PARKINSON'S DISEASE
OVERVIEW
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Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
While virtually anyone could be at risk for developing Parkinson’s, some research studies suggest this disease affects more men than women. It’s unclear why, but studies are underway to understand factors that may increase a person’s risk. One clear risk is age: Although most people with Parkinson’s first develop the disease after age 60, about 5% to 10% experience onset before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.
SYMPTOMS
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Parkinson's disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect both sides.
Parkinson's signs and symptoms may include: A tremor, or shaking, usually begins in a limb, often the hand or fingers. Over time, Parkinson's disease may slow ones movement, making simple tasks difficult and time-consuming. Steps may become shorter when walking. Muscle stiffness may occur in any part of the body. The stiff muscles can be painful and limit range of motion. Posture may become stooped, or one may have balance problems as a result of Parkinson's disease. It may cause a decreased ability to perform unconscious movements, including blinking, smiling or swinging the arms when walking. Speech changes may occur, one may speak softly, quickly, slur or hesitate before talking. Speech may be more of a monotone rather than have the usual inflections. It may become hard to write.
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COMPLICATIONS
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Parkinson's disease is often accompanied by additional problems, which may be treatable: Thinking difficulties. One may experience cognitive problems (dementia) and thinking difficulties. Depression and emotional changes. One may experience depression, sometimes in the very early stages. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson's disease. Swallowing problems. One may develop difficulties with swallowing as the condition progresses. Saliva may accumulate in the mouth due to slowed swallowing, leading to drooling. Chewing and eating problems. Late-stage Parkinson's disease affects the muscles in the mouth, making chewing difficult. This can lead to choking and poor nutrition. Sleep problems and sleep disorders. People with Parkinson's disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day.
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CAUSES OF PARKINSON’S DISEASE
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In Parkinson's disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in the brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of Parkinson's disease. The cause of Parkinson's disease is unknown, but several factors appear to play a role, including: Genes. Researchers have identified specific genetic mutations that can cause Parkinson's disease. But these are uncommon except in rare cases with many family members affected by Parkinson's disease. However, certain gene variations appear to increase the risk of Parkinson's disease. Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinson's disease, but the risk is relatively small.
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DIAGNOSIS
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No specific test exists to diagnose Parkinson's disease. A doctor trained in nervous system conditions (neurologist) will diagnose Parkinson's disease based on medical history, a review of signs and symptoms, and a neurological and physical examination. Imaging scans and lab tests may be used to rule out other disorders.
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TREATMENTS FOR PARKINSON’S DISEASE
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Although there is no cure for Parkinson’s disease, medicines, surgical treatment, and other therapies such as exercise, physical therapy, and lifestyle modifications can often relieve the symptoms. There are also some experimental options, such as stem cell-based treatments, but their availability often varies.
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Medicines for Parkinson’s disease
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Medicines can help treat the symptoms of Parkinson’s by Increasing the level of dopamine in the brain, effecting other brain chemicals, such as neurotransmitters, which transfer information between brain cells, and help control non-movement symptoms.
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Surgical procedures
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Deep brain stimulation. In this procedure surgeons implant electrodes into a specific part of the brain. The electrodes are connected to a small generator implanted in the chest near the collarbone that sends electrical pulses to the brain and may reduce Parkinson's disease symptoms.
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Exercise
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Exercising may increase muscle strength, flexibility and balance. Exercise can also improve well-being and reduce depression or anxiety. A doctor may suggest working with a physical therapist and occupational therapist to develop an exercise program that works. One may also try exercises such as walking, swimming, gardening, dancing, and water aerobics or stretching, as possible.
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Lifestyle Changes
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Certain lifestyle changes also may help make living with Parkinson's disease easier. These include working with diet to find which foods help alleviate the symptoms, and various alternative medicine treatments such as massage, Tai chi, yoga, and meditation which may also be helpful.
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CARING FOR SOMEONE WITH PARKINSON’S DISEASE
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The incidence and severity of Parkinson’s disease (PD) symptoms vary from day to day and even from one time of day to another. It takes skill and patience to know when to assist with a task and when to simply allow the person more time to do the task independently. It also takes time and ongoing education to learn the many symptoms of Parkinson’s as well as the often-complicated medication regimens that offer the most symptom relief and improve quality of life. The web sites listed below have educational resources to help caregivers understand the disease and how to work with patients.
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SUPPORT FOR PEOPLE LIVING WITH PARKINSON’S DISEASE
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While the progression of Parkinson’s is usually slow, eventually a person’s daily routines may be affected. Activities such as working, taking care of a home, and participating in social activities with friends may become challenging. Experiencing these changes can be difficult, but support groups can help people cope. Many support groups can provide information, advice, and connections to resources for those living with Parkinson’s disease, their families, and caregivers. Below are some of the sites which offer education and resources on Parkinson’s disease.
https://www.nia.nih.gov/health/parkinsons-disease
https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview
Information contained in this summary is from the National Institutes of Health, the Mayo Clinic, the Parkinson’s Organization, and the Cleveland Clinic
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Nutrition for Parkinson's disease by Pharmacist Suzy Cohen
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https://suzycohen.com/articles/nutritional-status-matters-in-parkinsons-disease/
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