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Guide to Parkinson’s Disease

Parkinson’s disease is a slowly developing degenerative brain disease. It is classified as a “movement disorder” because the damage it does to your brain affects your ability to move parts of your body when you want (or don’t want) them to move.

The disease was named after the doctor, James Parkinson, who detailed the first definitive and descriptive instance of it. In the early 1800s, Parkinson published “An Essay on the Shaking Palsy,” which described a new medical condition as “paralysis agitans,” where he laid out some of the disease’s main qualities. These symptoms included “a slight sense of weakness” and “a proneness to trembling in some certain part” of the body, like your head, arms, or hands. He defined the disease as follows:

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The disease was first generalized as “palsy,” because the main symptoms of the disease include shaking (tremors) and, later on, paralysis—both of which generally make up a palsy diagnosis. Parkinson made the distinction between general palsy and this new disease, as he identified patients who were having tremors while resting and not trying to use the muscles that were shaking, rather than the shaking occuring while the muscles were in use. Eventually, the disease would bear the namesake of its first in-depth descriptor.

The disease has a history of being loosely described in texts for thousands of years, but the 200 years since Parkinson’s work—including Jean-Martin Charcot’s work identifying bradykinesia (the slowness of movement) as one of the main developments in Parkinson’s disease—helped bring clarity to the diagnosis.

In the 21st century, there are more than one million people living with Parkinson’s disease in the U.S. alone. That number balloons to about 10 million when looking at the worldwide population. In general, men are diagnosed more frequently than women, but the difference in diagnostic rates among various races isn’t significant.

In the U.S., the economic impact of Parkinson’s disease is estimated to be around $25 billion every year between treatment for the disease, lost income, and government programs (Medicaid, social security) that help those with the disease live.

As of January 2018, there is one government-funded research program dedicated to Parkinson’s disease research, but there are dozens of Parkinson’s-centric non-profit organizations like the Michael J. Fox Foundation for Parkinson’s Research and the Parkinson’s Research Foundation that have raised billions of dollars to help define, understand, and help find a cure for Parkinson’s disease.

Now that we’ve defined what Parkinson’s disease generally is, let’s take a look at how and when the disease onsets, what the stages of the disease are, your prognosis if diagnosed, and your treatment options.

Symptoms and Signs of Parkinson’s Disease

It’s difficult to directly diagnose Parkinson’s disease. There is no specific test doctors can perform to confirm a diagnosis, which is why it’s important for research to continue to identify the ever-evolving definition of Parkinson’s. In addition to pinpointing many of these symptoms, doctors will also delve through family history and perform an overall examination of the brain to officially diagnose someone.

The rate at which these symptoms onset varies per person, and there’s no specific amount of time you’re guaranteed to lived once diagnosed. It can develop quickly or you can live 30 years before the worst of the disease starts to show. While Parkinson himself identified six main qualities of the disease when he first detailed it, the symptoms of Parkinson’s have developed over time. They include, but aren’t completely limited to, the following:

Does Parkinson’s Lead to Dementia?

During the final stage of Parkinson’s disease, your symptoms may progress from severe motor function inhibition to memory loss. Generally, any form of memory loss is known as dementia.

There are multiple forms of dementia, such as:

Parkinson’s disease is listed as a form of dementia simply because memory loss occurs in its later stages. It’s estimated that memory loss doesn’t become a concern until at least 10 years after the initial diagnosis. While memory loss isn’t a cardinal symptom of the disease, more than half of Parkinson’s patients develop some form of dementia. Like Alzheimer’s disease, the dementia associated with Parkinson’s disease progressively grows worse.

The Alzheimer’s Association says that if dementia does stem from Parkinson’s disease, the symptoms are similar to dementia with Lewy bodies. This is because patients start to develop these protein deposits (the Lewy bodies) on the parts of their brain that affect movement and cognition, which can then affect memory.

Symptoms of the dementia include:

Dementia may not explicitly be a symptom of Parkinson’s disease. It may just be that people with the disease are at a higher risk of developing dementia than people without it. It also may be that memory loss is occurring separately from the disease. Most Parkinson’s patients who experience dementia are over 70, which is when rates of memory loss start to increase, too. Nevertheless, it’s a significant development in the progression of Parkinson’s and something that doctors need to include in the treatment process.

Stages of Parkinson’s Disease

Because Parkinson’s disease develops over time, there are various stages that help identify how symptoms have progressed and what should be expected next.

Generally, doctors follow a set of five stages as outlined below:

Stage 1

The beginning stage of Parkinson’s disease sometimes doesn’t show any signs at all. If symptoms are noticeable, they’re usually tremors and affect one side of the body. The symptoms usually don’t affect your daily routine, but they should be taken seriously and brought to the attention of your doctor, if they haven’t already.

Stage 2

During this stage, the disease starts to affect your whole body. The tremors and stiffness cause routine activities to take a little longer to complete, and your overall movement starts to be affected. Your posture and facial expressions may should start to change, which can impact your ability to walk at a normal pace or communicate like you used to.

Stage 3

This stage features a worsening of all the symptoms that started to progressively deteriorate in stage 2, but you also start to experience a loss of balance and coordination, as well as how quick your reflexes are. As these symptoms start to come into the fold, people with the disease start to fall more, which can cause their own injuries and debilitations. Activities like getting out of bed, eating, and getting dressed start to get more difficult.

Stage 4

At this stage, it’s nearly impossible to live on your own. Your ability to complete activities of daily living (dressing, taking a shower, eating) become severely inhibited, and you shouldn’t perform them without assistance because it’s dangerous—especially cooking and trying to bathe. Walking is limited, too, with your movement being restricted to a walker (if possible).

Stage 5

This is the final and most severe stage, and you can’t live without assistance by this point. Basically all motor functions are lost, and you’re confined to a bed or a wheelchair for movement. Stage 5 is when dementia, hallucinations, and confusion begin to set in.

In addition to the onset of the disease developing slowly, there is not one singular form of Parkinson’s disease but rather multiple that take effect at different speeds and produce different symptoms. While different forms of the disease have in-depth rating symptoms about how severely the disease is progressing, the aforementioned rating system presents a solid progression of symptoms across all forms of Parkinson’s.

Parkinson’s is not always the explicit cause of death for those with the disease, but rather the dangers and the inhibitions (immobility leading to heart issues, instability leading to fatal falls) of the disease that can become fatal.

Different Types of Parkinson’s Disease

As Parkinson’s begins to take its full effect, the disease can ravage different parts of the brain and cause varying symptoms. The diagnosis of what type of Parkinson’s you have depends on this (symptoms, where it starts, etc.). Sometimes, doctors don’t know the exact cause, either, but they know you exhibit symptoms that line up with Parkinson’s. Let’s dig into the different forms of the wicked disease:

There are other generations of the disease, but they are the most rare forms. Nevertheless, they carry similar symptoms as all other forms of the disease.

Parkinson’s Disease Treatment and its Future

Parkinson’s disease has no cure. However, millions of dollars are going into research every year to help better understand the disease, from how it’s defined to how it’s treated. The ultimate end goal is developing a cure for Parkinson’s, but in the meantime, doctors and researchers have developed treatment plans based on what they presume is causing the disease in the first place—most often the lack of certain brain chemicals and cells like dopamine.

The plans vary per patient, and some of these treatment options include:

There isn’t any real way to definitively prevent the disease, either. As with prevention for any disease or malady, it’s suggested that you maintain a healthy lifestyle before and after a diagnosis. Remaining physically engaged through activities like running, yoga, and weight lifting and eating healthy are both ways to provide your body with the best opportunity for a healthy life.

Clinical trials are also viewed as a “treatment option” because they may give you as good of a chance of relieving symptoms as other already-existent treatments. There are clinical trials happening year-round with various institution and foundations, and your demographic may fit a trial in its beginning pre-clinical stage or an advanced stage.

Talk to your doctor about any available clinical trials that you may qualify for and how to become a part of them. Also stay in contact with your doctor regarding any concerns that you may have with Parkinson’s or how to get it treated.

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