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.
Is Early Diagnosis Possible
Experts are becoming more aware of symptoms of Parkinsons that precede physical manifestations. Clues to the disease that sometimes show up before motor symptoms and before a formal diagnosis are called prodromal symptoms. These include the loss of sense of smell, a sleep disturbance called REM behavior disorder, ongoing constipation thats not otherwise explained and mood disorders, such as anxiety and depression.
Research into these and other early symptoms holds promise for even more sensitive testing and diagnosis.
For example, biomarker research is trying to answer the question of who gets Parkinsons disease. Researchers hope that once doctors can predict that a person with very early symptoms will eventually get Parkinsons disease, those patients can be appropriately treated. At the very least, these advances could greatly delay progression.
Parkinson’s Disease and Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
Tips For Caring For Someone With Parkinsons Disease
Caring for a loved one with early onset Parkinsons can be difficult. If youre a caregiver for someone with this condition, its important that you remember your own emotional and physical health.
Not only are you dealing with a difficult diagnosis, youre also managing an increased number of responsibilities. Burnout is common in caregivers, so make sure youre checking in with your own needs.
The Michael J. Fox Foundation Center for Parkinsons Research recommends these tips for caregivers:
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How It All Fits Together
Diagnosing Parkinsons disease can be tricky. The process relies heavily on your doctors judgment. In addition, the causes and risk factors of Parkinsons are not entirely clear yet, which contributes to the difficulty in diagnosing this condition.
However, there have been efforts to try and detect this disease earlier. For instance, clinicians have started focusing more on prodromal symptoms, which are early symptoms that appear before movement-related difficulties begin.;
These symptoms include:
- Loss of smell, which can sometimes occur years before other symptoms
- Chronic constipation, without any other explanation
- Rapid eye movement behavior disorder, which causes sleep disturbances
Gait & Balance Abnormalities
Parkinsons Disease Exam
Patients with Parkinsons disease can develop an alteration of the postural reflexes that causes instability in gait and balance control. Such alterations usually develop later in the course of the illness and are a major cause of disability, especially because of the high risk for falls that derives.
Using the exam to pick up postural instability is of the utmost importance for the management of patients with PD, since it will trigger either a medication adjustment or a physical therapy intervention both aimed at falls prevention.
We have three tests for this part of the PD exam:
1);;;; Standing up from a chair
2);;;; Free walking
3);;;; Provoked pull test maneuver for balance
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How Parkinsons Disease Is Diagnosed
Diagnosing Parkinsons disease can be complicated because there isnt a specific blood test or screening test that can determine whether or not you have it.
Instead, Parkinsons is diagnosed clinically, which means a doctor will examine you, review your symptoms and medical history, and diagnose accordingly.;
Parkinsons disease is a neurological condition that can make movement difficult. If your general practitioner thinks you might have Parkinsons, they may refer you to a neurologist who specializes in movement disorders for a diagnosis.;
It can be challenging to catch Parkinsons in the early stages because the symptoms may be too mild to notice or meet the diagnostic criteria. Also, early Parkinsons symptoms are often mistaken for typical signs of aging.
The symptoms of Parkinsons disease are also similar to those of other health conditions, which may be misdiagnosed as Parkinsons at first. Your doctor may suggest specific tests and scans to help eliminate other conditions that can mimic the symptoms of Parkinsons disease.
Other Typical Symptoms Of Parkinson’s
Tremor is;an uncontrollable movement that affects a part of the body. A Parkinsons tremor typically starts in the hand before spreading to affect the rest of the arm, or down to the foot on the same side of the body.;
There is no cure for a tremor, but there are ways to manage the symptom with support from a specialist or Parkinsons nurse.
Slowness of movement also known as bradykinesia may mean that it takes someone with;Parkinson’s;longer to do things. For example, they might struggle with coordination, walking may become more like a shuffle or;walking speed may slow down.;
Everyday tasks, such as paying for items at a check-out or walking to a bus stop, might take;longer to do.
Parkinsons causes stiff muscles, inflexibility and cramps. This can make certain tasks such as writing, doing up buttons or tying shoe laces, hard to do. Rigidity can stop muscles from stretching and relaxing. It can be particularly noticeable, for example, if you;struggle to turn over or get in and out of bed.
Symptoms and the rate at which they develop will vary from person to person. The most important thing to do if youre worried you have Parkinsons is to speak to your GP.;
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Why Is Distinguishing Young
Socially, people who are affected by PD at a younger age experience the disease differently they may be at a different stage of their career and often have less time to engage in their own care. They may also have children or are planning to have children and have questions regarding passing on PD genes.
Medically, doctors tailor treatment when it is a younger person with PD. The younger you are, the more likely the disease is genetic. Your care team may offer genetic testing or counseling. Younger brains also have a higher neuroplasticity potential which allows the brain to handle and respond to disease and therapy differently.;
A Patient Perspective On Early
Michael S. Fitts, assistant dean for user access and diversity for The University of Alabama at Birmingham, speaks on his experience with early-onset Parkinson disease and the challenges and misconceptions associated with the condition.
Michael S. Fitts, assistant dean for user access and diversity for The University of Alabama at Birmingham, speaks on his experience being diagnosed with early-onset Parkinson disease at the age of 38 and the challenges and misconceptions associated with the condition.
Transcript
AJMC®: Hello, I’m Matthew Gavidia. Today on the MJH Life Sciences Medical World News, The American Journal of Managed Care® is pleased to welcome Michael S. Fitts, assistant dean for user access and diversity for The University of Alabama at Birmingham.
Diagnosed at the age of 38 with Parkinson disease, Michael serves as an advocate for the education of those with early-onset Parkinson disease and is part the Michael J. Fox Foundation Patient Council.
Michael, glad to have you on. Can you just introduce yourself and tell us a little bit more about your work?
Fitts: Yes, thank you for having me. As you already said, my name is Michael Fitts, and I am a patient advocate for the Michael J. Fox Foundation’s Patient Council. As far as my full-time job, I work at the University of Alabama at Birmingham, specifically UAB libraries, and there I serve as assistant dean for user access, which is all the services that we provide for the students, staff, and faculty.
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Diagnosing Early Onset Parkinsons Disease
There is no single test to detect Parkinsons. A diagnosis may be difficult and take a while. The condition is usually diagnosed by a neurologist based on a review of your symptoms and a physical exam.
A DaTscan to visualize your brains dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, dont diagnose Parkinsons. However, they may be used to rule out other conditions.
Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons 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.
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Manage Parkinsons Disease Through Diet & Nutrition
A healthy diet can help people living with Parkinsons disease achieve or maintain normal body weight, increase your energy level, boost your immune system, decrease risk factors for certain conditions or illnesses, and reduce constipation.
Parkinsons disease and diet should be considered together. It can be particularly helpful for people with early onset Parkinsons disease to pay close attention to issues of diet and nutrition to living with Parkinsons. Thats because poor nutritional status can result in, and contribute to, many of the common complaints associated with Parkinsons disease. For example, difficulties with swallowing can prevent people with Parkinsons disease from getting adequate nourishment, which can lead to a worsening of motor symptoms and increased weakness resulting in falls.
People with Parkinsons Disease may also find that certain medications, or medication side effects, have an impact on their diet or nutrition. Any time you are prescribed a new medication, it is a good idea to ask your physician about any dietary restrictions and whether it is best to take the medication with or without food. This is particularly important with Parkinsons disease medications because certain food groups as well as the timing of meals can interfere with how quickly or fully your body is able to absorb the medication
Why Is Expert Care Important
Early expert care can help reduce PD complications. Findings show that 60 percent of people with Parkinson’s fall short of getting the expert care they need. The National Parkinson Foundation has estimated that about 6,400 people with Parkinson’s die;unnecessarily;;each year due to poor care.
Trained neurologists will help you recognize, treat and manage the disease. Common approaches include medication, surgical treatment, lifestyle modifications , physical therapy, support groups, occupational therapy and speech therapy. The best approach is interdisciplinary care, where you are seen by multiple specialists on a regular basis and all of the specialists talk and arrange the best possible coordinated care. This is what is referred to as a patient-centric approach to Parkinson’s care.
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Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
Diagnosis In Young Onset Parkinsons
Many young onset patients experience delay in diagnosis given the uncommon age and often different symptoms as outlined below. Similar to late onset patients, the diagnosis is made based on history and clinical examination. There are still no proven diagnostic tests that can definitively diagnose PD. In some cases, other mimics of Parkinsons need to be evaluated for given their increased likelihood in younger patients. Given the complexities, it is important to seek evaluation by a neurologist and in many cases a movement disorder specialist.
In addition, young onset patients are more likely to have a genetic risk factor or cause to their symptoms, especially if there is a family history. Genetic testing can be considered, but should always be done after consulting a physician and in many cases a genetic counselor.
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How To Spot Symptoms In Yourself Or Someone You Love
Most diagnoses of;Parkinsons disease;come after age 60, but about 4 percent of diagnoses come before age 50. What signs of Parkinsons should you watch out for in yourself or someone you love?;
Diagnosing Parkinsons; SomeParkinsons diseases symptomsare well known, like the tremors;that;boxing great Muhammad;Ali;experienced. But Parkinsons is often difficult to diagnose when its in its early stages, and no blood or imaging test can confirm if someone has the disease.;
So how is Parkinsons diagnosed? A healthcare provider will take a medical history and look for signs. In addition to slow movementcalled bradykinesiaeither stiffness or tremors must also be present. The HCP may also use a SPECT test that tracks the chemical dopamine in the brain. But your HCP needs to know to look for Parkinsons, and thats where you come in. Tell your HCP if youve noticed any of these early warning signs.;
Early warning signs;of Parkinsons;disease;1. Tremors. If one of your fingers, a foot, or part of the jaw or face shakes while youre at rest, that could be an early sign of Parkinsons. Tremors usually start on one side of the body, and eventually progress to the whole body as the disease progresses.;
3. Rigid limbs.Stiffness in the arms or legs is another hallmark sign;of Parkinson’s. Like tremors, rigidity often starts on one side of the body before it progresses to the other. Take note if you notice that you’re starting to shuffle, or not swinging one of your arms as you walk.;
What Is Parkinson’s Disease
Parkinsons disease occurs when;brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is;unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Parkinsons affects;nearly 1 million people in the United States;and;more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our;Parkinsons 360 toolkit.
What Is Parkinson’s Disease?
Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
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What Is The Pattern Of Disease In Pd
The onset of PD usually occurs in patients in their sixties, and the disease progresses slowly. Although PD eventually results in severe disability and often dementia, life expectancy is not significantly shortened. Death is often due to secondary problems associated with the disease such as falls, pneumonia, aspiration, and immobility.
Figure 2. The onset of Parkinsons disease usually occurs in patients older than 60 and the disease progresses slowly.
Signs And Symptoms Indicating That The Patient May Not Have Classic Pd
There are several other Parkinsons-like diseases that, while similar to PD, are not technically classified as PD. These diseases may not respond as well to treatment as PD does:
- Progressive supranuclear palsy;
- Dementia with Lewy bodies;
- Corticobasal degeneration
Be sure to evaluate your patient for signs and symptoms which may indicate that the patient does not have classic PD. These signs and symptoms may include urinary or fecal incontinence, disabling;orthostatic hypotension, early onset , poor;response to PD medications, symmetry;of findings early in the disease, and a lack;of tremor.;
Figure 5. Signs;and symptoms which may indicate that the patient does not have classic Parkinsons disease, including urinary incontinence, orthostatic hypotension, early onset, poor response to PD medications, symmetry of findings early in the disease, and a lack of tremor.
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