Parkinson’s Disease is a debilitating motor condition with no known cause or cure. According to the Parkinson’s Disease Foundation, more than 10 million people worldwide are currently living with this disease. As many as one million Americans live with Parkinson’s disease and nearly 60,000 more are diagnosed each year. As our population tends to live longer, these numbers are expected to increase. Unfortunately, the 60,000 diagnosed annually does not reflect the thousands of cases that go undetected.
Now, you might ask yourself, how does this disease go undetected? Although it is a debilitating disease, it can have a rather slow onset and symptoms can be subtle at first. This is a disease that primarily affects individuals over the age of 50 when many people are naturally starting to slow down and are seeing changes in their abilities. It should also be noted that Parkinson’s is one and a half times more prevalent in men than women.
So what are some of the early warning signs of Parkinson’s Disease? Many individuals start with what are considered Primary Motor Symptoms. These can include the following:
This symptom is typically seen in about 70% of cases as the first sign that something is going on. The term “resting” is used because the person is doing just that, resting, and has a tremor present. This is different from a “purposeful tremor” that is seen when some individuals attempt to perform a task. A resting tremor usually starts as one finger, hand or foot moving (on one side of the body) with the inability to control or stop it. This tremor usually stops on its own though when a person begins an action.
The medical term for this is known as Bradykinesia. This is a true feature of Parkinson’s that defines it from other disorders. With this symptom, a person appears abnormally still. This includes movement related to walking, repetitive actions and even facial expression. Eventually it affects the ability to complete daily living activities (buttoning a shirt or brushing teeth) and speech.
The muscles involved usually are located in the neck, shoulders and legs. The person will experience stiffness that does not let up. The limbs will remain rigid and arms do not swing as normal when walking. This rigidity can be uncomfortable and at times quite painful.
People with Parkinson’s have various changes in their muscles and movement that limit their ability to maintain proper balance. They have a tendency to be unstable when standing upright. A person with Parkinson’s has lost some of the reflexes needed for maintaining an upright posture, and may fall backwards even if slightly bumped.
Secondary Motor Symptoms associated with Parkinson’s Disease are present as the disease progresses. Just like many other diseases, Parkinson’s is considered chronic. This means that it is a long term condition for which there is treatment available but not a cure. The Primary Motor Symptoms continue (which may become worse) and they then are following by the secondary symptoms listed below:
Inability to Start Movement
Also referred to as “freezing.” This happens when a person with Parkinson’s tries to move and can’t. You see this often when they are trying to take a step to walk. This is sometimes called the Parkinsonian Gait or Shuffle.
The person typically appears hunched over (leaning slightly forward at the waist), and the knees bend back and forth between the two legs. Once they can initiate a step it is very stuttered. They tend to take short steps without lifting the feet much. Arms are at the sides without movement and any turns are made with numerous steps in the same manner without lifting the head.
Small handwriting. This is the result of slowing movement and the inability to complete repetitive actions.
A symptom that makes the person appear as if they are wearing a mask. Lack of unconscious express or a blank or motionless stare.
It should be noted that some people with Parkinson’s experience acceleration of movements and actions instead of slowing. This is typical with speech. This person speaks rapidly and stammers, making it very difficult to understand them. This may also be present when walking. This is referred to as festination. It is an uncontrollable acceleration in pace/gait leading to an increased risk of falling.
The brain changes caused by Parkinson’s disease begin in a region that plays a key role in movement. As Parkinson’s brain changes gradually spread, they often begin to affect mental functions, including memory and the ability to pay attention, make sound judgments and planning the steps needed to complete a task. These symptoms are called Non Motor Symptoms. While a person’s family and friends may not be able to see them, these “invisible” symptoms can actually be more troublesome for some people than the motor impairments. These changes include the following:
Changes related to the different senses include a decreased sense of smell, vision and dental problems (increased salivation) and skin disturbances.
These include memory difficulties, slowed thinking, confusion and in some cases, dementia.
Many Parkinson’s Disease patients report difficulties sleeping.
If a person has one or more of these symptoms, it does not mean that they will develop Parkinson’s, but these markers are helping scientists to better understand the disease process. Some other troubling changes can include constipation, decreased blood pressure when standing up, bladder problems, sexual dysfunction, mood changes, depression, fatigue, weight loss or gain, fear and anxiety and impulsive behavior.
That brings us to the question of, what do we know about Parkinson’s Disease and where are we with current research? Despite decades of research, we still do not know exactly what causes this disease. Without a known cause(s) it is very difficult to develop a cure. There are several theories that include genetics and or environmental exposure.
At this point, genetics has not been ruled out, but is not a strong contender. There has not been any substantial evidence identifying a gene and people with the disease report just a 15-25% association with a family member with Parkinson’s. To date no case has been directly linked to heredity.
A second theory that scientists have, is that Parkinson’s disease may result from exposure to an environmental toxin or injury. Some research studies have discovered several factors that may be linked to Parkinson’s. These include rural living, well water, manganese and pesticides.
One important factor you should know, is that simple exposure to an environmental toxin is never enough to cause Parkinson’s. Most people that have been exposed to a toxin do not develop the disease. In fact, there is no definitive evidence that any environmental factor, alone, can be the cause of this disease.