What is Parkinson’s disease?
Parkinson’s is a progressive neurological condition that occurs due to a loss of nerve cells in the brain. Symptoms start to show when around 70% of the nerve cells have been lost. This causes a lack of dopamine in the brain which causes a person’s movements to become slower so it can take longer to do things.
There is currently no cure for Parkinson’s but the symptoms can be treated to some extent by medication. Although the disease doesn’t directly cause people to die, it is a progressive disease so symptoms do get worse over time.
Who is affected?
One person in every 500 has Parkinson’s; this is about 127,000 people in the UK. Most people who develop the condition are over the age of 50 but 1 in 20 people are under 40.
Types of Parkinson’s and Parkinsonism
Parkinsonism is an umbrella term used to cover a range of conditions that all share the main symptoms of slow movement, possible tremor, rigidity and problems walking.
The main type of Parkinson’s is Idiopathic Parkinson’s. Idiopathic means that the cause is unknown. If someone is showing symptoms of Parkinsonism but is not diagnosed with idiopathic Parkinson’s, they may have another type of Parkinsonism.
Forms of Parkinsonism’s that are not idiopathic Parkinson’s are:
Vascular Parkinsonism – The most likely causes of this are hypertension and diabetes. A stroke and cardiac arrest may also be a cause. Symptoms can include difficulty speaking and making facial expressions and swallowing, as well as problems with memory or having confused thoughts and incontinence. Vascular Parkinsonism is a progressive condition so symptoms can change over time.
Dementia with Lewy bodies – This is similar to Parkinson’s and Alzheimer’s. Symptoms can include problems with memory and concentration, spatial awareness, attention and language. People with Dementia with Lewy bodies often experience hallucinations and Parkinson’s type symptoms such as slowness of movement, stiffness or tremor. For more information about Dementia with Lewy bodies go to www.parkinsons.org.uk
Inherited Parkinson’s – It is very rare that Parkinson’s is hereditary. However it is thought that some people may have genes that increase the possibility of developing Parkinson’s. People who have these genes are more likely to develop the condition when combined with other factors such as viruses. It is estimated by Parkinson’s UK that 5% of people with Parkinson’s may have a genetic cause.
Drug Induced Parkinson’s – Around 7% of people with Parkinsonism have developed their symptoms following treatment with particular medications. Dopamine is a chemical in the brain that allows the brain to send messages and coordinate movement. Neuroleptic drugs (that are used to treat psychotic disorders such as schizophrenia) block dopamine and when the levels of dopamine fall, Parkinson’s symptoms can appear. Most people will recover within months or often days or hours of stopping the medication that caused the dopamine block.
Parkinson’s is a very individual condition that everybody experiences differently. That means that people will experience different symptoms to varying degrees. The main symptoms are;
- Tremor (shaking)
- Slowness of movement
- Rigidity (stiffness)
There are also physical symptoms that individuals may experience;
- Eye problems
- Bladder and bowel problems
- Falls and dizziness
- Restless leg syndrome
- Skin, scalp and sweating problems
- Sleep problems
- Difficulty swallowing
- Speech and communication problems
Parkinson’s can also cause mental health symptoms such as;
- Memory problems
- Hallucinations and delusions
If you are worried about a loved one who experiences these symptoms, talk to your GP.
Drugs are currently the main treatment for Parkinson’s. Drug treatments aim to increase the level of dopamine that reaches the brain and stimulate the parts of the brain where dopamine works. There are lots of different drugs used to treat Parkinson’s and each drug treatment is prescribed specifically to the individual.
As with all drugs there are side effects of Parkinson’s medication. Not everybody will experience these but it’s useful to be aware of them. Some things that may seem like symptoms of Parkinson’s may only be side effects of the medication so it’s important to speak to your GP or Parkinson’s Nurse if you notice any new symptoms when starting medication.
Impulsive and compulsive behaviour can be a side effect of medication. Only a small number of people experience this but it can have a big impact on both the person affected and the people around them. People affected may often not realise they have a problem, so if you notice anything unusual it is important to speak to your GP or other healthcare professional.
When Parkinson’s medication is working well and symptoms are controlled this is called ‘on’ time. When symptoms are not being controlled this is called being ‘off’. As Parkinson’s progresses some individuals may find that doses of medication don’t last as long as they used to, this is called ‘wearing off’. Sometimes the effects of ‘wearing off’ can happen quickly, and there may be a sudden change between being ‘on’ and being ‘off’. If you notice this happening, book an appointment with your specialist for a medication review.
Caring for someone with Parkinson’s
Finding out that someone you love has been diagnosed with Parkinson’s can be very emotional. Try to find out as much about the condition as you can. http://www.parkinsons.org.uk/ can be a great place to start.
Many people with Parkinson’s stay independent for years after being diagnosed. Not everyone who has Parkinson’s will develop the same symptoms at the same time and in the same order, so the care you provide will vary day to day or even hour to hour. Because of this it’s a good idea to ask the person what help they want from you. Try and allow the person to do things for themselves, even if it takes longer and try not to worry if you get it wrong sometimes; it’s a learning curve. Most of all make sure you have the support you need to help you carry out your caring role.
People with Parkinson’s can be on a very complicated medication regime taking a number of different tablets at different times of the day. Being in charge of this for someone else can seem very daunting. Don’t try and do it yourself if you’re not sure, speak to your GP, pharmacist or specialist.
Some types of Dementia can be related to Parkinson’s, so if you notice anything out of the ordinary, speak to your GP. To find out more about the types of dementia click here or visit http://www.dementiauk.org/