still be diagnosed with the condition.

Early-Onset Parkinson’s Disease

What is early-onset Parkinson’s disease? This term refers to cases diagnosed before the age of 50, which account for about 5-10% of all Parkinson’s cases. Early-onset Parkinson’s often has a stronger genetic component and may progress differently compared to later-onset cases. Understanding the unique challenges faced by younger patients with Parkinson’s is crucial for tailored treatment approaches and support strategies.

The Progression of Parkinson’s Disease Over Time

How does Parkinson’s disease typically progress? Parkinson’s is a progressive disorder, meaning symptoms tend to worsen over time. However, the rate of progression can vary significantly between individuals. The course of the disease is often described in stages:

1. Stage 1: Mild symptoms affecting one side of the body
2. Stage 2: Symptoms worsen and begin to affect both sides of the body
3. Stage 3: Balance problems and slower movements become more apparent
4. Stage 4: Severe symptoms limit daily activities, but some independence is maintained
5. Stage 5: Advanced stage with significant disability, often requiring full-time care

It’s important to note that not everyone with Parkinson’s will experience all stages or progress through them in the same way. Some individuals may remain in earlier stages for many years, while others may progress more rapidly.

The Impact of Parkinson’s on Daily Life

As Parkinson’s progresses, it can significantly impact various aspects of daily living. This may include:

• Difficulty with fine motor tasks, such as writing or buttoning clothes
• Changes in speech, including softening of voice or rapid, mumbled speech
• Increased risk of falls due to balance and gait issues
• Challenges with personal care and hygiene
• Social isolation due to communication difficulties or mobility issues
• Emotional and psychological impacts, including depression and anxiety

Understanding these potential challenges can help patients, caregivers, and healthcare providers develop strategies to maintain quality of life and independence for as long as possible.

Treatment Approaches for Parkinson’s Disease

What treatments are available for Parkinson’s disease? While there is currently no cure for Parkinson’s, various treatment options can help manage symptoms and improve quality of life. These may include:

1. Medications: Levodopa, dopamine agonists, MAO-B inhibitors, and others
2. Deep Brain Stimulation (DBS): Surgical implantation of electrodes to regulate brain activity
3. Physical therapy: To improve mobility, balance, and flexibility
4. Occupational therapy: To maintain independence in daily activities
5. Speech therapy: To address communication and swallowing difficulties
6. Lifestyle modifications: Including exercise, diet, and stress management
7. Complementary therapies: Such as acupuncture, massage, or mindfulness practices

The choice of treatment depends on individual symptoms, disease progression, and personal preferences. A multidisciplinary approach involving various healthcare specialists often provides the most comprehensive care.

Emerging Treatments and Research

What new treatments are on the horizon for Parkinson’s disease? Ongoing research is exploring several promising avenues:

• Gene therapies targeting specific genetic mutations
• Stem cell treatments to replace lost dopamine-producing neurons
• Immunotherapies to target alpha-synuclein accumulation
• Neuroprotective agents to slow disease progression
• Advanced brain-computer interfaces for symptom control

While many of these treatments are still in experimental stages, they offer hope for more effective management and potential disease modification in the future.

Living with Parkinson’s: Strategies for Symptom Management

How can individuals with Parkinson’s disease manage their symptoms effectively? While medical treatments are crucial, there are several lifestyle strategies that can help:

1. Regular exercise: Engaging in activities like dancing, tai chi, or boxing can improve balance and mobility
2. Dietary considerations: A balanced diet rich in antioxidants and fiber can support overall health
3. Sleep hygiene: Establishing good sleep habits to manage fatigue and sleep disturbances
4. Stress management: Practicing relaxation techniques like meditation or yoga
5. Social engagement: Maintaining social connections and participating in support groups
6. Cognitive stimulation: Engaging in mentally stimulating activities to support brain health
7. Adaptive technologies: Using specialized tools and devices to maintain independence

Implementing these strategies alongside medical treatments can significantly improve quality of life and help individuals maintain independence for longer periods.

The Role of Caregivers in Parkinson’s Management

Caregivers play a crucial role in supporting individuals with Parkinson’s disease. Their responsibilities may include:

• Assisting with daily activities and personal care
• Managing medications and medical appointments
• Providing emotional support and encouragement
• Adapting the home environment for safety and accessibility
• Advocating for the patient’s needs in healthcare settings
• Helping to maintain social connections and engage in activities

It’s important for caregivers to also prioritize their own well-being and seek support when needed to prevent burnout and maintain their ability to provide care effectively.

The Future of Parkinson’s Disease Research and Treatment

What does the future hold for Parkinson’s disease research and treatment? The field is rapidly evolving, with several exciting areas of focus:

1. Personalized medicine approaches tailored to individual genetic profiles
2. Advanced neuroimaging techniques for earlier and more accurate diagnosis
3. Wearable technologies for continuous symptom monitoring and management
4. AI-driven analysis of large datasets to identify new treatment targets
5. Improved understanding of the gut-brain axis in Parkinson’s pathology
6. Development of biomarkers for early detection and disease progression tracking
7. Novel drug delivery methods for more effective symptom control

These advancements offer hope for improved diagnosis, treatment, and potentially even prevention of Parkinson’s disease in the coming years.

The Importance of Clinical Trials in Parkinson’s Research

Clinical trials play a crucial role in advancing our understanding and treatment of Parkinson’s disease. Participation in clinical trials can offer several benefits:

• Access to cutting-edge treatments before they become widely available
• Contributing to the advancement of scientific knowledge
• Closer monitoring and support from healthcare professionals
• Potential for improved symptom management or disease modification
• Opportunity to play an active role in one’s own healthcare

Individuals interested in participating in clinical trials should discuss options with their healthcare providers and consider the potential risks and benefits carefully.

Support and Resources for People with Parkinson’s Disease

Living with Parkinson’s disease can be challenging, but numerous resources and support systems are available to help individuals and their families navigate the journey:

1. Patient advocacy organizations like the Michael J. Fox Foundation and the Parkinson’s Foundation
2. Local support groups for patients and caregivers
3. Online communities and forums for sharing experiences and advice
4. Educational resources and webinars on various aspects of Parkinson’s management
5. Financial assistance programs for medication and treatment costs
6. Occupational therapy and home modification services
7. Respite care services to support caregivers

Utilizing these resources can provide valuable information, emotional support, and practical assistance in managing the challenges of Parkinson’s disease.

Advocacy and Awareness: Making a Difference in the Parkinson’s Community

Raising awareness about Parkinson’s disease is crucial for increasing public understanding, promoting early diagnosis, and driving research funding. Ways to get involved include:

• Participating in awareness events like Parkinson’s Awareness Month in April
• Sharing personal stories to educate others about the realities of living with Parkinson’s
• Supporting fundraising efforts for Parkinson’s research and patient support programs
• Advocating for policies that improve care and support for people with Parkinson’s
• Volunteering with local Parkinson’s organizations or support groups

By coming together as a community, individuals affected by Parkinson’s can make a significant impact in advancing research, improving care, and supporting those living with the disease.

Parkinson’s Disease | National Institute on Aging

Parkinson’s disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination.

Parkinson’s symptoms usually begin gradually and get worse over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.

Both men and women can have Parkinson’s disease. However, the disease affects about 50 percent more men than women.

One clear risk factor for Parkinson’s is age. Although most people with Parkinson’s first develop the disease at about age 60, about 5 to 10 percent of people with Parkinson’s have “early-onset” disease, which begins before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.

What Causes Parkinson’s Disease?

Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.

People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many automatic functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.

Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinson’s disease and Lewy body dementia.

Although some cases of Parkinson’s appear to be hereditary, and a few can be traced to specific genetic mutations, in most cases the disease occurs randomly and does not seem to run in families. Many researchers now believe that Parkinson’s disease results from a combination of genetic factors and environmental factors such as exposure to toxins.

Symptoms of Parkinson’s Disease

Parkinson’s disease has four main symptoms:

• Tremor (trembling) in hands, arms, legs, jaw, or head
• Stiffness of the limbs and trunk
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls

Other symptoms may include depression and other emotional changes; difficulty swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.

Symptoms of Parkinson’s and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.

Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.

People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.

Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other.

Many people with Parkinson’s note that prior to experiencing stiffness and tremor, they had sleep problems, constipation, decreased ability to smell, and restless legs.

Diagnosis of Parkinson’s Disease

A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.

There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.

Treatment of Parkinson’s Disease

Although there is no cure for Parkinson’s disease, medicines, surgical treatment, and other therapies can often relieve some symptoms.

Medicines for Parkinson’s Disease

Medicines prescribed for Parkinson’s include:

• Drugs that increase the level of dopamine in the brain
• Drugs that affect other brain chemicals in the body
• Drugs that help control nonmotor symptoms

The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy—such as nausea, vomiting, low blood pressure, and restlessness—and reduces the amount of levodopa needed to improve symptoms.

People with Parkinson’s should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.

Other medicines used to treat Parkinson’s symptoms include:

• Dopamine agonists to mimic the role of dopamine in the brain
• MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
• COMT inhibitors to help break down dopamine
• Amantadine, an old antiviral drug, to reduce involuntary movements
• Anticholinergic drugs to reduce tremors and muscle rigidity

Deep Brain Stimulation

For people with Parkinson’s who do not respond well to medications, deep brain stimulation, or DBS, may be appropriate. DBS is a surgical procedure that surgically implants electrodes into part of the brain and connects them to a small electrical device implanted in the chest. The device and electrodes painlessly stimulate the brain in a way that helps stop many of the movement-related symptoms of Parkinson’s, such as tremor, slowness of movement, and rigidity.

Other Therapies

Other therapies may be used to help with Parkinson’s disease symptoms. They include physical, occupational, and speech therapies, which help with gait and voice disorders, tremors and rigidity, and decline in mental functions. Other supportive therapies include a healthy diet and exercises to strengthen muscles and improve balance.

For More Information About Parkinson’s Disease

Parkinson’s Foundation
800-473-4636 (toll-free)
[email protected]
www.parkinson.org

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
May 16, 2017

Parkinson’s 101 | Parkinson’s Disease

No blood test, brain scan or other test can be used to make a definitive diagnosis of Parkinson’s disease.  Doctors diagnose Parkinson’s “clinically” — the diagnosis is based on a person’s medical history, answers to certain questions and a physical examination.

Any clinical diagnosis rests heavily on the physician’s expertise and judgment. If you suspect you have Parkinson’s, you should see a movement disorder specialist, who is a neurologist with specialized training in Parkinson’s and other movement disorders. On examination, the doctor looks for slowness, stiffness and resting tremor — the movement symptoms of Parkinson’s. (Read more about symptoms.) Being treated by a movement disorder specialist remains critically important as the disease progresses.

Even though no lab (blood, urine or spinal fluid) or imaging test can confirm a diagnosis of PD, doctors may order these tests to exclude other conditions that can look like Parkinson’s. DaT scan is a brain imaging test that captures detailed pictures of the dopamine system in the brain. DaT scan can’t diagnose Parkinson’s on its own and not everyone with suspected Parkinson’s needs this test. In some cases, though, such as when it’s difficult to distinguish Parkinson’s tremor from essential tremor (another common movement disorder), this can be a helpful addition.

Quicker and earlier diagnosis of Parkinson’s will become possible when research uncovers an objective test — underpinned by what is called a “biomarker” — that reveals the risk, presence or progression of a disease. (Cholesterol, which helps doctors diagnose and monitor the progression of heart disease, is an example of a biomarker.) The Michael J. Fox Foundation-sponsored Parkinson’s Progression Markers Initiative study is gathering data over several years from 1,400 people with and without PD to find a biomarker.

Ask the MD: Parkinson’s Diagnosis and Biomarkers

The Michael J. Fox Foundation (MJFF) has made finding a test for Parkinson’s disease one of our top priorities.

Parkinson’s disease – NHS

Parkinson’s disease is a condition in which parts of the brain become progressively damaged over many years.

Get the flu vaccine

Flu can be very serious if you have Parkinson’s disease. Ask for your free flu jab at:

• your GP surgery
• a local pharmacy that has a flu vaccine service

Find out more about the flu vaccine

Information:

Coronavirus advice

Get advice about coronavirus and Parkinson’s disease from Parkinson’s UK

Symptoms of Parkinson’s disease

The 3 main symptoms of Parkinson’s disease are:

• involuntary shaking of particular parts of the body (tremor)
• slow movement
• stiff and inflexible muscles

A person with Parkinson’s disease can also experience a wide range of other physical and psychological symptoms.

These include:

Seeking medical advice

See a GP if you’re concerned that you may have symptoms of Parkinson’s disease.

They’ll ask about the problems you’re experiencing and may refer you to a specialist for further tests.

Find out more about diagnosing Parkinson’s disease

Causes of Parkinson’s disease

Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.

Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.

Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.

Who’s affected

It’s thought around 1 in 500 people are affected by Parkinson’s disease.

Most people with Parkinson’s start to develop symptoms when they’re over 50, although around 1 in 20 people with the condition first experience symptoms when they’re under 40.

Men are slightly more likely to get Parkinson’s disease than women.

Treating Parkinson’s disease

Although there’s currently no cure for Parkinson’s disease, treatments are available to help reduce the main symptoms and maintain quality of life for as long as possible.

These include:

You may not need any treatment during the early stages of Parkinson’s disease, as symptoms are usually mild.

But you may need regular appointments with your specialist so your condition can be monitored.

Outlook

As the condition progresses, the symptoms of Parkinson’s disease can get worse and it can become increasingly difficult to carry out everyday activities without help.

Many people respond well to treatment and only experience mild to moderate disability, whereas the minority may not respond as well and can, in time, become more severely disabled.

Parkinson’s disease does not directly cause people to die, but the condition can place great strain on the body, and can make some people more vulnerable to serious and life-threatening infections.

But with advances in treatment, most people with Parkinson’s disease now have a normal or near-normal life expectancy.

Find out more about living with Parkinson’s disease

It may also be useful to read information and advice on: 

Parkinson’s UK

Parkinson’s UK is the main Parkinson’s support and research charity in the UK.

They can help if you’re living with the disease and let you know about support groups in your local area.

You can contact them by:

• calling their free helpline on 0808 800 0303 (Monday to Friday, 9am to 7pm, and 10am to 2pm on Saturdays)
• emailing [email protected]

The Parkinson’s UK website features news, publications, research updates and an online community where you can share your experiences.

Information:

Social care and support guide

If you:

• need help with day-to-day living because of illness or disability
• care for someone regularly because they’re ill, elderly or disabled, including family members

Our guide to care and support explains your options and where you can get support.

Video: Parkinson’s disease – Karen’s story

This video explores the effect that Parkinson’s has had on Karen’s life.

Media last reviewed: 1 April 2021
Media review due: 1 April 2024

Page last reviewed: 30 April 2019
Next review due: 30 April 2022

Parkinson’s & Personality Changes | APDA

Changes in Personality

The idea that a disease could cause even modest changes in who we are makes many of us uncomfortable. However, there is no question that the brain is changing because of Parkinson’s.

There has been a lot of discussion about a “Parkinson’s Personality” over the years. Although controversial, some researchers have attempted to go back into the past to search for a common set of personality traits among people who later develop PD. There are a number of problems here, not the least of which is the bias that is bound to occur when anyone looks to the past with knowledge of what the present looks like. It is more reasonable to assume that the neurological effects of Parkinson’s Disease cause a great deal of similarity in personality among people with the disease. Therefore, I think it is more important to consider the likelihood of personality change with PD.

Talk with any family member of a person who has Parkinson’s Disease and you will frequently hear them say, “Parkinson’s has made my spouse/partner/parent/sibling different.” They are reporting that there is something discernibly altered in who their loved one is as a person. It might be subtle or it might be quite blatant, but the person is no longer the same as he or she once was. I recently presented a talk on Parkinson’s Disease and personality change to a group of family members and was astonished at the number of people with whom this idea resonated.

We are not really used to talking about Parkinson’s as an agent of personality change because we focus on the disease as a movement disorder in most of our discussions. This allows us to talk about brain change in terms of dementia or executive dysfunction. But both of these conditions manifest as a fundamental change in who the person is. The idea that a disease could cause even modest changes in who we are makes many of us uncomfortable. However, there is no question that the brain is changing because of PD. Because a substantial part of our personality relies on our brain function, it is not a stretch of logic to ask if a changing brain produces a changing personality.

One of the most difficult neurological disorder symptoms of Parkinson’s

Why might this be important to families challenged by PD? Because the biggest source of conflict in families occurs when loved ones fail to recognize that a person with brain changes is not the same person who existed at an earlier time in life. Human beings greatly value continuity in personality but by expecting the person to be the same as they once were, loved ones are unfair to the person with brain insult. This person could no more return to an earlier personality state than he or she can will away tremors or rigidity. Energy expended in any way other than coming to terms with this “new” person is fruitless. There is actually some fascinating research in this area and it is likely to be a topic for a great deal more discussion in future blogs.

The American Psychological Association (APA) defines personality as “the organization of an individual’s distinguishing, traits or habits.” According to the APA Encyclopedia of Psychology, this individualized organization comprises four domains: thinking, feeling, behaving, experiencing the environment. Words such as traits and habits imply that personality is an enduring function of the person. Based on our perceptions of what one’s personality is like, we are able to make reasonable predictions about how a person functions across those four domains. We do so with folk terms that have been in our language for ages because these provide not only a common understanding but also allow us to make predictions about how a person is likely to act under given circumstance. It is important to remember that this might sometimes mean a more/less energized form of characteristics that were already present (e.g. controlled vs volatile for how a person responds when angry).

Because of the greater likelihood for executive dysfunction and dementia, personality change is easier to see among individuals with more advanced PD. Motivation (a personality characteristic we might call engagement) is frequently affected, resulting in apathy (introversion) that diminishes how actively an individual interacts with other people (aloofness) and with the world (withdrawn). Thinking or cognition changes can cause the person to process information more slowly and with less focus and concentration (inattentive, absent minded). A previously methodical, consistent (conscientious) individual often becomes increasingly chaotic (disorganized) in their response to their environment (undisciplined). One easily becomes less interested (bored) and hopeful about the future (pessimistic).

Even among individuals with young onset PD, there can be subtle changes in personality. Thus, a person may begin to experience more negative emotions (neuroticism), becoming more anxious (fearful) or depressed (withdrawn or moody). They may have difficulty letting go of ideas/beliefs (stubbornness) or become overly drawn to detail (obsessive). They may exhibit difficulty completing work assignments (unproductive) because they have difficulty organizing (careless). They might try previously unsuccessful methods over and over (uncreative).

Many readers might ask why it is necessary to complicate an already complicated disease by talking about it in terms of personality. The simple answer is that our families use personality terms when describing behaviors to professionals (“He is very compulsive about getting his meals on time”) and when trying to articulate their feelings that a person has changed (“She was never this stubborn before PD”). Medically-untrained individuals typically use personality terms as kind of shorthand to communicate what they are seeing or experiencing because there is some degree of cultural agreement about what the terms mean. Finally, physicians who try to treat stable states occurring with Parkinson’s Disease (such as apathy) medically may be less inclined to do so if they recognize these concerns as expressions of personality, resistant to change. There are after all, no FDA-approved treatments to make a person care about what they are constitutionally disinclined to care about.

It is important to recognize that our personality is relatively stable over time, although aging, life experience, and other factors (including disease) can lead to at least some modest changes. Given the chronic and progressive nature of PD, it makes no sense to believe that personality changes will magically disappear. They are likely to become increasingly more prominent and new traits may arise. Although we may be uncomfortable looking at Parkinson’s Disease as a condition that changes who we are, it makes sense to do so. We already recognize the disease to be a life-changer but may wish to consider that part of the reason is because it can change who we are.

Parkinson’s Disease and Dementia | Johns Hopkins Medicine

What is Parkinson disease?

Parkinson disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinson’s disease also have tremors and may develop cognitive problems, including memory loss and dementia.

Parkinson disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, it’s called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. It’s also much more common in men than in women.

Parkinson disease is a chronic and progressive disease.  It doesn’t go away and continues to get worse over time.

What causes Parkinson disease?

Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.

What are the symptoms of Parkinson disease?

Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:

• Tremors that affect the face and jaw, legs, arms, and hands
• Slow, stiff walking
• Trouble maintaining balance
• Problems with coordination
• A stiff feeling in arms, legs, and torso area
• Changes in handwriting

Eventually, Parkinson disease symptoms get worse and include:

• Depression
• Gastrointestinal problems (like constipation)
• Problems with urination
• Trouble chewing and swallowing food
• Memory loss
• Hallucinations
• Dementia
• Weight loss

How is Parkinson disease diagnosed?

Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinson’s disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.

How is Parkinson disease treated?

Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.

A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.

What are the complications of Parkinson disease?

Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.

Parkinson disease dementia can cause problems with:

• Speaking and communicating with others
• Problem solving
• Understanding abstract concepts
• Forgetfulness
• Paying attention

If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.

Experts don’t understand how or why dementia often occurs with Parkinson disease. It’s clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.

Can Parkinson disease be prevented?

Experts don’t yet understand how to prevent Parkinson disease. In some instances, there seems to be a genetic predisposition to develop Parkinson disease, but this isn’t always the case. Research is underway to find new ways to treat and prevent the disease.

Living with Parkinson disease

These measures can help you live well with Parkinson disease:

• An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
• High protein meals can benefit your brain chemistry
• Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
• If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.

When should I call my healthcare provider?

Call your healthcare provider if you or your loved one notices a sudden or significant change in symptoms or if mood changes, increased symptoms of depression or feelings of suicide develop.

Key points about Parkinson disease

• Parkinson disease is a movement disorder that can make your muscles tight and rigid.
• It can make walking and taking care of yourself difficult.
• It can lead to problems such as depression, hallucinations, and dementia.
• Parkinson disease will progress but medicines can help with some symptoms.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Causes, Symptoms, Stages, Treatment, Support

Overview

What is Parkinson’s disease?

Parkinson’s disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinson’s disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.

Who gets Parkinson’s disease?

About 50% more men than women get Parkinson’s disease. It is most commonly seen in persons 60 years of age and older. However, up to 10% of patients are diagnosed before age 50.

About 60,000 new cases of Parkinson’s disease are diagnosed in the United States each year.

Is Parkinson’s disease inherited?

Scientists have discovered gene mutations that are associated with Parkinson’s disease.

There is some belief that some cases of early-onset Parkinson’s disease – disease starting before age 50 – may be inherited. Scientists identified a gene mutation in people with Parkinson’s disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinson’s disease and in people with a type of dementia called Lewy body dementia.

Several other gene mutations have been found to play a role in Parkinson’s disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells’ ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinson’s disease.

Scientists think that about 10% to 15% of person’s with Parkinson’s disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.

Symptoms and Causes

What causes Parkinson’s disease?

Parkinson’s disease occurs when nerve cells (neurons) in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical (neurotransmitter) that helps the cells of the brain communicate (transmits signals, “messages,” between areas in the brain). When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brain’s commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinson’s disease.

People with Parkinson’s disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the body’s autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinson’s disease.

Scientists aren’t sure what causes the neurons that produce these neurotransmitter chemicals to die.

What are the symptoms of Parkinson’s disease?

Symptoms of Parkinson’s disease and the rate of decline vary widely from person to person. The most common symptoms include:

• Tremor: Shaking begins in your hands and arms. It can also occur in your jaw or foot. In the early stages of the disease, usually only one side of your body or one limb is affected. As the disease progresses, tremor may become more wide spread. It worsens with stress. Tremor often disappears during sleep and when your arm or leg is being moved.
• Slowness of movement (bradykinesia): This is the slowing down of movement and is caused by your brain’s slowness in transmitting the necessary instructions to the appropriate parts of the body. This symptom is unpredictable and can be quickly disabling. One moment you may be moving easily, the next you may need help moving at all and finishing tasks such as getting dressed, bathing or getting out of a chair. You may even drag your feet as you walk.
• Rigid muscles/stiff limbs: Rigidity is the inability of your muscles to relax normally. This rigidity is caused by uncontrolled tensing of your muscles and results in you not being able to move about freely. You may experience aches or pains in the affected muscles and your range of motion may be limited.
• Unsteady walk and balance and coordination problems: You may develop a forward lean that makes you more likely to fall when bumped. You may take short shuffling steps, have difficulty starting to walk and difficulty stopping and not swing your arms naturally as you walk. You may feel like your feet are stuck to the floor when trying to take a step.
• Muscle twisting, spasms or cramps (dystonia). You may experience a painful cramp in your foot or curled and clenched toes. Dystonia can occur in other body parts.
• Stooped posture. You have a “hunched over” posture.

Other symptoms include:

• Decreased facial expressions: You may not smile or blink as often as the disease worsens; your face lacks expression.
• Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged (monotone).
• Handwriting changes: You handwriting may become smaller and more difficult to read.
• Depression and anxiety.
• Chewing and swallowing problems, drooling.
• Urinary problems.
• Mental “thinking” difficulties/memory problems.
• Hallucinations/delusions.
• Constipation.
• Skin problems, such as dandruff.
• Loss of smell.
• Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
• Pain, lack of interest (apathy), fatigue, change in weight, vision changes.
• Low blood pressure.

What are the different stages of Parkinson’s disease?

Each person with Parkinson’s disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinson’s disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms; others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.

In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:

Early stage

Early symptoms of Parkinson’s disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.

Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement (no arm swing when walking) slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.

Mid stage

Symptoms start getting worse. Tremor, muscle stiffness and movement problems may now affect both sides of the body. Balance problems and falls are becoming more common. You may still be fully independent but daily tasks of everyday living, such as bathing and dressing, are becoming more difficult to do and take longer to complete.

Mid-late stage

Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.

Advanced stage

You now require a wheelchair to get around or are bedridden. You may experience hallucinations or delusions. You now require full-time nursing care.

Diagnosis and Tests

How is Parkinson’s disease diagnosed?

Diagnosing Parkinson’s disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT (computed tomography) or MRI (magnetic resonance imaging) scans, may be used to rule out other disorders that cause similar symptoms.

To diagnose Parkinson’s disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.

If you think you may have Parkinson’s disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.

Management and Treatment

How is Parkinson’s disease treated?

There is no cure for Parkinson’s disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinson’s symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.

What medications are used to treat Parkinson’s disease?

Medications are the main treatment method for patients with Parkinson’s disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.

Medications combat Parkinson’s disease by:

• Helping nerve cells in the brain make dopamine.
• Mimicking the effects of dopamine in the brain.
• Blocking an enzyme that breaks down dopamine in the brain.
• Reducing some specific symptoms of Parkinson’s disease.

Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinson’s disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinson’s disease. Levodopa is usually taken with carbidopa (Sinemet®) to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes (discussed below).

As people have Parkinson’s for a longer amount of time, the effects of their levodopa doses don’t last as long as they did before, resulting in their symptoms (tremor, muscle rigidity, slowness) worsening before they are due to take their next dose. This is called ‘wearing off.’ They may also notice involuntary, fluid, dancing or fidgeting-like movements of their body called dyskinesias. These movements can indicate the levodopa dose is too high. These ups and downs of the effects of levodopa are called motor fluctuations and are often improve with adjustment of the medication by the neurologist.

Dopamine agonists: These drugs mimic the effects of dopamine in your brain. They are not as effective as levodopa in controlling slow muscle movement and muscle rigidity. Your doctor may try these medications first and add levodopa if your symptoms are not well controlled depending on severity of your symptoms and your age.

Newer dopamine medications include ropinirole (Requip®) and pramipexole (Mirapex®). Rotigotine (Neupro®) is given as a patch. Apomorphine (Apokyn®) is a short-acting injectable medication.

Side effects of dopamine agonists include nausea, vomiting, dizziness, lightheadedness, sleeping problems, leg swelling, confusion, hallucinations and compulsive behavior (such as excessive gambling, buying, eating, or sex). Some of these side effects are more likely to occur in people over 70 years old.

Catechol O-methyltransferase (COMT) inhibitors: These drugs block an enzyme that breaks down dopamine in your brain. These drugs are taken with levodopa and slow your body’s ability to get rid of levodopa, so it lasts longer and is more reliable. Entacapone (Comtan®) and tolcapone (Tasmar®) are examples of COMT inhibitors. Opicapone (Ongentys®) is the newest medication in this class, receiving FDA approval in April 2020. Because these drugs increase the effectiveness of levodopa, they may also increase its side effects, including involuntary movements (dyskinesia). Tolcapone is rarely prescribed because it can damage the liver and requires close monitoring to prevent liver failure.

MAO B inhibitors. These drugs block a particular brain enzyme – monoamine oxidase B (MAO B) – that breaks down dopamine in your brain. This allows dopamine to have longer lasting effects on the brain. Examples of MAO B inhibitors include selegiline (Eldepryl®, Zelapar®), rasagiline (Azilect®) and safinamide (Xadago®). Side effects of these drugs include nausea and insomnia. Giving carbidopa-levodopa with an MAO B inhibitor increases the chance of hallucinations and dyskinesia. MAO B inhibitors are not prescribed if you are taking certain antidepressants or narcotic medications. Your doctor will review all your current medications and make the best treatment choice for you.

Anticholinergics. These drugs help reduce tremor and muscle stiffness. Examples include benztropine (Cogentin®) and trihexyphenidyl (Artane®). These are the oldest class of drugs to treat Parkinson’s disease. Side effects include blurred vision, constipation, dry mouth and urine retention. Persons over age 70 who are prone to confusion and hallucinations or have memory impairment should not take anticholinergics. Because of the high rate of side effects these medications are less commonly used.

Amantadine. Amantadine (Symmetrel®), first developed as an antiviral agent, is useful in reducing the involuntary movements (dyskinesia) caused by levodopa medication. There are two extended-release forms of the drug, Gocovri®, and Osmolex ER®. Side effects include confusion and memory problems.

Istradefylline. Istradefylline (Nourianz®) is an adenosine A2A receptor antagonist. It is used for people taking carbidopa-levodopa but experiencing off symptoms. Like the other drugs that act to increase the effectiveness of levodopa, they may also increase its side effects, including involuntary movements (dyskinesia) and hallucinations.

What are the surgical treatments for Parkinson’s disease?

Most patients with Parkinson’s disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable – reducing symptoms during “on” periods and no longer controlling symptoms during “off” periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they can’t. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.

• Deep brain stimulation (DBS) involves implanting electrodes in the brain, which deliver electrical impulses that block or change the abnormal activity that cause symptoms. DBS can treat most of the major movement symptoms of Parkinson’s disease such as tremor, slowness of movement (bradykinesia) and stiffness (rigidity). It does not improve memory, hallucinations, depression, and the other non-movement symptoms of Parkinson’s disease. Only patients whose symptoms are not controlled despite medication trials and who meet other strict criteria may be candidates for DBS. Your doctor will discuss if this is the right treatment for you.
• Carbidopa-levodopa infusion involves the surgical placement of a feeding tube into the small intestine. A gel form of the medication carbidopa-levodopa (Duopa®) is delivered through this tube. This method of continuous infusion of the drug keeps a stable dosage in the body. This helps patients who have had variation in their response to the oral form of carbidopa-levodopa but are still benefitting from the combination drug.
• Pallidotomy involves destroying a small portion of a part of the brain that controls movement (the globus pallidus). Pallidotomy help reduce involuntary movements (dyskinesias), muscle stiffness and tremor.
• Thalamotomy involves destroying a small part of the thalamus. This may help a small number of patients who have severe tremors of their arm or hand.

Prevention

Can Parkinson’s disease be prevented?

Unfortunately, no. Parkinson’s disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease (at this current moment in time), medications may significantly relieve your symptoms. In some patients – especially those with later-stage disease, surgery to improve symptoms may be an option.

Outlook / Prognosis

What is the outlook for persons with Parkinson’s disease?

Although there is no cure or absolute evidence of ways to prevent Parkinson’s disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.

Currently, you and your healthcare team’s efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations (exercise, healthy eating, improved sleep). By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinson’s disease can live fulfilling lives.

The future is hopeful. Some of the research underway includes:

• Using stem cells (from either bone marrow or embryos) to produce new neurons, which would produce dopamine.
• Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
• Using a naturally occurring human protein – glial cell-line derived neurotrophic factor, GDNF – to protect dopamine-releasing nerve cells.

Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.

Living With

What lifestyle changes can I make to ease Parkinson’s symptoms?

Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinson’s disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didn’t exercise or didn’t start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics (running, walking, dancing). All types of exercise are helpful.

Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinson’s, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.

Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments — whether medicines or deep brain stimulation — are optimal; and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.

Improve the quality of your sleep.

How do I prevent falls from common hazards?

• Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
• Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
• Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
• Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
• Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
• Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.

What are some tips to help me maintain balance?

• Keep at least one hand free at all times. Try using a backpack or fanny pack to hold things rather than carrying them in your hands. Never carry objects in both hands when walking as this interferes with keeping your balance.
• Attempt to swing both arms from front to back while walking. This might require a conscious effort if Parkinson’s disease has diminished your movement. It will, however, help you to maintain balance and posture, and reduce falls.
• Consciously lift your feet off of the ground when walking. Shuffling and dragging of the feet is a common culprit in losing your balance.
• When trying to navigate turns, use a “U” technique of facing forward and making a wide turn, rather than pivoting sharply.
• Try to stand with your feet shoulder-length apart. When your feet are close together for any length of time, you increase your risk of losing your balance and falling.
• Do one thing at a time. Don’t try to walk and accomplish another task, such as reading or looking around. The decrease in your automatic reflexes complicates motor function, so the less distraction, the better.
• Do not wear rubber or gripping soled shoes–they might “catch” on the floor and cause tripping.
• Move slowly when changing positions. Use deliberate, concentrated movements and, if needed, use a grab bar or walking aid. Count 15 seconds between each movement. For example, when rising from a seated position, wait 15 seconds after standing to begin walking.
• If you become “frozen,” visualize stepping over an imaginary object, or have someone place his or her foot in front of yours to step over. Try not to have a caregiver or family member “pull” you–this might throw you off balance and even prolong the episode.
• If balance is a continuous problem, you might want to consider a walking aid such as a cane, walking stick, or walker. Once you’ve mastered walking with help, you might be ready to try it on your own again.

Resources

Living with Parkinson’s disease can be a frustrating experience. It’s normal to feel angry, depressed and anxious. You and your family members might find it helpful to reach out to others who have this disease – to share your knowledge and insights, experiences and tips for living. You may want to check out local support groups of these Parkinson’s organizations:

You might also be interested in learning more about or joining a clinical trial. See the following sites for more information:

Parkinson’s Disease Dementia | Symptoms & Treatments

Parkinson’s disease dementia is a decline in thinking and reasoning that develops in many people living with Parkinson’s at least a year after diagnosis.

About Parkinson’s disease dementia

Parkinson’s disease dementia is a decline in thinking and reasoning that develops in many people living with Parkinson’s at least a year after diagnosis. The brain changes

caused by Parkinson’s disease begin in a region that plays a key role in movement, leading to early symptoms that include tremors and shakiness, muscle stiffness, a shuffling step, stooped posture, difficulty initiating movement and lack of facial expression. As brain changes caused by Parkinson’s gradually spread, they often

begin to affect mental functions, including memory and the ability to pay attention,

make sound judgments and plan the steps needed to complete a task.

The key brain changes linked to Parkinson’s disease and Parkinson’s disease dementia are abnormal microscopic deposits composed chiefly of alpha-synuclein, a protein found widely in the brain with a normal function not fully known. The deposits are called “Lewy bodies” after Frederick H. Lewy, M.D., the neurologist who discovered them while working in Dr. Alois Alzheimer’s laboratory during the early 1900s.

Lewy bodies are also found in several other brain disorders, including dementia with

Lewy bodies (DLB). Evidence suggests that DLB, Parkinson’s disease and Parkinson’s disease dementia may be linked to the same underlying abnormalities in the brain processing of alpha-synuclein. Another complicating factor is that many people with both Parkinson’s disease and DLB dementia also have plaques and tangles — hallmark brain changes linked to Alzheimer’s disease.

A study published on July 29, 2019 in Scientific Reports suggests that Lewy bodies

are problematic because they pull alpha-synuclein protein out of the nucleus of brain

cells. The study, which examined the cells of living mice and postmortem brain tissue

in humans, reveals that these proteins perform a crucial function by repairing breaks

that occur along the vast strands of DNA present in the nucleus of every cell of the

body.Alpha-synuclein’s role in DNA repair may be crucial in preventing cell death. This

function may be lost in brain diseases such as Parkinson’s and DLB, leading to the

widespread death of neurons. Sign up for our e-news to receive updates about Alzheimer’s and dementia care and research.

Learn more: Lewy Body Dementia and Mixed Dementia

Prevalence

Parkinson’s disease is a fairly common neurological disorder in older adults, estimated to affect nearly 2% of those over age 65. The National Parkinson’s Foundation estimates that one million Americans will have Parkinson’s disease by 2020. Recent studies following people with Parkinson’s over the entire course of their illness estimate that 50 to 80% of those with the disease may experience dementia.

Causes and risk factors

An estimated 50 to 80 percent of those with Parkinson’s eventually experience

dementia as their disease progresses. Some studies have reported that the average

time from onset of Parkinson’s to developing dementia is about 10 years.

Certain factors at the time of Parkinson’s diagnosis may increase future dementia

risk, including advanced age, greater severity of motor symptoms and mild cognitive

impairment (MCI).

Additional risk factors may include:

• The presence of hallucinations in a person who doesn’t yet have other dementia symptoms
• Excessive daytime sleepiness
• A Parkinson’s symptom pattern known as postural instability and gait disturbance (PIGD), which includes “freezing” in mid-step difficulty initiating
  
  movement, shuffling, problems with balancing and falling. 

Symptoms

Commonly reported symptoms include:

• Changes in memory, concentration and judgment
• Trouble interpreting visual information
• Muffled speech
• Visual hallucinations
• Delusions, especially paranoid ideas
• Depression, irritability and anxiety
• Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder.

Diagnosis

There is no single test — or combination of tests — that conclusively determines that a person has Parkinson’s disease dementia. Guidelines for diagnosing Parkinson’s

disease dementia and DLB are:

• The diagnosis is Parkinson’s disease dementia when a person is originally diagnosed with Parkinson’s disease based on symptoms related to movement and dementia symptoms don’t appear until a year later or more.
• The diagnosis is DLB when dementia symptoms consistent with DLB either develop first; are present along with symptoms related to movement; or appear within one year after movement symptoms.

Outcomes

Because Parkinson’s disease and Parkinson’s disease dementia damage and destroy brain cells, both disorders worsen over time. Their speed of progression can vary widely.

Treatment

There are no treatments to slow or stop the brain cell damage caused by Parkinson’s

disease dementia. Current strategies focus on improving symptoms. If your treatment

plan includes medications, it’s important to work closely with your physician to

identify the drugs that work best for you and the most effective doses.

• Cholinesterase inhibitors — drugs that are the current mainstay for treating cognitive changes in Alzheimer’s — may help Parkinson’s disease dementia symptoms, including visual hallucinations, sleep disturbances and changes in thinking and behavior.
• Carbidopa-levodopa — may be prescribed to treat Parkinson’s movement symptoms. However, it can sometimes aggravate hallucinations and confusion in those with Parkinson’s dementia or DLB.
• Deep brain stimulation — deep brain stimulation (DBS) is currently contraindicated for Parkinson’s disease dementia (PDD). Although one small clinical study suggested it was safe for those with PDD, additional studies must be conducted to confirm its effectiveness.
• Selective serotonin reuptake inhibitors (SSRIs) — used to treat depression, which is common in both DLB and Parkinson’s disease dementia.
• Clonazepam and melatonin — may be used to treat REM disorder.

Caution: Antipsychotics drugs (such as haloperidol, fluphenazine or thioridazine)

that are used to treat behavioral symptoms should be avoided. About 60 percent of

people with DLB experience worsening of Parkinson symptoms, sedation, impaired

swallowing or neuroleptic malignant syndrome (NMS). NMS is a life-threatening

condition characterized by fever, generalized rigidity and muscle breakdown

following exposure to traditional antipsychotics.

Help is available

The Alzheimer’s Association can help you learn more about Alzheimer’s disease and other dementias, and help you find local support services. Call our 24/7 Helpline at 800.272.3900.

Michael J. Fox Foundation for Parkinson’s Research website offers information for people living with Parkinson’s disease and research updates.

Parkinson’s Foundation is a nonprofit organization providing information and resources for diagnosed individuals, families and health professionals. Call the Parkinson’s Foundation at 800.473.4636.

90,000 “My son was diagnosed with Parkinson’s at age 11”

• Claire Bates
• BBC

April 12, 2018

When Sarah Hill’s son complained of pain in his legs, the family doctor told her, that there is nothing to worry about. However, later it turned out that this was the first symptom of Parkinson’s disease, which usually affects people in old age.

Alex Hill was only 8 years old when his mother first suspected that something was wrong with him.

Sarah noted that he had been complaining of pain in his legs for several days after his physical education class in school. She also noticed that he dragged one leg a little when he got tired.

“I thought it was not normal for a small child,” says Sarah.

Then she took Alex to her family doctor in Folkestone, who said there was nothing to worry about. However, soon Alex had other, even stranger complaints.

“He didn’t want to leave me, even though he loved going to school.In addition, he became obsessed with something. For example, he had to fill his backpack with several pairs of underpants, and without that we could not leave the house, “- says the woman.

Once Alex opened the window of his room and began to shout at the birds to” shut up “.

“It was all very strange and not like him, so I again went to our doctor to ask if I should show Alex to a psychiatrist, but they turned me around again,” she recalls.

A few months later, during conversation with his mother Alex suddenly fell on his back.He could not explain what happened to him.

His handwriting deteriorated and Sarah’s father also noticed that Alex had a slight tremor. He suggested that this could be a Parkinson’s symptom, which once again made their family doctor laugh.

Alex was referred for a consultation with the local pediatrician, who decided that the young patient had epilepsy and prescribed treatment. However, the prescribed medication did not help, and over the ensuing months, it dropped up to 28 times a day.

“He could not sit because he was covered in bruises and could only lie on his stomach,” says Sarah.

Then Alex was sent for examination to the London children’s hospital “Evelina”, where on the same day he was diagnosed with juvenile parkinsonism. A brain scan revealed low levels of the neurotransmitter dopamine (dopamine), which confirmed the diagnosis.

Sarah says it felt like they had fallen into the abyss, although she found the strength to cheer up her son, promising him that they would cope with all the difficulties.

Photo caption,

April 11 – World Parkinson’s Day

“Jet Fuel”

There are about 120 thousand people in Britain.people suffer from Parkinson’s disease, although most were diagnosed after 60 years. About 5% of patients begin to experience symptoms around age 40 and rarely before age 20.

After watching some family videos, the team said that Alex showed signs of the disease at the age of three, but they could not explain why he had the disease at such an early age. Neither Alex’s mother nor Alex’s father had any of his relatives ever suffered from this disease.

Alex was prescribed Levodopa, which worked like a jet fuel on him.

“The medication helped him move, but it was very overexcited. I had to hide the handsets because he called the police just to talk to them,” Sarah recalls.

Sarah had to leave her job as a fitness instructor to take full care of Alex.

Diagnosis and Treatment of Parkinson’s Disease

There are more than 40 symptoms of the disease, such as vomiting – because it is difficult for the body to digest food in the stomach.

Parkinson’s disease also affects a person’s mood, which may explain why Alex sometimes screams.

Often a person begins to feel that he is accustomed to his condition, but suddenly a new symptom appears, and since they are very diverse, there is no single treatment for each symptom.

There is some promise from stem cell and gene therapy research, but further research is needed.

We know that people under the age of 40 often fail to get a correct diagnosis because juvenile parkinsonism is rare.

However, Parkinson’s disease can occur in people of any age.

It is very important that diagnosticians pay attention to the person’s symptoms when diagnosing, rather than basing their conclusions on the patient’s age.

Professor David Dexter is Associate Research Director at Parkinson’s UK.

Special Needs

By the age of 12, Alex had to use a wheelchair almost all the time.It became difficult for him to be close to his school friends, who could still run around tirelessly.

Eventually he transferred to a school for children with special educational needs, but the teaching level there was too low for him.

After a couple of years, Alex stopped responding to treatment, so at the age of 14 he received deep brain stimulation. During this procedure, electrodes are implanted into the brain, which send high-frequency pulses to the desired areas.

This surgery reduced the tremor and returned his smile, his mother says.

“He was able to do so much more, like playing his Xbox.”

Photo caption,

Alex with his mother (right) and sister Becky at the 2012 London Olympics

Alex was transferred again to another school in Sevenoaks, where he was helped to continue his studies in high school using a computer with speech output.

Subsequently, he could no longer attend school, but he did not stop loving to study to this day.

“He loves science and he loves doing math and English,” says Sarah.

What is the forecast?

As her son’s condition worsened, Sarah felt it became increasingly difficult for her to deal with it.

“Since Alex was so young, it seemed to me that I alone was fighting Parkinson. I asked what the prognosis was, and they only replied to me so that I would support him in the state in which it is possible at the moment.I was completely exhausted, I began to prematurely mourn him, and only my sister helped me to get out once again, “Alex’s mother admits.

Finally Sarah decided that the best way out – for herself and for Alex – would be to place him in a special shelter not far from home.

“This meant that I could be his mother again, and not just a nurse. We can play games again, have fun, “she explains.

Caption,

Alex and Sarah Hill

Alex continues to participate in all family activities and celebrations – from barbecues in the yard to his own sister Becky’s wedding.

“He had a great time [at the wedding]. Without him, it wouldn’t be so,” Sarah admits.

Since Alex has difficulty swallowing, he is fed through a tube. It is also difficult for him to sleep, and sometimes he shouts out something at night. He needs help in almost everything, and he has a good relationship with two of his nurses.

Mother comes to him every other day, and every day they communicate via video link.

He is now 24 years old, but he does not want to discuss the details of his illness, although he admits that the most difficult thing for him was losing the ability to walk.

“Alex doesn’t like to be immersed in memories. He will be more willing to enjoy life now, which is right,” says his mother.

He is interested in Harry Potter films and TV series like Doctor Who. He also loves to paint.

“He can no longer play his Xbox, but he likes to watch me play and tell me where I missed,” explains Sarah.

Alex calls Sarah “the best mom in the world.” This summer they are going to go on vacation to Wales.

Sarah Hill, meanwhile, is constantly looking for new drugs that could alleviate her son’s condition. “Every day is our only day, and we get through it as well as possible,” she says.

Photos courtesy of Sarah Hill

Parkinson’s disease: causes, symptoms and treatments :: Health :: RBC Style

Parkinson’s disease and Parkinson’s syndrome

The phrase “Parkinson’s syndrome”, which is often searched on the Internet, is not correct.There is a term “Parkinson’s syndrome”. This is a general category that includes slowness of movement, muscle stiffness, resting tremors in the arms or legs. However, this syndrome can be a manifestation of various diseases: not only Parkinson’s disease, but also, for example, multisystem atrophy or Wilson’s disease. In this material, we talk directly about Parkinson’s disease.

What is Parkinson’s disease

Parkinson’s disease is a progressive neurodegenerative disease that ranks second in prevalence after Alzheimer’s disease [1].Despite the large number of studies devoted to the study of Parkinson’s disease, the causes and mechanisms of development of this disease remain completely unclear. It is known that this disease develops due to the gradual death of neurons that produce dopamine. Most often, symptoms of Parkinson’s disease appear in people over the age of 50, and as they age, the likelihood of developing the disease increases. Nevertheless, in 5-10% of patients, manifestations of this disease may occur at the age of 30-40 years and even earlier.Parkinson’s disease is much more common in men than in women, which may be associated with a certain protective effect of female sex hormones on dopamine-producing neurons.

© Andrea Piacquadio / Pexels

Symptoms of the disease were described in the Egyptian papyri of the XII century, and the Bible mentions “people with tremors” [2].The name was proposed by the French neurologist Jean-Martin Charcot in honor of the British physician James Parkinson. The latter wrote an Essay on Shaking Palsy, which outlines the manifestations of the disease based on observations of passers-by with characteristic movement disorders. The work was published in 1817, but during the life of the author it was not appreciated.

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Parkinson’s disease symptoms

The first obvious signs of Parkinson’s disease are slowing down of motor activity [3].Smoothness and the required speed of movement are largely controlled by dopamine. With illness, brain cells begin to die in an area called the substantia nigra, in which this neurotransmitter is formed. This leads to a decrease in dopamine content. The visible symptoms of Parkinson’s disease appear when about 60-80% of the cells of the substantia nigra, part of the extrapyramidal system located in the midbrain, have already died. It plays an important role in the regulation of cardiac activity, muscle tone, motor and respiratory functions.

Some early symptoms may develop several years before motor impairment. So, one of the first signs of Parkinson’s disease can be hypo- or anosmia (decreased or no sense of smell), chronic constipation, as well as human motor activity during dreams (the so-called behavioral disorder during sleep with rapid eye movements) [4].

After many years, slowness of movements and a feeling of muscle stiffness (rigidity) in the arm and leg on one side of the body appear, which is accompanied by a change in handwriting (it becomes small, the letters seem to be compressed), a decrease in the swing of the arm when walking, a slow and squirming gait.In addition, the voice may become more muffled, and facial expressions – less expressive, the face takes on a mask-like appearance. Many people with Parkinson’s disease develop tremors (tremors) in the arms and / or legs, which are most pronounced at rest. Then similar symptoms spread to the opposite side of the body [5]. As the disease progresses, posture is impaired (a person acquires a stoop), as well as the ability to properly control balance.

If treatment is not started on time, the symptoms of the disease will significantly disrupt daily activities.They may be supplemented with seborrheic dermatitis (white and yellow scales on the skin), sleep disturbances, depression, anxiety, hallucinations, memory problems, and visual-spatial perception difficulties [6]. In some cases, surgery may be indicated in addition to medication and exercise.

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Causes of Parkinson’s disease

Scientists are studying this disease in detail and developing methods that would not only reduce the severity of its symptoms, but also slow down the rate of progression of disorders.However, the exact reasons for the development of Parkinson’s disease remain unclear until now [7]. It is known that the death of neurons in which dopamine is produced is associated with the accumulation in them of a special protein with a disturbed structure called alpha-synuclein. The predisposition to Parkinson’s disease is due to both genetic and external factors. According to epidemiological studies, there are criteria leading to an increased risk of its development [8].

• Pos. Men suffer from Parkinson’s disease 1.5 times more often than women.
• Age. The main group of patients is people over 50 years old.
• Genetics. People with a family history of Parkinson’s disease are more likely to develop it.
• Toxins. Exposure to hazardous substances (eg pesticides) may increase the risk of disease.
• Head trauma (not necessarily unconscious). Among the patients, there are often those who have had them.

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Stages of Parkinson’s disease

The number of brain cells that produce dopamine and control movement decreases gradually.Along with this, the symptoms of Parkinson’s disease also progress.

© Bret Kavanaugh / Usplash

They can be different: it is not necessary that people with this disease experience the same problems of the same severity. But there are typical patterns in the development of Parkinson’s disease [9]. Experts distinguish five stages during its course.

• First stage. Mild symptoms that do not interfere with daily activities. For example, slowness and slight tremors on one side of the body, changes in posture and facial expressions.
• Second stage. Symptoms progressing: tremors, muscle stiffness on both sides of the body. Obvious problems occur with posture as well as with walking.
• Third stage. This is the middle stage, when loss of balance develops, movement slows down significantly, and it becomes more difficult to control the limbs.It is difficult for a person to perform simple everyday tasks: dressing, eating, taking a bath. At this stage, it is better if he is under the supervision of doctors, relatives, as well as qualified nursing professionals.
• Fourth stage. Symptoms are worse; the patient cannot stand unaided. Walkers are often required to get around, and the daily help of other people is required.
• Fifth stage. Most debilitating stage: Stiffness in the body can lead to a complete inability to move and maintain oneself.The person needs a wheelchair or becomes bedridden. A 24-hour medical staff is required. A patient at the fifth stage may experience mental complications – delusions and hallucinations [10].

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Diagnosis of Parkinson’s disease

There is no specific test for detecting Parkinson’s disease. The diagnosis is made on the basis of medical history, physical and neurological examination, taking into account the analysis of complaints and symptoms [11].Neuroimaging techniques such as computed tomography or magnetic resonance imaging can be used to rule out other conditions. In some countries, a study may also be conducted to assess the persistence of the dopamine transporter in brain cells (DaTscan), which helps doctors in difficult cases to confirm or deny the diagnosis of Parkinson’s disease.

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Treatment of Parkinson’s disease

Therapy is based on lifestyle changes, medication and exercise [12].The patient needs adequate rest, physical activity and a balanced diet. Normalization of sleep plays an important role. Chronic sleep deprivation leads to malfunctioning of the body and increased production of cortisol, a stress hormone that can also affect the development of neurodegenerative diseases. In many cases, work with a speech therapist is required to improve speech, as well as medications to help control various physical and psychological symptoms.

© Karolina Grabowska / Pexels

The drugs compensate for the lack of dopamine or mimic its action in the brain.Anticholinergic medications are sometimes used to help relieve tremors. Most of them provide short-term relief from movement. The drugs can only be prescribed by a doctor who supervises the treatment process, since they have potential side effects and are contraindicated for independent use. Surgery is considered when medications and lifestyle changes alone are not enough to control the symptoms of the disease. Such operations include, for example, implantation of electrodes for chronic electrical stimulation of deep brain structures or installation of a pump (pump) with a drug for continuous administration [14].

Start treatment as soon as possible. Parkinson’s disease is fraught with complications due to impaired control of movements: blood clots can form in the lungs and legs of sedentary patients, fatal injuries due to falls are not excluded. Supportive therapy can help reduce unpleasant symptoms as well as significantly improve quality of life.

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Prevention of Parkinson’s disease

Due to the lack of knowledge about the causes of the disease, it is difficult to determine ways to avoid it.According to research data, its development is influenced by lifestyle, including nutrition and physical activity [15]. Scientists claim that antioxidants and aerobic exercise play an important role in prevention.

In addition, coffee and green tea drinkers are less likely to suffer from Parkinson’s disease [16], [17]. Genetic predisposition does not mean that a person will necessarily get sick, but it does increase the risks.

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Coronavirus and Parkinson’s disease

The issue of the interaction of diseases is especially acute, because older people are more susceptible to complications from COVID-19. And this can aggravate the already difficult course of Parkinson’s disease [18]. In addition, viruses spread faster in crowded areas such as nursing homes. Elderly people must avoid crowds and practice good hygiene, and their rooms must be kept clean and ventilated.Doctors advise to vaccinate according to the necessary indications, which can be discussed with the attending physician.

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Expert commentary

Seliverstov Yuri Aleksandrovich, Researcher, FGBNU NTSN, doctor of the highest category, Ph.D. Member of the Education Committee of the European Section of the International Parkinson and Movement Disorder Society

“In general, patients with classic Parkinson’s disease have a life expectancy after the onset of the first symptoms comparable to that of people without this disease.Nevertheless, the rate of the course of the disease can vary depending on a large number of both modifiable and non-modifiable factors.

The rate of progression of Parkinson’s disease depends both on a large number of individual genetic characteristics of a person and on his lifestyle. Treatment with special anti-Parkinsonian drugs allows the patient to optimize the daily physical and cognitive activity, and this, in turn, slows the increase in the severity of the symptoms of Parkinson’s disease.A rapid deterioration in the patient’s condition, despite adequate treatment, may indicate an alternative diagnosis.

Currently, there are no methods to cure Parkinson’s disease, which must be borne in mind when meeting with various kinds of advertisements on this topic. However, symptomatic treatment should not be neglected: it helps to significantly improve the quality of life of a person with this disease. As Parkinson’s disease progresses, dosages and medications need to be adjusted accordingly.

Except in rare cases (most often up to 50 years of age), Parkinson’s disease is not associated with any one specific gene, and the risk of developing it in the patient’s relatives is only slightly higher than the population average ”.

90,000 Parkinson’s disease – prices for treatment, symptoms and diagnosis of Parkinson’s disease in the “CM-Clinic”

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Parkinson’s disease is a neurological disease characterized by the progression of degenerative changes in the motor system. Parkinsonism occurs due to the death of cells in the nervous system that produce dopamine. Dopamine is a chemical that is responsible for transmitting electrical impulses between nerve cells. The disease is typical for the elderly.

Parkinson’s disease symptoms

Parkinsonism has signs that allow a doctor to make a diagnosis.These include:

• trembling of arms, legs and trunk, which increases with fatigue
• limitation of motor activity, strength of muscle contraction, facial expressions
• shuffling gait
• impairment of the ability to maintain balance
• increasing muscle tone
• sleep disorders
• disorders of the vestibular apparatus
• mental disorders
• violation of speech and writing functions
• typical slouching posture

Symptoms of the disease are individual and can occur in various combinations.

If you experience these symptoms, we advise you to make an appointment with your doctor. Timely consultation will prevent negative consequences for your health. Phone for appointment +7 (495) 292-39-72

Causes of Parkinson’s disease

Risk factors that can lead to the development of parkinsonism include:

• heredity
• adverse environment
• long-term use of antipsychotics
• infectious diseases of the brain
• atherosclerosis of cerebral vessels
• head trauma
• tumors
• intoxication with poisonous substances

Diagnostics of Parkinson’s disease in the “CM-Clinic”

The diagnosis of parkinsonism in the “CM-Clinic” center in Moscow is carried out by neurologists with many years of experience and knowledge of all processes of the disease.The doctors of the clinic are constantly improving their knowledge at specialized international conferences and have mastered the latest methods of diagnosing the treatment of neurological diseases.

The diagnosis of Parkinson’s disease is made after a thorough questioning and examination of the patient, taking into account typical and non-typical complaints, the moment of their appearance and other features. Among the diagnostic tests to confirm the disease in the “CM-Clinic” the following are carried out:

one.Electroencephalography is a method of studying the electrical activity of the brain.

2. Computed tomography – a study of the brain to determine the changes in the brain characteristic of parkinsonism.

3. Magnetic resonance imaging is a method of layer-by-layer visualization of brain structures.

4. Transcranial sonography is a technique for ultrasound recording of brain signals.

5. The method of evoked potentials – evaluates the electrical activity of the brain as a reaction to the action of external stimuli.

Treatment of Parkinson’s disease at the “CM-Clinic”

When the question arises of where to treat Parkinson’s disease, “CM-Clinic” is the best choice. Our neurologists treat the disease in a comprehensive manner, with the help of colleagues from other specialties, and carefully thought out individual therapy is selected for each patient.

Methods for treating Parkinson’s disease are aimed at alleviating a person’s condition and prolonging an active life, improving its quality. The drugs prescribed by SM-Clinic doctors work effectively and allow patients to maintain their professional activities for many years.

Among the drugs that are prescribed as part of complex therapy, the following are prescribed:

• eliminating movement disorders
• increasing the content of dopamine in the central nervous system
• antioxidants
• anti-inflammatory
• trophic
• excitatory amino acid antagonists
• vitamin complexes

In addition to drug therapy, each patient of the “CM-Clinic” is selected an individual diet and physical activity regimen.Physiotherapy courses are also conducted to get rid of many symptoms and slow down the progression of the disease.

Prevention of Parkinson’s disease

For the prevention of Parkinson’s disease, it is useful to lead an active healthy lifestyle, eat well and control the state of blood vessels and pressure, especially after 50 years. You should also avoid places with a high concentration of toxic substances.

You can find out the cost of consultations and procedures, as well as make an appointment with a doctor, by calling +7 (495) 292-39-72.

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Parkinson’s disease – GBUZ “Crimean CRH” MH KK

Parkinson’s disease is a chronic progressive disease of the central nervous system, which is based on a degenerative lesion of a part of the brain called the substantia nigra. Here, a chemical called dopamine is produced, with the participation of which signals are transmitted to the brain cells that control human movement.In Parkinson’s disease, the nerve cells that produce dopamine die off, and the production of a vital substance is drastically reduced. As a result, the leading clinical manifestations of the disease are impaired voluntary movements and control over their movements, slowness and stiffness when walking, trembling of the arms, legs and chin.

For the first time this disease called “tremor palsy” was described in detail by the English physician James Parkinson in 1817. Subsequently, tremor paralysis began to be called Parkinson’s disease, and the symptom complex, the main manifestation of which is tremor of the limbs, – Parkinsonism.

Parkinson’s disease is one of the most common ailments of people in old age and can rival vascular diseases and memory impairments in frequency. People of different nationalities, men and women, are ill with it with the same frequency. Most often, Parkinson’s disease occurs at the age of 50-65 years. However, in some cases, the initial signs of tremor paralysis begin to appear after 40 years.

Natural aging of the body is called the main factor in the origin of Parkinson’s disease.With age, the number of nerve cells, including those that produce dopamine, decreases, and if this process occurs rapidly, then the phenomena of parkinsonism appear and increase. An important role in the development of Parkinson’s disease is played by heredity. It is noted that if a close relative suffers from this ailment, then the risk of getting sick himself doubles in comparison with other healthy people. In recent years, scientific information has appeared on the development and severe course of Parkinson’s disease in young drug addicts who take synthetic heroin.In addition, it has been proven that people who work with herbicides and pesticides are much more at risk of developing the disease than others. In some cases, the impetus for the development of Parkinson’s disease can be viral infections, atherosclerosis of the cerebral vessels, traumatic brain injury, and brain tumors.

The disease begins gradually, often with trembling or awkwardness in one hand, less often with difficulty walking or general stiffness. Back pain, muscle cramps are noted.Gradually, the symptoms become bilateral, the movement slows down, the muscle tone increases like a “cogwheel”. In 75% of patients, hand tremors are observed, more pronounced at rest and reminiscent of “rolling pills”. Trembling of the legs, chin, lips and tongue is often noted. The increased muscle tone determines the characteristic stooped posture of a sick person, called the “supplicant’s pose”. Gait becomes shuffling or mincing, hands do not participate in walking. To get under way, patients are often forced to take several small steps.In the later stages of the disease, the patient has difficulty maintaining balance, often falls. Dementia develops in 20% of patients. Here is a general description of Parkinson’s disease, however, the type of symptoms, their combination, the severity in each case are different.

Modern drugs are able to stop the death of cells with dopamine and reduce the manifestation of the disease. Levopoda is considered the most effective drug in the treatment of Parkinson’s disease. The drug is intended for continuous administration in individually selected doses.Today there are a number of other drugs used in the early stages of the disease. Sudden discontinuation of prescribed drugs can cause a crisis and confine the patient to bed. In addition to drug therapy, massage is prescribed and, of course, physiotherapy exercises, a set of exercises for which will be selected by a specialist. Patients should be encouraged to be active for them, keeping in mind that “bed is the enemy of Parkinson’s.”

There are several tips for maintaining the necessary balance.It is necessary that at least one hand is always free. You cannot carry anything in both hands. This makes it difficult to maintain balance while walking. It is important to try to deliberately lift your feet off the ground, and not shuffle them – when a person drags his feet, there are much more risks of losing balance. When turning, the turn should be gentle and unhurried – sharp turns are prohibited. You should not do several actions at the same time. While walking, you do not need to read or stare around. A person with Parkinson’s disease should not wear rubber or stiff-soled shoes, as they can easily stumble and fall.In some cases, it is advisable to use a cane or walker.

Tips for the prevention of Parkinson’s disease are the most common, constantly recommended by doctors: to lead a healthy lifestyle, maintain physical activity, observe a proper diet, avoid contact with harmful substances. More recently, scientists have noticed an interesting fact: people who are professionally involved in dancing practically do not have Parkinson’s disease. Today, experts recommend that patients with initial signs of tremor paralysis regularly perform dance movements in the rhythm of tango, which improves their general mobility.

If ​​you do not start the disease and do not let it take its course, then you can live with Parkinson’s disease for a long time and actively.

GBUZ “Center for Medical Prevention” of the Ministry of Health of the Krasnodar Territory

Pension for Parkinson’s patients in Moscow Native People

Degenerative diseases most often affect the elderly, and their treatment can only slightly affect the patient’s well-being.Such a disease requires round-the-clock medical care, which the Parkinson’s boarding house offers. Here, a person is assisted, constantly monitoring his condition in conditions that are most similar to those at home.

Such diseases require the constant presence of family and friends, as well as periodic medical attention. Therefore, transferring your loved one into our hands, you express your love to him. This relieves him of feelings of guilt for the inconvenience, feelings of uselessness and stress due to lack of communication.

Benefits of staying with us:

No hidden fees

Comfortable living conditions

Free WI-FI

Daily activities with an animator

Excursions to nearby attractions

We welcome guests at any time without a call – we have nothing to hide

Daily walks

Organized leisure

How the Native People boarding house is suitable for patients with Parkinson’s

A private boarding house for patients with Parkinson’s in Moscow not only provides support to patients with this disease, but creates conditions for a fulfilling life.At your service:

• comfortable accommodation conditions, contributing to the maintenance of morale at the required level;
• an environment conducive to compliance with the regime, which is important in such a disease;
• nutrition, taking into account the characteristics of the organism;
• various procedures aimed at maintaining a person in a comfortable state;
• periodic medical examination by a specialist;
• fulfillment of doctor’s prescriptions by personnel;
• Pleasant atmosphere and variety of leisure activities.

The most important advantage of the boarding house for patients with Parkinson’s disease is its specialization in the field of this disease. This is not a typical nursing home, but a specialized institution with decent maintenance.

Our establishment cannot be compared even with an experienced nurse. Guests receive comprehensive care, lead an active lifestyle, communicate and feel like full-fledged members of society. You should not deprive them of such pleasures, closed at home with a person who does not understand the features of such a state.

Guests of our boarding house lead an active lifestyle. According to their health condition and doctor’s indications, they participate in various programs, play sports and participate in communication with other people of their age. Such an environment helps to improve the internal state and raise the mood.

Find out the cost of living

You can find out more about the cost of living for elderly people in each boarding house in the main office
or using an online calculator.

Medical

24/7 care and supervision

Daily health monitoring

Functional beds and anti-decubitus mattresses are provided for bedridden patients

Good balanced nutrition (3-6 meals a day)

Control over the intake of medicinal products

Rehabilitation recovery programs

Regular examinations by doctors: therapist and psychiatrist

Physiotherapy exercises

90,000 How to recognize Parkinson’s disease in its early stages?

Until now, medicine cannot give a definite and clear answer to the question of when and why a person begins to develop Parkinson’s disease? At what point does the loss of dopamine-producing cells in the fine motor part of the brain begin to occur?

Parkinson’s disease – causes, developmental factors

The cause of the degeneration is unknown, although a genetic link can be determined in a small percentage of patients.Some scientists suggest that changes in a particular gene are a decisive factor in the onset and development of the disease. As a rule, the disease begins at the age of about 50-60, but it can appear earlier. Various studies have tried to find a link between the development of Parkinson’s disease and environmental factors such as chemical pollution. Others have speculated that nicotine may play a role, but strong evidence has never been found until today.

Parkinson’s disease is a progressive degenerative brain disease characterized by the following clinical signs: limb tremor (tremor at rest), muscle stiffness and slow movement.Patients diagnosed with Parkinson’s have problems with balance, it is difficult for them to stand for a long time, which often leads to falls and, as a result, fractures. Often, external signs of the disease can also appear in facial expressions: the face can seem devoid of expression, flat. But this does not mean that people with Parkinson’s disease do not feel anything and do not understand what is happening around them. The disease does not affect the memory and consciousness of patients.

Diagnosis of Parkinson’s disease

The main problem of Parkinson’s disease is that the symptoms of the disease remain invisible for a long time, the disease develops slowly, for many years a person does not feel anything suspicious in his condition and behavior.Clinical symptoms usually become evident at very late stages, when more than half of the cells of the substantia nigra of the brain are already dead. It is these cells that play an important role in adjusting the motor function of the body. Nerve cells begin to die already in the early stages of the disease, the process occurs gradually, the brain can cope with this problem on its own. But over time, the process of cell death accelerates, and by the time the diagnosis is made, most of the neurons have died. In such a situation, medicine at the current stage of its development can only offer supportive therapy.

The diagnosis of Parkinson’s disease is based on the general clinical picture obtained after consultation with a neurologist. Diagnostic examinations – MRI, ultrasound of the brain – are done mainly in order to exclude other brain pathologies, such as stroke, tumors.

Specialists of neurological departments of medical clinics in Israel say that the main question now is to find optimal and effective examination methods that could solve the problem of early detection of signs of the disease.This is important because at the beginning of the development of the degenerative process, it is still possible to intervene and stop cell death.

How to recognize early signs of illness and predisposition to it?

• You can suspect the first signs if you notice a characteristic gesture of rubbing with your fingers in a loved one: he seems to be counting small coins with his thumb and forefinger.
• The facial expressions change – it becomes poorer, more constrained.
• The sense of smell may disappear.By the way, this is a very characteristic sign for the onset of the development of Parkinson’s disease, and a reason to visit a neurologist.
• It is difficult for a person to get up from a place, to start any movement
• A person may be in a permanent state of depression

The earlier a person turns to a specialist for advice, the more chances of recovery. In the early stages of the disease, drug therapy (drugs amantadine, levodop), physiotherapy, and classes with a psychologist are used.In the early stages, healing is still possible. 90,000 causes, symptoms in women and men, stages of the disease

Parkinson’s disease is one of the most formidable and mysterious diseases of the nervous system. Modern medicine still does not have an answer to the question of why Parkinson’s disease develops and whether it is possible to develop an effective prevention system. Everything related to the causes of parkinsonism is still a mystery for scientists, but the course of the disease has been well studied and active work is currently underway to find drugs, as well as means that can prolong patients’ life and improve its quality.

Parkinson’s disease: what the diagnosis means

This is a disease of the nervous system in which neurons that produce one of the most important neurotransmitters, dopamine, are gradually destroyed. Most often, Parkinson’s disease affects people aged 55–65 years. However, there are cases when the disease was diagnosed in young people aged 30–40 years. There is also the so-called juvenile form, in which the disease affects adolescents under the age of 20.

It is worth saying that men suffer from Parkinson’s disease more often than women, although science has not yet identified the objective reasons for this fact.

Interesting fact

According to statistics, about 4 million people worldwide suffer from Parkinson’s disease today.

The causes of the development of the disease

As already mentioned, the causes of Parkinson’s disease are unclear. All science has is guesswork and theory. The reasons for the development of this disease include primarily genetics.If you have had cases of parkinsonism in your family, especially among close relatives, then your chances of getting sick are slightly higher. About 15% of all patients have relatives who also suffered from Parkinson’s disease.

The environmental situation also plays a role – it is known that some herbicides, pesticides and heavy metal salts can aggravate the symptoms of Parkinson’s disease or provoke its development.

Interesting fact

Parkinson’s disease is the second most common neurodegenerative disease.Alzheimer’s disease ranks first.

In 80% of cases, Parkinson’s disease develops without any prerequisites, but in the remaining 20%, parkinsonism is a complication of other diseases such as encephalitis, brain tumors, stroke, traumatic brain injury and some others. Sometimes poisoning with certain toxic substances (carbon monoxide, ethanol), as well as the intake of narcotic substances and certain medications, in particular antipsychotics, leads to parkinsonism.

Symptoms and signs of Parkinson’s disease

One of the first signs of Parkinson’s disease is a tremor in one arm at rest.As the disease progresses, both hands and head begin to tremble. If the person is agitated or anxious, the tremor increases, but with deliberate action, such as tying shoelaces or working with a computer keyboard, it decreases. Sometimes, in the later stages of the disease, tremors of the eyelids or lower jaw and tongue are added to the tremors of the hands and head.

The main signs of Parkinson’s disease are stiffness and slowness of movements. Patients with such a diagnosis can freeze for a long time in one position, even if it seems uncomfortable.A characteristic shuffling gait develops – a person walks in small steps, as if moving on slippery ice. Hypokinesia also affects the face – it becomes frozen and indifferent, there is a “mask effect”. Speech also suffers, losing its emotional fullness. Patients with parkinsonism speak monotonously and quietly.

Another symptom of Parkinson’s disease is muscle stiffness, or increased muscle tone. Constant tension prompts a person to take a certain posture – the arms bend at the elbows, a stoop appears, the head is tilted forward, the legs are slightly bent.

In the later stages of the disease, the so-called postural instability develops. It is difficult for a person to start moving, and then it is very difficult to stop. The patient gradually loses control over his body, it becomes difficult for him to maintain balance.

Movement disorders are not the only symptom of Parkinson’s disease. In parallel, and sometimes even before the manifestation of tremor, there are disturbances in the work of the autonomic nervous system. The skin becomes oily, there is profuse salivation and sweating, which does not depend on the ambient temperature and physical effort.The sense of smell can be reduced to a complete disappearance. Patients complain of constipation and urinary problems.

Reference

Parkinson’s disease is named for the British doctor James Parkinson, who described its symptoms in his 1817 article “Essay on Shaking Palsy”. Today, the term “tremor palsy” is outdated. Moreover, tremor of the extremities is far from the only symptom of Parkinson’s disease.

Parkinson’s disease rarely affects the intellectual sphere – most patients in the early and middle stages of the development of the disease retain a sharp mind.However, Parkinson’s disease is often accompanied by a slowdown in all thought processes, memory impairment and problems with the formulation of thoughts, indifference to the world and to oneself, low mood and depression.

Visual examination, history taking, and symptom checking are usually sufficient to make a diagnosis. If Parkinson’s disease is suspected, examination methods such as substantia nigra ultrasound, CT or MRI of the brain are used.

Forms of the disease

Today, doctors distinguish three forms of Parkinson’s disease, which differ in the manifestation of one or another symptomatology:

• akinetic-rigid. In this form, the increase in muscle tone is most pronounced, the patient’s movements slow down, complete immobility is possible;
• trembling. This form is manifested by trembling hands, tongue, lower jaw;
• mixed. Usually this form is manifested by tremors of the hands, but later stiffness of movements is added to it.

By the way

Many famous people were diagnosed with Parkinson’s disease – Pope John Paul II, actors Michael Jay Fox (he also organized a fund to study this disease in 2000) and Valentin Gaft, boxers Mohammed Ali and Freddie Roach, musician Ozzy Osbourne, artist Salvador Dali, racer Phil Hill, politician Erich Honnecker.Microsoft founder Bill Gates and basketball player Brian Grant also suffer from Parkinson’s.

Stages of the disease

There are 5 stages of Parkinson’s disease. This classification was developed in 1960 and is still used today:

0 stage – no movement disorders;

Stage I – movement disorders on one side of the body;

Stage II – bilateral movement disorders, in which the patient walks without restrictions, maintains balance;

Stage III – moderate postural instability appears, but the patient does not yet need outside help;

Stage IV – significant disturbances in motor activity, the patient cannot perform complex movements, but does not need support in order to stand and walk;

Stage V – the patient cannot move without assistance.