What is Parkinson’s Disease?
What is Parkinson’s Disease?
Parkinson’s disease (PD) is a nervous system disorder affecting the neurons in the brain that produce dopamine. Parkinson’s is progressive – symptoms tend to appear slowly at onset and ultimately cause a loss of muscle control. Early signs of the disease generally develop at a slow pace and may seem unnoticeable at first, but the rate and severity of symptoms vary from person to person. Some common signals of PD include tremors, slow movement, rigid muscles, and balance issues.
The disease affects over 500,000 people in the U.S., with about 60,000 new cases diagnosed in the country annually. PD is not fatal, but due to the severity of its symptoms it can significantly alter everyday life, especially when it comes to doing simple tasks and activities.
Parkinson’s Symptoms & Signs
Parkinson’s presents itself differently from one person to another, meaning people experience different symptoms at different times. However, there tend to be four major motor signs that could indicate the development of the disease:
- Bradykinesia (Slow Movement)
- Balance Issues
Two of these four major symptoms must be present over a period of time for a doctor to take PD into account as a possible diagnosis.
Other physical symptoms that might occur:
- Walking Challenges
- Dystonia (a disorder in which muscles contract uncontrollably)
- Vocal Changes (slower, softer, monotone, speaking rapidly, or stuttering)
PD is largely characterized as a disease affecting physical movement, however, individuals may experience non-motor-related symptoms as well. Some of these signs may precede the more commonly known physical symptoms of the disease by months or even years:
- Decreasing Sense of Smell and/or Taste
- Lightheadedness, Dizziness, and/or Fainting
- Depression and/or Anxiety
- Sleep Disorders
- Weight Loss or Weight Gain
- Changes in Vision
- Urinary Issues
- Excessive Sweating
- Hallucinations or Delusions
- Changes in Cognitive Behaviors (associated with personality, attention, language, memory, etc.)
- Shortness of Breath
Receiving Parkinson’s Diagnosis
There is no definitive test for Parkinson’s, so if you suspect you may have PD consult your physician. They’ll likely refer you to a neurologist or movement disorders specialist who can examine you further and conduct diagnostic testing. It’s important to note that diagnosing Parkinson’s in its early stages can be difficult as symptoms may be too mild to formally identify PD. As a result, your doctor may suggest follow-up appointments to monitor your symptoms over time.
Tests your doctor may order:
- Blood Testing
- MRI, Ultrasound, CT, PET, SPECT, or DaT Scans
Doctors may also instruct you to take an oral medication called carbidopa-levodopa (Rytary, Sinemet, Duopa, among others). If your symptoms substantially improve while on this drug, it often signals a formal PD diagnosis.
The Stages of Parkinson’s
Though individuals with PD experience different symptoms, intensities, and development, there are generally five stages of the disease that help doctors conclude how far Parkinson’s has progressed.
The initial stage of Parkinson’s disease presents very mild symptoms and may not be noticeable at first. Individuals may experience a tremor, stiffness, or other movement symptoms that typically happen to only one side of the body. People may also show slight changes in posture, walking and gait, or their facial expressions. These signs are minimal and usually don’t impact your daily living routine.
In the second stage, symptoms increase in severity and begin to affect both sides of the body. With worsening symptoms and more noticeable changes in rigidity and movement, communication and daily activities may seem more difficult than usual. Individuals are still able to live independently but everyday tasks require more effort than they used to.
This mid-stage includes continued worsening symptoms, as well as experiencing decreased balance and coordination which can lead to falls. People also begin to have reflex challenges. While many individuals are able to live alone, managing a daily routine such as eating or dressing becomes markedly difficult.
In the fourth stage of the disease, people typically cannot live on their own any longer. Activities of daily living like cooking, dressing, and other tasks become too much of a hindrance and individuals need assistance with their daily lives. While most people can stand, walking is a challenge and movement may require a walker.
Stage five is the most advanced stage of PD. When the disease is at this final stage, motor functions are severely impaired or completely lost. People experiencing this stage are often confined to a bed or wheelchair and need full-time assistance in all areas of life. Non-motor symptoms such as hallucinations, delusions, dementia, and confusion may also occur.
Parkinson’s Disease Causes
Parkinson’s disease is idiopathic, meaning the cause is largely unknown. With advancing research, however, scientists believe PD occurs through a result of both genetic and environmental factors.
According to the NIH, an estimated 15 percent of people with PD have a family history of the disease. Researchers have discovered multiple causal genes of Parkinson’s, estimating that about 30 percent of risk is due to genetic susceptibility. It’s important to note that not everyone who carries these genetic mutations will develop the disease.
Among these causal genes, the most common genetic mutation of PD is called the LRRK2 defect, often found in families of Jewish or North African descent. However, in many cases of individuals with Parkinson’s, there is no distinct genetic cause. With this in mind, we also turn to environmental factors that can trigger the condition.
There is no primary environmental factor that contributes to the disease. Since many years can pass between exposure to the environmental trigger and the disease’s barely noticeable symptoms, it’s difficult to exactly pinpoint the causes.
With that being said, some elements of the environment have been linked to potential increased risk of Parkinson’s:
- Substantial exposure to pesticides (in addition to Agent Orange, an herbicide)
- Significant exposure to heavy metals
- Drinking well water or exposure to solvents and polychlorinated biphenyls (PCBs)
- Consuming manganese
- Head trauma
In addition, other factors outside of genetics and environment include developing Lewy bodies, loss of dopamine, and age and gender. Individuals are more susceptible to developing Parkinson’s as the body ages, and men are affected by the disease more than women.
While PD cannot be fully cured, there are options to help you control your symptoms and quality of life. Treatment options include medications, physical therapy, speech therapy, exercise, and surgery depending on your case and your doctor’s recommendations. Talk to your doctor to discuss the best methods of treatment for you.
Living with Parkinson’s disease can have its moments of feeling frustrated and disheartened as everyday life becomes more challenging. Once simple tasks like dressing or cooking turn into a time-consuming undertaking, and it’s easy to fall into a depressed state. To cope, there are options from antidepressant medication to local support groups. You can find support groups of people with Parkinson’s online and in-person. Here are a few resources:
- My Parkinson’s Team
- Parkinson’s Foundation & Parkinson’s Foundation Open Forum
- For Southeast PA Residents: Perelman School of Medicine at UPenn
- For Southeast PA Residents: Penn Medicine Resources
- Daily Strength
Parkinson’s can be a debilitating condition that hinders your daily life, however, the disease is not fatal and there are many ways to manage PD. Create a treatment plan with your doctor that best suits your condition and lifestyle. Our team at Open Systems Healthcare can also help! Check out our Personal Care services and find an office near you to get started.