Parkinson’s disease is a progressive and incurable disorder of the nervous system. It affects movement and is characterised by tremors, stiffness and slowing down of movement.

Early symptoms may be barely noticeable. The condition often starts with a slight tremor in one hand and a feeling of stiffness in the body, but as the disease develops the symptoms become more pronounced.

Symptoms of Parkinson’s disease

Symptoms of Parkinson’s disease may vary from person to person. Some of the early signs include:

• Tremors or shaking – this often begins in the hands or fingers and you may notice tremors in the hand even when it is resting.
• Slowed movement (bradykinesia) – Parkinson’s disease causes a slowing of movement which may make even everyday tasks, such as walking or getting up out of a chair, more difficult and time-consuming.
• Speech changes – you may start to slur or hesitate before speaking. Your speech may lose its normal inflections and become more monotone.
• Muscle stiffness – muscles may become stiff and painful, limiting your range of movement.
• Changes in posture – you may start to stoop or have problems balancing.
• Loss of automatic movement – movements that you perform without thinking about them, such as swinging your arms when you walk or smiling, may become more difficult.
• Writing changes – you may find it more difficult to write and your writing may become illegible.

In addition, you may also develop:

• Depression, anxiety or loss of motivation.
• Problems chewing, eating or swallowing – these tend to occur as the condition develops.
• Sleep problems.
• Bladder problems.
• Constipation due to a slower digestive tract.
• Problems with your sense of smell including difficulty distinguishing between different odours.
• Pain.

What are the 5 stages of Parkinson’s disease?

Doctors have identified five stages to Parkinson’s disease, known as the Hoehn and Yahr Scale. This scale is used to classify patients in research studies.

• Stage 1: the earliest stage with mild symptoms only on one side of the body and little or no functional impairment.
• Stage 2: Symptoms have spread to both sides of the body and may now include loss of facial expression and speech abnormalities. This may come months or years after stage 1.
• Stage 3: By this stage you may have loss of balance and slowness of movement. However, you will still be able to dress, eat and wash by yourself.
• Stage 4: You may be able to walk and stand unassisted, but you have become increasingly disabled and can no longer perform daily activities without assistance.
• Stage 5: The most advanced stage of the disease. You can no longer get out of a chair or bed without help. You may fall frequently when standing and stumble when walking. You need round the clock assistance and you may have hallucinations.

Causes of Parkinson’s disease

Scientists are not absolutely sure what causes Parkinson’s disease, but it is linked to the death of nerve cells in the brain and a fall in level of dopamine levels which causes abnormal brain activity. If it is accompanied by changes in the Lewy bodies of the brain, dementia may also develop.

Certain factors seem to be associated with an increased risk of developing Parkinson’s disease. These include:

• Age – the disease is most common in people aged 60 and over.
• Hereditary – if you have a close family member with the disease, you are more likely to develop it.
• Sex – A French study in 2015 found that men are 50% more likely to develop Parkinson’s disease than women. However, the risk for women increases with age.
• Environmental factors – studies suggest ongoing exposure to certain pesticides may slightly increase your risk of Parkinson’s.

Dr David Choluj discusses more about the causes of Parkinson’s disease.

Diagnosis of Parkinson’s disease

There is no specific test for Parkinson’s disease, and it may take some time to establish a definitive diagnosis. A neurologist will assess your medical history and review your signs and symptoms. You may be given an MRI, CT or ultrasound scan and/or blood tests to rule out other disorders. A dose of Parkinson’s disease medication may be administered to see if it improves your symptoms. This may help to confirm a diagnosis of Parkinson’s.

Parkinson’s disease treatment

• Medication: There is no cure for Parkinson’s disease but there is a wide range of medications that have been shown to be effective in controlling symptoms, including medication to increase or provide a substitute for lost dopamine. Medication can improve problems with movement, tremoring and walking.
• Surgery: People with advanced Parkinson’s disease who are no longer responding well to medication may be offered deep brain stimulation surgery. This implants electrodes into different parts of the brain that send pulses into the brain and may reduce symptoms.
• Lifestyle changes: Certain lifestyle changes have been shown to reduce the symptoms of Parkinson’s disease. These include eating high fibre foods and drinking plenty of fluids to prevent constipation; eating a diet rich in omega-3 fatty acids; exercising to improve balance, flexibility and strength.

Interested to know more about how Parkinson’s disease can be treated?

Dementech specialise in diagnosing and treating neurological disorders like Parkinson’s disease. For more information contact our experienced and friendly team.