Parkinson’s mainly affects people in later life by slowing the body’s functions and impacting its ability to control movement.
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Find out about the symptoms, diagnosis, and treatment.
Parkinson’s disease (PD) is a progressive neurodegenerative condition. This means the symptoms start gradually and slowly become worse over time. PD affects the health of the brain’s nerve cells (neurons) that control movement, and as a result, many bodily functions and movements become affected.
Parkinson’s belongs to a group of conditions called parkinsonism. This is an umbrella term that also includes other conditions with similar symptoms (for example, tremor, slow movement, muscle stiffness, and problems with walking).
Parkinson’s disease is the most common neurodegenerative cause of parkinsonism. Other parkinsonism conditions are sometimes referred to as atypical parkinsonism or parkinson-plus syndromes. These conditions tend to have a worse prognosis than PD and they don’t respond to traditional PD treatment, which focuses on increasing dopamine levels.
In 2016, the Global Burden of Disease Study estimated that approximately 6.1 million people worldwide have Parkinson’s. This was a significant increase from 2.5 million people in 1990. In the EU, it’s estimated to affect 1.2 million people.
The same report estimated that by 2040, the number of people living with Parkinson’s would be closer to 13 million people. This estimated increase is because:
The symptoms of Parkinson’s can vary from person to person. They usually start off very subtly and can consequently be overlooked for some time.
Symptoms can be divided into motor symptoms (those involving movement) and non-motor symptoms, which don’t involve movement. There are three primary symptoms, and many other secondary symptoms which are less noticeable but can still affect quality of life.
Symptoms differ for everyone and it’s unlikely that someone with PD will experience all of them.
To start with, symptoms tend to be very mild and often go unnoticed, which can lead to a delay in diagnosis. Symptoms normally begin on one side of the body but eventually affect both sides.
The progression of PD can vary greatly from one person to another, which makes it hard to predict how quickly a case of Parkinson’s will progress. Many people also find that their symptoms fluctuate from day to day, resulting in good and bad days.
It’s common to experience a tremor or shaking in the hand or fingers in the early stages. Over time this can gradually worsen, until it becomes difficult to carry out simple, everyday tasks such as eating. The shaking can develop in other parts of the body too.
Movement can also slow down progressively. People in the later stages of Parkinson’s often have difficulties with walking and may end up using small, shuffling steps to get around.
The other primary symptom, muscle stiffness, can progress to the point where it becomes difficult to make facial expressions; it can also cause painful muscle cramps.
An individual’s response to drugs can also change over time. Medication may produce a clear improvement initially, but the effectiveness can ‘wear off’ or become inconsistent over time and may need to be adjusted as the disease progresses.
The progression of PD is different for everyone, but it’s common for symptoms to be mild at first, and they often go unnoticed in the early stages. Symptoms normally start on one side of the body and eventually affect both sides. It’s common for PD to start with a tremor or shaking in the hand or fingers.
It’s not known exactly why people get Parkinson’s, but the symptoms are triggered when the nerve cells that produce dopamine in the brain weaken and die. Researchers believe that the death of these nerve cells is linked to a combination of age, genetics and environmental factors, such as exposure to certain chemicals.
Known risk factors for developing PD include exposure to fungicides and pesticides, such as maneb, rotenone and paraquat, and traumatic brain injury.
Chemicals in the brain called neurotransmitters help to control body movements by passing messages between nerve cells and the rest of the body. One of the most significant neurotransmitters in this process is dopamine. In people with PD, around 70–80% of dopamine-producing cells deteriorate and eventually die.
This process is called neurodegeneration. It means that people with PD have low levels of dopamine in the part of the brain that controls movement and balance. Symptoms of Parkinson’s appear because the nerve cells are no longer able to pass on the right messages to control the body’s movements.
Parkinson’s affects people of all races and backgrounds. The chance of getting the disease increases with age, but it’s estimated that around 4% of people with Parkinson’s are diagnosed under the age of 50.
Men are more likely to get PD than women. Some research suggests that as many as twice as many men as women are diagnosed, and women are an average of 2.1 years older than men at the time of diagnosis.
Parkinson’s is a lifelong disease that significantly affects day-to-day life and can make people more vulnerable to other illnesses and infections. However, thanks to advances in treatment, most people with the condition have a normal or near-normal life expectancy.
A range of assessments are used to help doctors to determine whether someone has Parkinson’s. They may also use certain tests to help rule out other conditions.
It can be difficult to diagnose Parkinson’s, for several reasons. In the early stages, symptoms are often mild, making it hard for doctors to be certain that they are caused by Parkinson’s. Symptoms can vary considerably between individuals, and other illnesses – such as essential tremor and Alzheimer’s disease – have similar symptoms, which can lead to misdiagnosis.
The other factor that makes PD difficult to diagnose is that there is no single test for the condition. Specialists may use a number of tests to help them rule out other conditions, but the diagnosis is primarily made based on the combined results of:
Doctors may use one or more of the following tests to help them rule out other conditions:
There is no single treatment to cure Parkinson’s, but there are many medications and therapies that can help to control its symptoms.
Various medications are available to help improve the symptoms of PD. Supportive therapies such as physiotherapy, speech and language therapy, and occupational therapy can also make a big difference in helping people with Parkinson’s to continue to live independently.
No treatment or therapy has yet been found to prevent Parkinson’s from developing, although there has been extensive research into the benefits of physical exercise in earlier life; it has been shown that people who exercise are less likely to develop Parkinson’s.
However, while research indicates that exercise is associated with a lower risk of Parkinson’s, it has not proved that physical exercise is the cause of the decreased risk. More research is needed to establish whether there is a direct link.
The treatment and prevention of Parkinson’s disease is a big area of research, and better understanding of the condition is an important factor in developing appropriate new drugs.
Studies such as one in Finland in 2020 are looking into ways to boost levels of dopamine and protect the dopamine-producing brain cells from dying, while other research is focusing on the causes of the motor symptoms in Parkinson’s. Such studies give scientists reason to believe that better ways of treating Parkinson’s disease can be developed in future.