Parkinson's disease (PD) is a chronic and progressive neurodegenerative movement disorder, meaning the symptoms worsen over time. The most well-known symptom is tremor, but PD can also cause slowness of movements, limb stiffness, and difficulties with gait and balance. Interestingly, the major symptoms of PD may be different from person to person. Currently, about 65,000 Australians and 13,000 New Zealanders are living with PD. Every year, over 10,000 and 2,000 respectively are diagnosed with the disease.
PD occurs when nerve cells (called neurons) in the mid-brain become damaged or begin to die. Normally, these neurons produce dopamine, a chemical that sends messages to other parts of the brain that are responsible for controlling the body’s movements. While the exact cause of PD is unknown, both genetics and environmental factors play a role in causing the disease.
Though PD can affect anyone, it is a disease most commonly occurring in older people (usually over age 60). PD can even occur in young adults as young as 18. The disease is more common in men than in women, and in those with a family history of PD (about 15% of people with PD have a relative with the disease). Studies suggest that repeated exposure to certain chemicals, such as pesticides, may increase the risk for PD; however, the risk of exposure to these environmental toxins is not fully understood.
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PD signs and symptoms vary from person to person, and generally worsen as the disease progresses over time. The primary symptoms of PD include the following:
Secondary symptoms can include loss of facial expression due to rigidity of facial muscles (called hypomimia), and low voice volume or muffled speech (called hypophonia). People with PD may also experience vision problems, speech, and swallowing problems, drooling, or excessive saliva due to slow swallowing. Other symptoms can include depression (common) and anxiety, sleep problems, and cognitive changes such as slowing of thought, language and memory difficulties, personality changes, and dementia. Medications that treat PD can cause hallucinations, delusions, agitation and mania.
The different stages of PD are mild, moderate and advanced. People with mild PD may have movement symptoms that are inconvenient, but do not affect daily activities. Movement symptoms typically occur on one side of the body, and are generally well controlled with medication use. Moderate PD occurs when movement symptoms affect both sides of the body. The body moves more slowly and it may become more difficult to maintain balance or move around. This is the stage in which most people with PD begin to experience side effects caused by their PD medications. People with advanced PD are usually confined to a wheelchair and are not able to live alone; however, the symptoms can be eased with medication use.
Unfortunately, there is no standard test to diagnose Parkinson’s disease. Diagnosis is based on medical history, a physical and neurological exam, and a review of signs and symptoms.
The doctor may check whether or not you:
You may be asked to undergo specific tests (e.g., CT, MRI) so that your doctor can rule out other conditions that could be causing your symptoms. As a result, getting a PD diagnosis may take some time. Still, if you or a loved one might have PD, it’s important to a see a doctor (or neurologist, a doctor who specialises in treating the nervous system).
As far as PD treatment, there is no cure. Symptoms are managed with medications that work to increase dopamine levels in your brain. For people whose symptoms do not improve with medication, a surgical procedure called deep brain stimulation may be recommended. However, as the disease progresses, most people with PD will have symptoms that worsen even with treatment.
Managing PD effectively is important whether you have PD or are caring for someone with PD. Here are a few important things to keep in mind:
Clinical trials for PD are being conducted to delay, prevent, and reverse the disease, as well as those exploring possible genetic and environmental links to the disease. Research to identify an accurate “biological” marker to indicate the presence of PD is also underway to improve diagnosis of the disease.
If you would like to know more, or wish to participate in a clinical trial near you, information is available at the Michael J. Fox Foundation.
Last reviewed: 15/08/2019
- Parkinson's Australia
- Parkinson's New Zealand
- Shake It Up Australia Foundation
- Neurological Foundation New Zealand