Parkinsons Goes Prime Time: Five Things To Know About Parkinsons Disease
Michael J. Fox is back in the spotlight this fall in a new sitcom The Michael J. Fox Show and spreading awareness about Parkinsons disease, a condition both he and his TV character have in common. Fox has been an outspoken advocate for Parkinsons disease research and awareness since disclosing his condition to the public in 1998.
Parkinsons disease is a progressive nervous system disorder that affects movement and may cause shaking, muscle stiffness, slowing of movement, impaired balance or other symptoms.;Mayo Clinic movement disorders specialist,;Anhar Hassan, M.D., says it;impacts about 1 in 200 people.;What Michael J. Fox is doing to spread awareness on Parkinsons from fundraising to education to playing a TV character with the disease is very commendable. Parkinsons disease touches the lives of many people. Education is vital.;says Dr. Hassan.
Journalists: Sound bites with Dr. Hassan are in the downloads.;To interview Dr. Hassan or another Mayo Clinic Parkinsons expert about the disease contact Nick Hanson at;;or call 507-284-5005.
What Causes Parkinsons Disease Dementia
A chemical messenger in the brain called dopamine helps control and coordinate muscle movement. Over time, Parkinsons disease destroys the nerve cells that make dopamine.
Without this chemical messenger, the nerve cells cant properly relay instructions to the body. This causes a loss of muscle function and coordination. Researchers dont know why these brain cells disappear.
Parkinsons disease also causes dramatic changes in a part of your brain that controls movement.
Those with Parkinsons disease often experience motor symptoms as a preliminary sign of the condition. Tremors are one of the most common first symptoms of Parkinsons disease.
As the disease progresses and spreads in your brain, it can affect the parts of your brain responsible for mental functions, memory, and judgment.
Over time, your brain may not be able to use these areas as efficiently as it once did. As a result, you may begin experiencing symptoms of Parkinsons disease dementia.
You have an increased risk of developing Parkinsons disease dementia if:
- youre a person with a penis
- youre older
How Is Progressive Supranuclear Palsy Diagnosed
PSP is diagnosed on the basis of clinical signs and exam findings, but it often isnt easy to diagnose. Theres no single test that points right at it with certainty. It is often mistaken for Parkinsons disease and it can sometimes take years to distinguish PSP from PD.
If your healthcare provider suspects PSP based on the symptoms you report, he or she will likely send you to get a MRI . This will help to rule out other diseases such as Parkinsons and occasionally it can show shrinking of your midbrain that raises the possibility of PSP in the appropriate clinical setting. Youll also be sent to a neurologist specializing in Parkinsons disease and movement disorders.
Although there are many symptoms of PSP, the one that confirms the diagnosis is trouble moving your eyes up and down. Other common symptoms like falling and difficulty swallowing also point at PSP.
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How Does Dementia Kill You
Dementia is not a specific disease; rather it refers to a series of various symptoms, which take place from damages in human brain and it typically results in memory loss. Alzheimers disease, known as its common form, dementia combined with Lewy bodies, vascular dementia, advanced dementia and frontotemporal dementia are all of the different types of dementia problem.
Lifespan Of Those With Parkinson’s
Many people think PD automatically means a shorter lifespan, but this isnt necessarily true. The area is under-researched, and the research that has been done has yielded variable results.
A study done at the Mayo Clinic found that overall, patients with PD had similar lifespans to those without PD, but if PD dementia or dementia with Lewy bodies were present, that did contribute to increased mortality rates.1 For those with typical PD without dementia, compared to the general population, they died approximately a year earlier.1,2 PD is not a direct killer like heart attack, and there are steps individuals can take to help maintain their functioning and health.
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The Neglected Side Of Parkinson’s Disease
Parkinson’s disease may not be an epidemic, but it’s more common than you might think. Approximately 1,000,000 Americans suffer from the illness, with 60,000 new cases appearing each year in the United States alone.
This neurodegenerative disorder, which is both progressive and incurable, usually begins around age 60, so neurologists believe that its prevalence is likely to increase dramatically with the graying of the nation’s population. But Parkinson’s disease shouldn’t be thought of only as an affliction of old age; it can also strike considerably earlier in life, a fact that has become well known through such prominent examples as Michael J. Fox and Muhammad Ali .
Figure 1. Although Parkinsons disease is normally an affliction of old age, it can strike considerably earlier in life. Three-time world heavyweight boxing champion Muhammad Ali , for example, was diagnosed with Parkinsons disease at the age of 42, just three years after his final fight. He is shown here in a 1965 match with Floyd Patterson.
Are There Signs And Symptoms Of Progressive Supranuclear Palsy That Are More Common Or Appear First
The most common first sign is a loss of balance when walking or climbing stairs. You might feel stiff, awkward when walking and have falls for reasons you cant explain. The second most common symptom is difficulty looking downward. Then, you might have a hard time finding words, freezing in the middle of walking and have forgetfulness, personality changes, increased irritability and loss of interest. Another very common initial symptom is a stare look on your face. Other symptoms that occur at first, but are less common, include slurred speech, difficulty driving and shaky hands.
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What Are The Signs And Symptoms Of Progressive Supranuclear Palsy
If you have PSP, youll likely experience the following symptoms that worsen with time. Youll likely:
- Lose your balance frequently. You may fall, especially backwards.
- Lose the ability to aim your eyes. You might not be able to look up or down, follow something thats moving, or keep your eyes fixed on something still. Your eyelids might retract , giving your face a surprised look.
- Have trouble swallowing.
- Feel stiff muscles and move slowly.
- Have trouble speaking. Your speech might be quieter and slurred, impairing your ability to pronounce words.
- Feel mood changes and observe behavioral changes.
- Experience depression and apathy .
- Get dementia. Your thoughts will be slow, youll have difficulty resisting impulses and you may find problem-solving difficult.
- Have insomnia .
- Feel irritable and agitated.
Parkinsons Doesnt Kill You
Its true that people do not die from Parkinsons, but they typically die from complications of the disease. As an example, Parkinsons can impair patients ability to swallow, putting them at risk for inhaling, or aspirating, food or liquid into their lungs, leading to aspiration pneumonia. Pneumonia is the leading cause of death in patients with this disease.
Still, I fear living with a poor quality of life and loss of my independence more than I fear dying.
In the grand scheme of things, comments made out of ignorance are no big deal considering what people with Parkinsons deal with every day. Now that you know what not to say, read Sherris column;on things you can say to someone with Parkinsons.
Sometimes you dont have to say anything. Silence speaks it all. Disha Patani
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Outside The Realm Of Dopamine
Unfortunately, levodopa therapy doesn’t satisfactorily control many clinical aspects of Parkinson’s disease, presumably because they result from degeneration of nondopaminergic parts of the nervous system.
Figure 4. Tissues taken from the substantia nigra pars compacta normally show a high density of dark-colored nerve cells under microscopic inspection . But people with Parkinsons disease experience extensive loss of such pigmented neurons . An enlarged view of one of the surviving neurons reveals a Lewy body , an inclusion within the cell containing dysfunctional protein masses.
Images courtesy of Martha Simmons.
Researchers are discovering that the pathology of the disease is far more extensive than their predecessors initially appreciated and is not restricted to dopaminergic nerve cells in the substantia nigra pars compacta. Indeed, they have identified signs of neurodegeneration with the development of Lewy bodies in nondopaminergic regions of the brain, the spinal cord and the peripheral nervous system, which use a variety of different neurotransmitters . Strangely, some regions of the brain can suffer profound nerve-cell loss with Lewy-body formation, while neighboring areas are completely spared, indicating that some as-yet-unknown factors make only certain nerve cells vulnerable to degeneration in Parkinson’s disease.
Do What You Can While You Can
I have had Parkinsons disease for nearly 20 years. My wife is a teacher, so we travel every summer when she is not working. Since my diagnosis, I have been to China, Nepal, Prague, Paris and many other places. The Parkinsons comes along, too, so our trips require more planning than they used to and we involve my care team. We factor in daily naps and take it slow. My balance isnt as good as it used to be and too much walking wears me out so we bring a collapsible wheelchair along or make sure one is available. I also use a cane. I dont know how many more places we will get to visit as my disease continues to progress, but we have made some wonderful memories that we wouldnt have if we had let my Parkinsons dictate every aspect of our lives. Nicholas, diagnosed at 52, still traveling at 72
Many people with Parkinsons disease are not allowing the condition to take over their lives. Despite the everyday setbacks they face, they are still creating fulfilling lives for themselves by redirecting their attention to people and activities that bring them joy. You can do the same. Try building a few hobbies into your routine that will give you a break from dwelling on the disease. Find some activities that help you forget about Parkinsons for a while. That may be painting, writing, gardening, or reading to your grandchildren. ;
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Q: I Received The Covid
A: The vaccine is certainly able to cause short term side effects of fatigue, aches and even fever. There isnt extensive data yet on how it affects PD symptoms, just anecdotal data.; For some people, PD symptoms are worse in the short term. This does not mean that your PD has progressed, and I would expect that you will return to your previous baseline in the next few days. I would talk with your neurologist about your worsened tremor as well.
How Can I Protect Myself From Pneumonia
- Get a viral influenza vaccine each year. Flu vaccines are prepared annually in anticipation of that year’s virus strain. Influenza can make pneumonia infection more likely.
- Get the pneumonia vaccine to protect yourself against Streptococcus pneumoniae.
- Get treated for any other infections in the respiratory system, especially those in the lungs.
- Wear a face mask and avoid exposure to people who may be sick with Covid-19, a flu, or a cold.
- Wash your hands before eating, before preparing food, and after going outside.
- Eat a healthy diet, exercise, and get plenty of rest.
- Contact your doctor if you think you have symptoms. Don’t wait for symptoms to worsen, as you may develop an emergency condition.
- Don’t smoke.
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Living With Parkinsons Disease
Patients living with PD can take steps to ensure they get quality care from their healthcare team, as well as take good care of themselves.
Staying as active as possible with help from an occupational therapist who can show you how to modify daily activities, eating a healthy and well-balanced diet, and taking medications as prescribed can all help optimize your health and promote well-being. Talking with the doctor about any challenges or concerns can also help you brainstorm solutions to problems or help create a plan to address issues.
Don’t neglect emotional health, as well. Depression and anxiety affect up to half of those living with PD.5
Mood disorders and changes like these can actually worsen symptoms and affect overall health, so proper treatment is crucial. Tell the doctor if youre noticing changes in mood at all, so this can be addressed with treatment, whether its medication, counseling, or both. Spending time with other people friends, family members, activity groups can also help decrease feelings of isolation or loneliness.
What Is The Difference Between Progressive Supranuclear Palsy And Parkinsons Disease
PSP frequently resembles Parkinsons disease, often making it difficult to distinguish these conditions from one another. Both cause difficulty with stiffness and clumsiness. Both cause slow movement and start later in life. And both show damage to the same areas of the brain that affect movement. In particular, PSP-P can be nearly indistinguishable from Parkinsons disease by clinical examination.
But, PSP and Parkinsons disease are different in several ways. On average, PSP gets worse quicker than Parkinsons and doesnt respond as well to medications. People with Parkinsons usually bend forward, while people with PSP stand very straight, or even slightly backwards. Problems with swallowing and with speaking appear early with PSP and they are far more severe. A tremor is rare with people who have PSP and common in people who have Parkinsons. Motor symptoms, such as slowing and loss of dexterity, typically start very asymmetrically in Parkinsons disease .
Additionally, their underlying pathological processes differ at the molecular level. Abnormalities relating to the protein tau and its effect on brain cells is central to PSP pathology. And, when looked at through a microscope, the damaged brain cells in someone with PSP look different than those of people who have Parkinsons.
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Does Parkinsons Run In Families
Genetics cause about 10% to 15% of all Parkinsons cases. Studies reveal that the appearance of Parkinsons disease is a mix of genetics and environmental factors that induce the development of the disease.
In some families, changes in specific genes are passed down from generation to generation. Yes, Parkinsons disease can run in families, but it is rare. Despite that, if someone is positive for gene mutations directly correlated to Parkinsons disease, that does not mean that the patient will surely develop Parkinsons.
It is possible for people who inherit these genes not to develop the disease if there is no environmental factor that triggers it and a healthy lifestyle.
There are ongoing clinical trials testing therapies to treat people with Parkinsons that carry specific gene mutations. For doctors, it is essential to know which gene mutation does the patient carries.
What Are The Symptoms Of End
Stage four for Parkinsons disease is often called advanced Parkinsons disease because people in this stage experience severe and incapacitating symptoms. This is when medication doesnt help as much and serious disabilities set in.
Theres an increased severity in:
- How you speak a softer voice that trails off.
- Falling and trouble with balance and coordination.
- Freezing a sudden, but temporary inability to move, when you start to walk or change direction.
- Moving without assistance or a wheelchair.
- Other symptoms such as constipation, depression, loss of smell, low blood pressure when going to stand up, pain, and sleep issues.
Many times someone with advanced PD cant live on their own and needs help with daily tasks.
Stage five is the final stage of Parkinsons, and assistance will be needed in all areas of daily life as motor skills are seriously impaired. You may:
- Experience stiffness in your legs. It may make it impossible to walk or stand without help.
- Need a wheelchair at all times or are bedridden.
- Need round-the-clock nursing care for all activities.
- Experience hallucinations and delusions.
As Parkinsons disease progresses into these advanced stages, its symptoms can often become increasingly difficult to manage. Whether you or your loved one with end-stage Parkinsons lives at home, in an assisted living facility or a nursing home, hospice services can optimize your quality of life and that of your family members as well.
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Q: What Side Effects Can I Expect From The Covid
A: While there have been some varied reactions, the COVID-19 vaccines are approved by the FDA and considered safe. Some people may simply experience a mildly sore arm and that is it . There are some who may have a more noticeable reaction and feel chills, body aches, headaches and/or fatigue for 1-2 days, but these generally clear up quickly.;There have also been some anecdotal reports of PD symptoms temporarily worsening after COVID-19 vaccination.
Weighing the risks of someone with PD getting COVID-19, as well as the significant downsides of all the pandemic-related restrictions on social and physical activities to someone with PD vs. the potential for side effects from the vaccine, I would favor getting the vaccine. As always, discuss all your medical concerns with your neurologist and primary care physician.
How Does Parkinsons Kill You
Most of the patients that have Parkinsons disease do not die specifically from it. Please, allow me to explain better.
As it is an affection that compromises several organs, it may trigger inadequate responses in each one of them. Nonetheless, the same diseases that cause death on healthy patients cause death on these patients.
Parkinsons patients can die from heart attacks, strokes, cancer, among other causes. Still, two specific causes are very common in these patients.
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