To mark April being Parkinson Awareness Month, we are putting the spotlight on Parkinson’s – the second most common neurodegenerative disorder after Alzheimer’s.
Parkinson’s is a disease that mostly affects older people. While over 100,000 Canadians are living with Parkinson’s, around 90% of them were diagnosed when they were over 50. It’s estimated that four million people worldwide have the disease. We examine what Parkinson’s is, what causes it, how you can spot the signs and the treatments available.
What is Parkinson’s disease?
Parkinson’s disease is a chronic, progressive degenerative neurological disease. What this means is that its symptoms appear gradually and continue to progress over time.
The body’s ability to move is controlled by dopamine, a chemical in the brain which carries signals between the brain’s nerves. Parkinson’s occurs when the cells that produce dopamine die and those brain signals gradually decrease. When nerve cell loss reaches 80%, the symptoms start to appear.
There is unfortunately no cure for Parkinson’s at this time, but there are various forms of treatment that enable patients to manage the symptoms of the disease and have a better quality of life.
How does Parkinson’s affect people?
The primary symptoms of Parkinson’s include:
- Uncontrollable shaking or tremors, often beginning in the hands
- Muscle stiffness or tension
- Bradykinesia, which means slow movement
- Impaired posture and balance
- Speech changes
- Changes to handwriting, often becoming smaller and more cramped
- Facial expression changes
- A shuffling gait
- Lower speaking voice
- Cognitive impairment
There are also associated symptoms of depression, sleep issues, fatigue and low blood pressure.
How is Parkinson’s disease diagnosed?
While there are no specific tests available that diagnose Parkinson’s, when symptoms start to show, doctors will often refer patients to a neurologist.
These specialists will diagnose Parkinson’s by studying the patient’s medical history and the symptoms that are showing. A physical and neurological examination will also take place and sometimes a dopamine transporter (DAT) scan.
A number of tests – like blood work – along with MRIs, CT scans and ultrasounds of the brain may be ordered to rule out other possible illnesses. It can take time to diagnose Parkinson’s and doctors may sometimes prescribe Parkinson’s medication to confirm the diagnosis. If the medication brings about considerable improvement in the symptoms, then this will confirm the diagnosis of Parkinson’s.
Treating Parkinson’s with medication, DBS and exercise
Because Parkinson’s cannot be cured, all treatments aim to reduce the severity of the symptoms and improve the patient’s quality of life. Typically, this entails a combination of drugs, increased aerobic exercise and Deep Brain Stimulation (DBS).
Parkinson’s is caused by a loss of dopamine in the brain, which means that most drugs used to treat it are either converted into dopamine in the brain or imitate the action of dopamine.
Common types of Parkinson’s drugs include levodopa and dopamine agonists. Sometimes they are combined with other drugs, such as carbidopa and benzerazide to improve the drug’s effectiveness and reduce side effects.
There can be considerable side effects, however. These include:
- Involuntary movements
- Obsessions with food, gambling, shopping and Internet use
- Some drugs may also lose their effectiveness over time
The surgery for Deep Brain Stimulation (DBS) involves placing electrodes into areas of the brain that control movement. A pacemaker-type device called a neurostimulator is then typically placed under the skin below the collarbone.
It then sends constant electrical pulses into the brain, thereby decreasing the symptoms of Parkinson’s. Doctors will monitor the settings and medication over time, to find the perfect balance of drugs and electrical pulses. Finding this balance can take up to a year. After DBS, patients can often reduce their medication.
What are the causes of Parkinson’s? And how can it be prevented?
The reason for the loss of nerve cells that cause Parkinson’s is unknown. Research has looked into the role of viral infections, environmental toxins and genetic predisposition. Some scientists believe that in some cases, a combination of both genetic and environmental factors cause the disease.
Given the lack of understanding as to the causes of Parkinson’s, there is no scientifically proven means of preventing the disease. However, avoiding some suspected risk factors, such as severe head injury and pesticides may be helpful.
If you or a loved one has been recently diagnosed with Parkinson’s, Parkinson Canada has many resources to help you live the best life possible.
Finding the finances to manage Parkinson’s
Almost two thirds of Canadians with Parkinson’s have to pay for ongoing expenses related to the disease, which aren’t covered by provincial or private health insurance.
These expenses typically cover mobility aids, physiotherapy and home care. Mobility aids include walkers, wheelchairs, lift chairs and stair lifts. Home care often consists of health care, help with housework, home maintenance or yard work, meal preparation and transportation for doctor appointments or shopping.
Without sufficient savings, it can be difficult for a Parkinson’s patient to find the money to lead the most fulfilling life possible. For those patients aged 55 and over, who are homeowners, the CHIP Reverse Mortgage® could provide the funds to cover all necessary expenses.
You don’t have to pay back what you owe until you decide to sell, so it won’t have an impact on your retirement income.