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 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 Parkinsons disease and Lewy body dementia.
End Stage Of Parkinsons
It starts with a;slight;tremor in the hand. Or maybe trouble sleeping.;Then the arms and legs grow stiff.;Shoulders hunch. Steps become slow and;spasmodic.;Your loved one can barely talk, and their muscles shake so badly;it is a struggle to get dressed.;Their balance;is so poor the doctor;advises;you to buy them a walker.;But the disease has left them so weak, you;doubt it is safe to leave them on their own anymore.;;
Parkinsons;develops;differently in each patient. Some;deteriorate;rapidly, while others;remain;strong and active for years.;It is unclear why. Doctors know that;exercise and physical therapy can slow the disease,;but;there is no way to stop it.;Even the healthiest patients;will;eventually;decline until the;end stage of Parkinsons, when they are left completely dependent on family and caretakers.;;;
Anyone;whos;loved one;has been diagnosed;needs to be aware of the challenges ahead. It will leave you ready to offer help;as their condition;worsens;and ask for it;when it grows unmanageable.;;
Va Disability Compensation And Parkinsons Disease
Presumptive Service Connection for Parkinsons
Creating a presumption is VAs way of making an exception to the usual requirements for service connection. Often used for toxic exposures that affected large groups of veterans, VA will automatically presume that veterans in a certain place during a certain time period were exposed to toxins . Presumptive conditions are diseases or disabilities that VA automatically assumes are related to the acknowledged exposure, meaning the veteran does not have to provide a medical nexus, or link, between the toxic exposure and the resulting condition .
Parkinsons disease is currently listed as a presumptive condition for veterans who served:
- in Vietnam for any length of time between January 9, 1962, and May 7, 1975,;or
- in the Korean Demilitarized Zone for any length of time between April 1, 1968, and August 31, 1971, or
- at Camp Lejeune for at least 30 days between the August 1953 and December 1987.
If you served in one of these locations during the specified time period, you need only show VA documentation of where you served and that you have a current diagnosis of Parkinsons disease to prove your claim.
Service Connection for Parkinsons without a Presumption
Exposure to burn pits: Parkinsons can also present in veterans who were exposed to burn pits in the Southwest Asia Theater of Operations after September 11, 2001.
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Identifying Risk Factors For Parkinson’s
The risk for early death increased by about 40% for every 10-year increase in age at diagnosis.
Parkinsonâs researcher Tobias Kurth, MD, agrees that identifying risk factors for early death could help clinicians better manage the disease.
Kurth is an adjunct associate professor of epidemiology at Harvard School of Public Health.
âThis is important research that adds to our understanding of the impact of specific features of Parkinsonâs disease on outcomes,â he tells WebMD.
His own study of Parkinsonâs-associated death matched Parkinsonâs patients with people without the disease who had similar non-Parkinsonâs-related illnesses.
Like the newly reported study, patients who were older when their Parkinsonâs disease was diagnosed had a greater risk for early death.
What Are The Risk Factors For Parkinsons Disease
Risk factors for Parkinsons disease include:
People with a first-degree relative with Parkinsons are at an increased risk for the disease possibly as much as 9 percent greater.
Fifteen to 25 percent of people with Parkinsons have a known relative with the disease, but a condition called familial Parkinsons, which has a known genetic link, is relatively rare.
The average age of onset is 60 years, and the incidence rises with advancing age. About 10 percent of people have early-onset or young-onset disease, which begins before age 50.
Parkinsons affects about 50 percent more men than women, for unknown reasons.
Exposure to some pesticides has been shown to raise the risk of developing Parkinsons.
Problematic chemicals include organochlorine pesticides like DDT, dieldrin, and chlordane. Rotenone and permethrin have also been implicated.
Fungicide and Herbicide Exposure
Exposure to the fungicide maneb or the herbicides 2,4-dichlorophenoxyacetic acid , paraquat, or Agent Orange may raise the risk of Parkinsons.
The U.S. Veterans Health Administration considers Parkinsons to be a possible service-related illness if the person was exposed to significant amounts of Agent Orange.
Head injuries may contribute to the development of Parkinsons in some people.
Coffee and Smoking
People who drink coffee or smoke tobacco have been found to have a lower risk of Parkinsons disease, for reasons that remain unclear.
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What Are Lewy Bodies
The affected neurons of people with Parkinsons disease have been found to contain clumped proteins called Lewy bodies, but researchers arent yet sure why Lewy bodies form or what role they play in the disease.
Lewy bodies are clumps of a;protein;called alpha-synuclein . Neurons cant break down these protein clumps, which may lead to the death of these cells.
Some other theories about what causes the death of brain cells in people with Parkinsons disease include free radical damage, inflammation, or toxins.
European Parkinsons Disease Association
The European Parkinsons Disease Association ;is a European Parkinson’s umbrella organisation. They represent 45 member organisations;and advocate for the rights and needs of more than 1.2 million people with Parkinsons and their families.
The EPDA vision is to enable all people with Parkinson’s in Europe to live a full life while supporting the search for a cure.
The group launched the European Parkinsons Disease Standards of care Consensus Statement;in the European Parliament in November 2011. The document defines what the optimal management of Parkinsons should be and what good-quality care should consist of. The document is not only developed by experts in the field of Parkinsons but includes the voice of people with Parkinsons. In addition to this, they have produced some amazing resources to introduce people to the condition.
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Stage Three Of Parkinsons Disease
Balance is compromised by the inability to make the rapid, automatic and involuntary adjustments necessary to prevent falling, and falls are common at this stage. All other symptoms of PD are also present at this stage, and generally diagnosis is not in doubt at stage three.
Often a physician will diagnose impairments in reflexes at this stage by standing behind the patient and gently pulling the shoulders to determine if the patient has trouble maintaining balance and falls backward . An important clarifying factor of stage three is that the patient is still fully independent in their daily living activities, such as dressing, hygiene, and eating.
Palliative Model Aims To Improve Quality Of Life At Early Disease Stages
People with Parkinson’s disease who had palliative care at relatively early stages of their disease had improved outcomes, a randomized clinical trial showed.
At the study’s primary endpoint of 6 months, Parkinson’s patients who added outpatient palliative care to their treatment plan had improved quality of life and better symptom burden than patients who had standard care alone, according to Benzi Kluger, MD, of the University of Colorado in Denver, and co-authors.
However, by 12 months, quality-of-life measures were not significantly different between the two groups, the team reported in JAMA Neurology.
No difference was found in caregiver burden at 6 months, but by 12 months, caregivers in the palliative care group experienced significantly less burden than caregivers in the standard care group, the researchers added.
This is the first large randomized trial of outpatient palliative care for neurodegenerative disease, Kluger said.
“There has been increasing rationale and interest within the field of palliative care to move outside of cancer and to deliver care earlier, but very little evidence,” he told MedPage Today. “This study tells us that palliative care can be helpful for persons with neurodegenerative illnesses and that it may be beneficial to deliver palliative care earlier in the course of these illnesses than traditionally done with hospice.”
The study was supported by a Patient-Centered Outcomes Research Institute grant.
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The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute;about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
Research And Statistics: Who Has Parkinsons Disease
According to the Parkinsons Foundation, nearly 1 million people in the United States are living with the disease. More than 10 million people worldwide have Parkinsons.
About 4 percent of people with Parkinsons are diagnosed before age 50.
Men are 1.5 times more likely to develop the disease than women.
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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
- 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. Its 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.
If You Live In South Jersey And Have Questions About The Final Stages Of Parkinsons Disease Or Hospice Care For Your Loved One Please Call Samaritan At 229
Samaritan is a member of the;National Partnership for Healthcare and Hospice Innovation, a network of not-for-profit hospice and palliative providers across the country. If you know someone outside of our service area who is living with advanced illness and can benefit from hospice or palliative care, please call;1 -GET-NPHI; for a referral to a not-for-profit provider in your area.
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What Is The Prognosis And Life Expectancy For Parkinson’s Disease
The severity of Parkinson’s disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinson’s disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
Do People Die From Parkinson’s
PD does not directly kill patients; people with PD die from other causes, not from PD itself. Two major causes of death for those with PD are falls and pneumonia.
People with PD are at higher risk of falling, and serious falls that require surgery carry the risk of infection, adverse events with medication and anesthesia, heart failure, and blood clots from immobility.3
Pneumonia is a common cause of death, and those with PD are at risk for aspiration pneumonia.3 People with PD often have problems with swallowing, so the risk of aspirating food or drink, or having food or drink going down the wrong pipe is higher. In PD, the person may not be able to cough up the food or drink they aspirated, and it can remain in the lungs, eventually causing an infection.3 Even with general pneumonia, when coughing is weakened, as in PD, the mucus and other material that needs to be coughed up isnt able to be expelled, and this makes effective treatment of pneumonia more difficult in those with PD.
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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
Diagnosis Of Parkinsons 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.
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How Can Parkinson’s Affect Someone At The Advanced Or Palliative Stage
Parkinsons progresses in stages: diagnosis, maintenance, advanced and palliative. Professionals should have talk to people with Parkinsons about advance care planning in the earlier stages of the disease. This can allow them to express their wishes and preferences for their care in the later stages of the disease and make plans for the future.
Although the condition progresses differently and at a different speed for each person, the advanced stage can potentially cover a long period of time.
Problems that affect someone with advanced Parkinsons may include:
- medicines being less effective at managing symptoms than before
- having to take lots of medicines to manage symptoms and side effects
- more off periods when the effects of medication are reduced, and people experience movement fluctuations and involuntary movements
- increased mobility problems and falls
- swallowing difficulties
- less control of their Parkinsons symptoms, which become less predictable
Some of the more advanced symptoms can lead to increased disability and poor health, which can make someone more vulnerable to infection, such as pneumonia. People with Parkinsons most often die because of an infection or another condition, usually caused by Parkinsons.
Myth : Parkinsons Is Only A Motor Condition
Fact: While its true that Parkinsons disease symptoms include shaking and tremor, rigid muscles, slowness of movement, and a frozen or flat expression, its a lot more than that.
Nonmotor symptoms deserve and are getting more attention from doctors and researchers. These symptoms include cognitive impairment or dementia , anxiety and depression, fatigue, sleep problems and more.
For some patients, nonmotor symptoms are more disabling than motor symptoms, which are the focus of treatment. Be sure to talk to your doctor about other issues so you can get all of your symptoms addressed.
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How Can I Support Someone With Parkinson’s At The Advanced Or Palliative Stage
In the advanced stages of Parkinsons, your patients care needs may be more complex and require careful planning along with the patient, their family and other health and social care professionals involved.
Palliative care should be holistic, considering the whole person to support the personal, social, psychological and spiritual needs of your patient and their family.;It should give your patient some control and choice over areas such as treatment options and where they will be cared for, as well as providing advice and support to all the people involved in their care.
Palliative care in Parkinsons may be supported by a number of professionals, including a Parkinsons nurse specialist, local hospice or specialist palliative care team, physiotherapist, occupational therapist, speech and language therapist or dietitian.;Many people with Parkinson’s also find complementary therapies beneficial.
It is important that you find out whether the person has a care plan in place regarding their preferences for how the issues surrounding advanced Parkinsons should be managed. This could include legal documentation such as a Lasting Power of Attorney and an advance care plan. Advance care plans include information on what the persons wishes and preferences are for their care in the future.;They may include decisions on any treatments the person doesnt want to have in the future this is called an Advance Directive, Advance Decision to Refuse Treatment or Living Will.
Stage Two Of Parkinsons Disease
Stage two is still considered early disease in PD, and it is characterized by symptoms on both sides of the body or at the midline without impairment to balance. Stage two may develop months or years after stage one.
Symptoms of PD in stage two may include the loss of facial expression on both sides of the face, decreased blinking, speech abnormalities, soft voice, monotone voice, fading volume after starting to speak loudly, slurring speech, stiffness or rigidity of the muscles in the trunk that may result in neck or back pain, stooped posture, and general slowness in all activities of daily living. However, at this stage the individual is still able to perform tasks of daily living.
Diagnosis may be easy at this stage if the patient has a tremor; however, if stage one was missed and the only symptoms of stage two are slowness or lack of spontaneous movement, PD could be misinterpreted as only advancing age.