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 Parkinsons 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.
How Is A Diagnosis Made
Because other conditions and medications mimic the symptoms of PD, getting an accurate diagnosis from a physician is important. No single test can confirm a diagnosis of PD, because the symptoms vary from person to person. A thorough history and physical exam should be enough for a diagnosis to be made. Other conditions that have Parkinsons-like symptoms include Parkinsons plus, essential tremor, progressive supranuclear palsy, multi-system atrophy, dystonia, and normal pressure hydrocephalus.
What Role Do Genes Play
Your genes are like your body’s instruction book. So if you get a change in one of them, it can make your body work in a slightly different way. Sometimes, that means you’re more likely to get a certain disease.
There are several genetic mutations that can raise your risk for Parkinson’s, each by a little bit. They have a part in about 1 in 10 cases.
If you have one or more of these changes, it doesn’t mean you’ll get Parkinson’s. Some people will, but many won’t, and doctors don’t know why. It may have to do with other genes or something in your environment.
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What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- 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 .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
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.
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How Is Parkinson’s Disease Diagnosed
The diagnosis of Parkinson’s disease usually takes into account the clinical condition of the patient, since there are no accurate exams for this. Indication of the performance of brain tomography and magnetic resonance its purpose is to rule out other diseases that can cause a similar clinical picture in the patient. There is also the single-photon emission tomography, a test that helps quantify brain dopamine.
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.
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What If I Carry The Gene
There are ongoing clinical trials testing therapies to treat people who have Parkinson’s and carry certain gene mutations. Proving that it can be important to know which gene mutation you carry. Consult with your doctor when considering a genetic test to determine if you are eligible to participate in gene-based clinical trials.
The Parkinsons Foundation study, PD GENEration: Mapping the Future of Parkinsons Disease, is the first national study to offer genetic testing and counseling at no cost for those with a confirmed Parkinsons diagnosis. Learn more and enroll at Parkinson.org/PDGENEration.
*Please note that not all content is available in both languages. If you are interested in receiving Spanish communications, we recommend selecting both” to stay best informed on the Foundation’s work and the latest in PD news.
How Is Parkinson’s Disease Managed
Your doctors will tailor your treatment based on your individual circumstances. You will manage your condition best if you have the support of a team, which may include a general practitioner, neurologist, physiotherapist, occupational therapist, psychologist, specialist nurse and dietitian.
While there is no cure for Parkinson’s disease, symptoms can be treated with a combination of the following.
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What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons 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 Parkinsons 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 Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa 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 .
Deep Brain Stimulation For Parkinson’s: Am I A Candidate
Deep brain stimulation is not a cure, but it can relieve your symptoms from Parkinson’s disease when medications are not an option. Only you and your doctor can decide if this surgical procedure is right for you. You may be a candidate for deep brain stimulation if:
- You have idiopathic Parkinson’s disease. Patients with atypical parkinsonism are not candidates.
- You have good motor function and independence during your best “on” state when taking the drug Sinemet.
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Contact Our Information And Referral Helpline
The Parkinson Canada Information and Referral Helpline is a toll-free Canada-wide number for people living with Parkinsons, their caregivers and health care professionals. We provide free and confidential non-medical information and referral services. When you have questions or need assistance, our information and referral staff help connect you with resources and community programs and services that can help you. We provide help by phone or email, Monday to Friday, 9:00 a.m. 5:00 p.m. ET.
Clinical History And Testing
Diagnostic tests can be used to establish some features of the condition and distinguish them from symptoms of other conditions. Diagnosis may include taking the person’s , a physical exam, assessment of neurological function, testing to rule out conditions that may cause similar symptoms, brain imaging, to assess cognitive function,, or myocardial scintigraphy. Laboratory testing can rule out other conditions that can cause similar symptoms, such as abnormal , , , or vitamin deficiencies that may cause symptoms similar to dementia.
Dementia screening tests are the and the . For tests of attention, , , and can be used for simple screening, and the Revised Digit Symbol Subtest of the may show defects in attention that are characteristic of DLB. The , and are used for evaluation of executive function, and there are many other screening instruments available.
If DLB is suspected when parkinsonism and dementia are the only presenting features, PET or SPECT imaging may show reduced dopamine transporter activity. A DLB diagnosis may be warranted if other conditions with reduced dopamine transporter uptake can be ruled out.
Since 2001, – has been used diagnostically in East Asia , but not in the United States. MIBG is taken up by nerve endings, such as those that innervate the heart, and is for scintigraphy with radioactive 123iodine. Autonomic dysfunction resulting from damage to nerves in the heart in patients with DLB is associated with lower cardiac uptake of 123I-MIBG.
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What Treatments Are Available
Many Parkinson’s patients enjoy an active lifestyle and a normal life expectancy. Maintaining a healthy lifestyle by eating a balanced diet and staying physically active contributes to overall health and well-being. Parkinson’s disease can be managed with self-care, medication, and surgery.
Self careExercise is as important as medication in the treatment of PD. It helps maintain flexibility and improves balance and range of motion. Patients may want to join a support group and continue enjoyable activities to improve their quality of life. Equally important is the health and well being of the family and caregivers who are also coping with PD. For additional pointers, see Coping With Parkinsons Disease.
These are some practical tips patients can use:
Medications There are several types of medications used to manage Parkinson’s. These medications may be used alone or in combination with each other, depending if your symptoms are mild or advanced.
After a time on medication, patients may notice that each dose wears off before the next dose can be taken or erratic fluctuations in dose effect . Anti-Parkinsons drugs can cause dyskinesia, which are involuntary jerking or swaying movements that typically occur at peak dosage and are caused by an overload of dopamine medication. Sometimes dyskinesia can be more troublesome than the Parkinsons symptoms.
How Is Parkinson’s Disease Treated
Many advances have been made since the initial description of Parkinson’s disease, however, although there are medicines that help reduce signs and symptoms, none of them have curative capacity. Also, there are surgical treatments that aim to reduce tremors in the patient.
Surgery, however, is not recommended in all cases and should not be performed, for example, in people who have developed dementia. To ensure a better quality of life for the patient, it is recommended that the treatment be multidisciplinary, with a team composed of professionals such as physiotherapists, speech therapists and psychologists.
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Questions People Ask About Parkinsons Disease
- How long can a person live with Parkinsons disease? People with this condition can expect to live almost as long as other people without the disease.
- Can Parkinson disease be cured? No, Parkinsons disease can not be cured.
- How do Parkinsons patients die? The two main causes of death in people with PD are pneumonia and falls. due to the rigidity associated with the disease, they are prone to higher risk of falling.
How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons 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 or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons 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 Parkinsons 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.
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Living With Parkinson’s Disease
As Parkinson’s develops, a person who has it may slow down and won’t be able to move or talk quickly. Sometimes, speech therapy and occupational therapy are needed. This may sound silly, but someone who has Parkinson’s disease may need to learn how to fall down safely.
If getting dressed is hard for a person with Parkinson’s, clothing with Velcro and elastic can be easier to use than buttons and zippers. The person also might need to have railings installed around the house to prevent falls.
If you know someone who has Parkinson’s disease, you can help by being a good friend.
Causes Of Parkinsons Disease
Parkinsons disease is a progressive neurodegenerative disorder best known for its movement-related symptoms. However, it also causes cognitive changes.
Parkinsons underlying cause is the death of dopamine-producing neurons, or nerve cells, in a brain region called the substantia nigra.
Dopamine is a neurotransmitter, which is a molecule produced by the body to send messages between nerve cells. It is involved in a range of behaviors, including control of body movements, learning and memory, the sleep-wake cycle, and moods, such as depression and mania.
Both genetic and environmental factors appear to influence a persons risk of developing Parkinsons. Thats why the disorder is thought to be a product of a combination of these factors. Genetics loads the gun and environment pulls the trigger, is one way Parkinsons has been described.
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How Do Doctors Diagnose Parkinsonism
No single test exists for doctors to diagnose Parkinsonism.
A doctor will start by taking a persons health history and review their current symptoms. They will ask for a medication list to determine if any medicines could be causing the symptoms.
A doctor will likely also order blood testing to check for underlying potential causes, such as thyroid or liver problems. A doctor will also order imaging scans to examine the brain and body for other causes, such as a brain tumor.
Doctors can perform a test that tracks the movement of dopamine in the brain. This is known as the DaT-SPECT test.
The test uses radioactive markers designed to track dopamine in the brain. This allows a doctor to watch the release of dopamine in a persons brain and identify the areas of the brain that do or do not receive it.
Because Parkinsonism does not respond to typical treatments and can have a variety of symptoms, doctors can have difficulty coming to a quick diagnosis. It may take time for doctors to rule out other conditions and begin to make treatment recommendations.
Which Age Group Is Parkinsonism More Prevalent In
There is more data on the incidence of Parkinsons disease than there is for Parkinsonism. The incidence of Parkinsons disease increases with age, and the diagnosis is more likely in older populations.
About 4% of people with Parkinsons disease will be diagnosed before they turn 50 years old.
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Parkinson’s Disease Diet And Nutrition
Maintaining Your Weight With Parkinson’s Disease
Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.
- Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
- If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
- Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.
Pesticide And Herbicide Exposure
A strong link has been shown between PD and exposure to pesticides and herbicides. We need more Parkinsons-specific research to better understand what causes PD and to work to prevent it and help eliminate the risk of getting the disease, when it comes to all environmental risk factors and whether genetics can cause an increased risk in developing Parkinsons.
One herbicide that has been linked to Parkinsons is paraquat, a widely used commercial herbicide in the U.S. that is banned in 32 countries, including the European Union and China. The Parkinsons Foundation, along with the Unified Parkinsons Advocacy Council, signed two letters to the U.S. Environmental Protection Agency encouraging them to cancel the registration of paraquat based on strong scientific research linking the herbicide to Parkinsons disease. In October 2020, the EPA re-approved paraquat for use in the U.S. Without additional action, paraquat will remain legal for sale and use in the U.S. for the next 15 years.
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