Parkinson’s disease may be one of the most baffling and complex of the neurological disorders. Its cause remains a mystery but research in this area is active, with new and intriguing findings constantly being reported. It is possible to develop Parkinson’s disease with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing Parkinson’s disease. If you have a number of risk factors, find out what you can do to reduce your risk.
Parkinson’s disease belongs to a group of conditions called motor system disorders. The four primary symptoms are tremor or trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; brady kinesia or slowness of movement; and postural instability or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks.
The disease is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. It is not contagious nor is it usually inherited — that is, it does not pass directly from one family member or generation to the next.
Parkinson’s disease is the most common form of parkinsonism, the name for a group of disorders with similar features. These disorders share the four primary symptoms described above, and all are the result of the loss of dopamine-producing brain cells. Parkinson’s disease is also called primary parkinsonism or idiopathic Parkinson’s disease; idiopathic is a term describing a disorder for which no cause has yet been found. In the other forms of parkinsonism either the cause is known or suspected or the disorder occurs as a secondary effect of another, primary neurological disorder.
Parkinson’s usually begins around age 60, but it can start earlier. It is more common in men than in women. There is no cure for Parkinson’s disease. A variety of medicines sometimes help symptoms dramatically.
CAUSES OF PARKINSON’S DISEASE
Experts agree that low dopamine levels in the brain cause the symptoms of Parkinson’s disease, but no one really knows why the nerve cells that produce dopamine get damaged and die. Some experts think that a change in a specific gene could explain why a person develops this disease. Other experts think it could be something in the environment that causes the damage, such as pesticides or other chemicals.
No one knows the exact cause, but we do know that it has been around for a long time. In 1817, an English physician named Dr. James Parkinson called it “Shaking Palsy.” Eventually, the disease that Dr. Parkinson first described was named after him.
The symptoms of Parkinson’s disease include tremors or trembling (shaking hands are often the most telltale signs of it); difficulty maintaining balance and coordination; trouble standing or walking; stiffness; and general slowness.
Over time, a person with Parkinson’s may have trouble smiling, talking, or swallowing. Their faces may appear flat and without expression, but people with Parkinson’s continue to have feelings – even though their faces don’t always show it. And the disorder has no effect on thinking or memory. Because of problems with balance, some people with Parkinson’s fall down a lot, which can result in broken bones. Some people with Parkinson’s may also feel sad or depressed and lose interest in the things they used to do.
The symptoms appear gradually and get worse over time. But because Parkinson’s disease usually develops slowly, most people who have it can live a long and relatively healthy life.
OTHER MINOR SYMPTOMS
Various other symptoms accompany Parkinson’s disease; some are minor, others are more bothersome. Many can be treated with appropriate medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person. None of these symptoms is fatal, although swallowing problems can cause choking.
Depression. This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Depression may not be severe, but it may be intensified by the drugs used to treat other symptoms of Parkinson’s disease. Fortunately, depression can be successfully treated with antidepressant medications.
Emotional changes. Some people with Parkinson’s disease become fearful and insecure. Perhaps they fear they cannot cope with new situations. They may not want to travel, go to parties, or socialize with friends. Some lose their motivation and become dependent on family members. Others may become irritable or uncharacteristically pessimistic.
Memory loss and slow thinking may occur, although the ability to reason remains intact. Whether people actually suffer intellectual loss (also known as dementia) from Parkinson’s disease is a controversial area still being studied.
Difficulty in swallowing and chewing. Muscles used in swallowing may work less efficiently in later stages of the disease. In these cases, food and saliva may collect in the mouth and back of the throat, which can result in choking or drooling. Medications can often alleviate these problems.
Speech changes. About half of all parkinsonian patients have problems with speech. They may speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. A speech therapist may be able to help patients reduce some of these problems.
Urinary problems or constipation. In some patients bladder and bowel problems can occur due to the improper functioning of the autonomic nervous system, which is responsible for regulating smooth muscle activity. Some people may become incontinent while others have trouble urinating. In others, constipation may occur because the intestinal tract operates more slowly. Constipation can also be caused by inactivity, eating a poor diet, or drinking too little fluid. It can be a persistent problem and, in rare cases, can be serious enough to require hospitalization. Patients should not let constipation last for more than several days before taking steps to alleviate it.
Skin problems. In Parkinson’s disease, it is common for the skin on the face to become very oily, particularly on the forehead and at the sides of the nose. The scalp may become oily too, resulting in dandruff. In other cases, the skin can become very dry. These problems are also the result of an improperly functioning autonomic nervous system. Standard treatments for skin problems help. Excessive sweating, another common symptom, is usually controllable with medications used for Parkinson’s disease.
Sleep problems. These include difficulty staying asleep at night, restless sleep, nightmares and emotional dreams, and drowsiness during the day. It is unclear if these symptoms are related to the disease or to the medications used to treat Parkinson’s disease. Patients should never take over-the-counter sleep aids without consulting their physicians
FIND OUT IF YOU ARE AT RISK
Most people develop Parkinson’s disease after the age of 60. It is relatively unusual to develop Parkinson’s disease before the age of 40, although it is certainly possible.
Men are about 1.5 to 2 times more likely than women to develop Parkinson’s disease.
If you have a close relative (parent, sibling, or child) with Parkinson’s disease, you are three times more likely to develop this disease yourself. If you have two close relatives with Parkinson’s disease, you are ten times more likely to develop it.
Research suggests that blacks and Asians have a slightly lower rate of Parkinson’s disease than whites.
Exposure to chemicals, such as herbicides and pesticides, is thought to increase your risk of developing Parkinson’s disease. You also have a greater risk if you live in a rural area, drink well water, or farm (perhaps due to an increased exposure to herbicides and pesticides).
Even for an experienced neurologist, making an accurate diagnosis in the early stages of Parkinson’s disease can be difficult. There are, as yet, no sophisticated blood or laboratory tests available to diagnose the disease. The physician may need to observe the patient for some time until it is apparent that the tremor is consistently present and is joined by one or more of the other classic symptoms. Since other forms of parkinsonism have similar features but require different treatments, making a precise diagnosis as soon as possible is essential for starting a patient on proper medication.
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 in the near future.
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. There are other drugs that also help decrease and manage the symptoms by affecting dopamine levels. In some cases, surgery may be needed to treat it.