Demystifying Parkinson's disease
4/27/2023 by Paul Takahashi, M.D.
What most people know about Parkinson's disease is that it causes tremors, and that Michael J. Fox, Neil Diamond and Katherine Hepburn were diagnosed with it. While not uncommon — about 1 million Americans have Parkinson's — this disease is not well-known.
What is Parkinson's disease?
Parkinson's disease is a neurological disorder marked by tremors, such as shaking of the hands or head, particularly on one side of the body. These tremors are seen at rest, not just when moving. Parkinson's disease progresses to stiffness and slowness of movement. Patients' mobility is affected, and they may not be able to move spontaneously. The disease worsens over time, and there is no cure.
However, just because people have tremors doesn't mean they have Parkinson's disease. Tremors also can be caused by medications that stimulate the body, such as asthma or chronic obstructive pulmonary disease inhalers, or other conditions like essential tremor.
Are there other symptoms of Parkinson's disease?
Other major symptoms of the disease include poor sleep, bowel problems, mood disorders and depression, and these side effects may be as challenging as movement issues. People may not make many spontaneous movements, and they may have limited facial expressions and trouble standing up. When they walk, they may be more stooped, shuffle, take smaller steps and have difficulty turning.
Who tends to get Parkinson's disease?
Parkinson's disease is more common in men than women, and in white people rather than people of other ethnicities. Typically, people are diagnosed with Parkinson's disease in their 60s and 70s, although a small percentage may develop it younger.
How is Parkinson's disease diagnosed?
To diagnose Parkinson's disease, your primary care clinician usually can perform bedside tests in the clinic. No blood test or imaging will reveal Parkinson's disease. As the disease progresses, you may want to see a neurologist.
How is Parkinson's disease treated?
Patients usually seek a diagnosis and treatment when symptoms begin to affect their lives. While there's no cure, medications can effectively treat the symptoms. The most common and well-tolerated medication is carbidopa/levodopa. This generic drug promotes the production of dopamine, a neurotransmitter in the brain that regulates movement, attention, learning and emotional responses.
As the disease progresses, your clinician typically will increase the frequency and dose of your medication.
What happens as Parkinson's disease progresses?
Parkinson's disease is a slow disease, so patients lose more function as time goes on. Disability becomes a challenge, the risk of falls increases and maintaining independence becomes more difficult. Cognitive issues may start appearing, including memory concerns and behavioral changes. Parkinson's disease patients may require support as the disease progresses.
What's being done to cure Parkinson's disease or improve treatment?
Researchers continue to explore the mechanism of degeneration and what's causing it, down to the molecular level. Drugs that can slow, treat or even reverse Parkinson's disease are in trials. Devices, such as stimulators, are being used to reduce tremors or other symptoms.
What should a patient do after being diagnosed with Parkinson's disease?
If you or a loved one has been diagnosed with Parkinson's disease, you can optimize your situation by maintaining your level of activity; focusing on strength training to minimize weakness; and eating a healthy, balanced diet. Also, follow your medication regimen and be aware of how it's working. Is it wearing off? Is it causing side effects? Since Parkinson's disease is progressive, now is the time to plan ahead and consider in-home and long-term care options.
If you or a loved one experience symptoms or have concerns, reach out to your care team for help.
Paul Takahashi, M.D., is an internal medicine physician in Primary Care in Rochester and Kasson's Division of Community Internal Medicine, Geriatrics and Palliative Care. He practices in the Baldwin Building in Rochester. His interests include geriatric medicine, long-term and nursing home care and public health.