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.
Talk To Your Physician
When multiple signs of Parkinsons disease appear, it is important that the senior consult with a doctor. A medical professional will develop a plan to stay healthy. A neurologist, physical therapist, occupational therapist, speech therapist or social worker may become involved to help the senior better live with the condition.
Since the cause of Parkinsons disease is unknown, prevention methods are unavailable. However, some research concludes that aerobic exercise may help reduce the risk of developing Parkinsons disease. Plus, other research finds that seniors who consume caffeine are less likely to get the disease.
Two Areas In Which Parkinsons Disease May Bring About Death
PD patients are at an increased risk of falling and bad falls can lead to death. This usually occurs as a complication of a fall that requires hospitalization, particularly if it involves surgery. While most people do not fracture their hips when they fall, some do, and hip surgery, while routine, is still major surgery. It carries the risk of infection, delirium related to pain medications and anesthesia, heart failure, pneumonia, blood clots in the legs that then go to the lungs, and general weakness from immobility. Hip fractures are probably the main cause for death for those who fall, but people can fracture other bones and require surgery. They may fracture their ribs, which leads to reduced coughing, because of the pain, and an increased risk of lung infections . It is surprisingly uncommon for Parkinsons Disease patients to die from brain injuries related to falls, but it still may occur.
PD patients also may develop pneumonias completely unrelated to difficulties with swallowing, just like their non-PD friends and relatives.
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Problems With Balance Or Walking
Bradykinesia can also contribute to increasing instability, walking difficulties and changes in gait. An early symptom of this is a decrease in the natural swing of one or both arms when walking. As things progress, the steps you take may become slower and smaller, and you may start shuffling your feet.
Some people with Parkinsons disease may also experience freezing episodes where it can feel like their feet are stuck in place, which can increase the risk of falling.
Do People Actually Lose Their Sense Of Smell With Parkinson’s
A: Yes. It’s a condition called anosmia, and if you have it with no other disease , you have at least a 50 percent chance of developing Parkinson’s disease in the next five to 10 years. What happens is that alpha-synuclein, the protein that clumps in the part of the brain that regulates dopamine and leads to Parkinson’s disease, also aggregates in the olfactory bulb, the part of the brain responsible for your sense of smell. This happens well before the protein accumulations cause motor symptoms.
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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.
Testing For Parkinsons Disease
There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.
A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.
The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.
The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.
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Early Symptoms Of Parkinson’s Disease
Parkinson’s disease is a progressive disease of the nervous system that affects movement. Approximately 1 million people in the U.S. are living with the disease. This year, about 60,000 more will be diagnosed with Parkinson’s disease.
Many people associate Parkinson’s disease with tremors or shaking of their hands. While this is a common symptom, other important symptoms include stiffness of muscles and slowing of movement.
Symptoms of Parkinson’s disease usually start on one side of the body. They usually remain worse on that side even after symptoms begin to affect both sides.
The early signs and symptoms are different for each person. The symptoms may be mild enough to go unnoticed for months or years.
Here are early symptoms that can raise concern for Parkinson’s disease:
- Smaller handwriting
- Family members may observe that one arm swings less on one side when walking.
- Soft or low voice Again, it is family members or friends who may ask one to speak louder. The speech may be more of a monotone without the usual inflections.
It is the combination of several symptoms that would raise suspicion for Parkinson’s disease. A single symptom is not enough to make a diagnosis of Parkinson’s disease.
It is important to talk with your health care provider if you have any of the symptoms associated with Parkinson’s disease. This is to properly diagnose the condition and rule out other conditions with similar symptoms.
What Is Parkinson’s Disease Its A Movement Disorder
Parkinson’s disease is a progressive brain illness that affects the way you move. In more clinical terms, Parkinsons disease is a neurodegenerative disorder of the central nervous system.
Normally, there are cells in the brain that produce a chemical called dopamine. Dopamine sends signals to the parts of your brain that control movement. When approximately 60-80% of the dopamine-producing brain cells are damaged, symptoms of Parkinson’s disease appear, and you may have trouble moving the way you want.
Parkinson’s disease is a chronic illness and it slowly progresses over time. While there is no therapy or medicine that cures Parkinsons disease, there are good treatment options available that can help you live a full life.
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What Are Signs Of Parkinsons Disease
When a senior displays one of the following signs, it should not be an immediate cause for concern. However, if the elderly individual shows multiple symptoms, an appointment should be made with the seniors doctor for a diagnosis and care plan.
A slight tremor in the hand, chin, finger or thumb while at rest is a common, early sign of Parkinsons disease. Shaking might even begin in a limb. The senior may also experience a pill-rolling tremor, where the individual rubs the thumb and forefinger back and forth.
It is normal for seniors to experience shaking or tremors after a heavy exercise session, an injury or when the individual is under stress. Certain medications can also cause shakiness or tremors. In such instances, Parkinsons disease may not be the culprit.
2. Difficulty Moving
Stiffness in the body, arms or legs can cause the senior to not sway her arms when she walks. When stiffness does not improve upon movement, it could be an early sign of Parkinsons disease. Pain in the shoulder or hips are common and can also indicate the condition.
3. Vocal Changes
Parkinsons disease can cause slurred, soft or hoarse speech. The affected individual may also speak more quickly than usual. Rather than be vocally expressive, a Parkinsons patient will speak in a monotone manner. Changes in voice should prompt the senior to see a doctor for an evaluation.
4. Facial Masking
5. Posture Changes
6. Smaller Handwriting
How Is Constipation An Early Warning Sign Of Parkinson’s It’s Such A Common Problem
A: It’s not as specific as other prodromal symptoms, like anosmia. The rate at which people with chronic and unexplained problems with constipation develop Parkinson’s disease is not as easy to pin down. But if someone has unexplained, persistent constipation, it should at least be noted, as it could be considered prodromal.
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Incidence Of Parkinsons Disease
Its estimated that approximately four people per 1,000 in Australia have Parkinsons disease, with the incidence increasing to one in 100 over the age of 60. In Australia, there are approximately 80,000 people living with Parkinsons disease, with one in five of these people being diagnosed before the age of 50. In Victoria, more than 2,225 people are newly diagnosed with Parkinsons every year.
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.
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What Is The Treatment For Parkinson’s Disease
There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.
Stage Four Of Parkinsons Disease
In stage four, PD has progressed to a severely disabling disease. Patients with stage four PD may be able to walk and stand unassisted, but they are noticeably incapacitated. Many use a walker to help them.
At this stage, the patient is unable to live an independent life and needs assistance with some activities of daily living. The necessity for help with daily living defines this stage. If the patient is still able to live alone, it is still defined as stage three.
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How Is Parkinson’s Disease Treated
If a doctor thinks a person has Parkinson’s disease, there’s reason for hope. Medicine can be used to eliminate or improve the symptoms, like the body tremors. And some experts think that a cure may be found soon.
For now, a medicine called levodopa is often given to people who have Parkinson’s disease. Called “L-dopa,” this medicine increases the amount of dopamine in the body and has been shown to improve a person’s ability to walk and move around. Other drugs also help decrease and manage the symptoms by affecting dopamine levels. In some cases, surgery may be needed to treat it. The person would get anesthesia, a special kind of medicine to prevent pain during the operation.
Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.
What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
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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.
New Diagnostic Standards For Parkinsons
Until recently, the gold-standard checklist for diagnosis came from the U.K.s Parkinsons Disease Society Brain Bank. It was a checklist that doctors followed to determine if the symptoms they saw fit the disease. But thats now considered outdated. Recently, new criteria from the International Parkinson and Movement Disorder Society have come into use. This list reflects the most current understanding of the condition. It allows doctors to reach a more accurate diagnosis so patients can begin treatment at earlier stages.
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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.
Apda In Your Community
This article was written at the request of a Parkinsons patient who wanted to know how patients die from PD.
Most patients die with Parkinsons Disease and not from it. The illnesses that kill most people are the same as those that kill people with PD. These are heart conditions, stroke and cancer. As we age we become increasingly aware that more than one bad thing can happen to our bodies.
Want To Learn More About The Latest Research In Parkinsons Disease Ask Your Questions In Our Research Forum
3. Loss of SmellMany people temporarily lose their sense of smell due to colds or the flu, but if the loss is sustained over a length of time without any noticeable congestion, then it could be an early sign of Parkinsons disease.
4. Sleeping DisordersTrouble sleeping can be attributed to many illnesses and Parkinsons disease is one of them. Waking due to sudden body movements, or thrashing your legs in your sleep could be a warning sign of the condition.
5. Stiffness in Walking and MovingGeneral stiffness that cant be attributed to exercise aches and pains and doesnt ease up when moving around could be an early warning sign of Parkinsons disease. Many patients complain that it feels like their feet are literally stuck to the floor.
6. ConstipationUnable to move your bowels is also a common early sign of Parkinsons disease. Although this is a common enough problem in healthy people, Parkinsons patients are more susceptible to constipation. If you suddenly find youre constipated and consider your diet normal then you should have a doctor check you out.
7. Low or Soft VoiceA sore throat or a cold can change the way you speak, but if you have been experiencing a sudden softness to the tone of your voice and are now speaking in a quieter or hoarser tone, this could be an early symptom of Parkinsons disease.
What Is Rem Behavior Disorder And How Is It Connected To Parkinson’s
A: REM behavior disorder is different than other sleep problems, like insomnia. People who have it may jerk or kick it’s as though they are acting out their dreams. In a similar pattern to anosmia, people with idiopathic REM sleep behavior disorder have at least a 50 percent chance of eventually developing Parkinson’s disease.
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