What is Parkinson’s disease?
Parkinson’s disease (PD) is a progressive, degenerative disorder of the brain. The most obvious signs involve movement difficulties, yet PD can also trigger a range of non-motor symptoms. The likelihood of developing PD grows with age, mainly affecting people over 65 years old. Nevertheless, it can also occur in younger individuals. It is estimated that approximately 80,000 Australians live with PD.1 This condition bears the name of Dr. James Parkinson, who first detailed it in 1817 in his work “ An Essay on the Shaking Palsy”. Although no cure exists today, many of its symptoms can be effectively managed. Scientists worldwide are actively investigating PD to develop better therapies and uncover its underlying causes.
Motor symptoms of Parkinson’s disease
These are the most visible signs that clinicians typically use to confirm a PD diagnosis. They include:
- Resting tremors
- Slowed movements (bradykinesia)
- Muscle rigidity
- Stooped posture
- Impaired balance
- Shuffling gait
- Reduced spontaneous actions, such as blinking or smiling
- Diminished facial expressiveness
Non-motor symptoms of Parkinson’s disease
Commonly referred to as the ‘invisible symptoms’, these manifestations can impact nearly every organ system and may appear at any point in the illness. They include:
- Variable blood pressure, often with episodes of low readings
- Constipation
- Sexual issues, such as erectile dysfunction in men or reduced libido and discomfort in women
- Excessive sweating
- Urinary problems, including frequent need to urinate, leakage, or difficulty emptying the bladder
- Persistent fatigue
- Sleep disturbances
- Diminished sense of smell
- Excessive saliva production, leading to drooling
- Difficulty swallowing
- Visual changes, for example dry eyes or double vision
- Speech alterations, such as reduced volume, slurring, or a flat tone
- Micrographia, where handwriting becomes abnormally small
- Unintended weight loss (mild to moderate)
- Apathy or depressive symptoms
- Other mood changes
- Cognitive issues, including problems with memory or concentration
- Hallucinations or paranoia in those with long-standing disease
Stages of Parkinson’s disease
Symptoms unfold gradually and usually follow a progression described in distinct stages.4
Stage 1
During this initial phase, symptoms are often mild and may not disrupt routine tasks. They can easily go unnoticed. Typically, tremors or other motor signs appear on only one side. Early changes in posture, gait, and facial expressions may emerge. Often, loved ones are the first to pick up on these subtle shifts.
Stage 2
Symptoms intensify as tremor and muscle stiffness involve both sides of the body. Difficulties with posture and walking become more noticeable. Speech may also start to suffer.
Stage 3
At this mid-stage, bradykinesia becomes more severe, and falls are more frequent. Daily tasks like dressing or eating are now clearly affected.
Stage 4
Symptoms grow significantly more disabling. A walker may be required for mobility. Individuals often need assistance with everyday activities and cannot live independently.
Stage 5
This final stage represents the most profound level of disability. Leg rigidity may lead to freezing, preventing standing or walking. A wheelchair is often necessary, and continuous care is essential to avoid falls. Hallucinations, delusions, confusion, and dementia are common at this point.
What causes Parkinson’s disease?
In PD, specific neurons in the brain progressively deteriorate and die. This reduces the number of cells that synthesize the neurotransmitter dopamine. When dopamine levels fall, abnormal neural signaling emerges, leading to the characteristic symptoms. In about 95% of cases, the trigger for this degeneration remains unknown.5 This form is referred to as idiopathic Parkinson’s disease. Although the exact origin of PD is still under investigation, several risk factors have been identified:6,7
- Increasing age, risk rises as you grow older
- Male sex, men have about a 50% higher likelihood than women to develop PD.8
- Environmental exposures, higher rates in rural regions, possibly linked to pesticides and other chemicals
- Family history, roughly 15% of cases report a genetic connection
- Head trauma, concussions and other brain injuries may raise PD risk
How is Parkinson’s disease diagnosed?
No definitive test exists for PD, and diagnosis can take time. A neurologist (a doctor specializing in nervous system disorders) will evaluate based on:
- Medical history
- Review of signs and symptoms
- Neurological examination
- Physical examination
Imaging studies are generally performed to exclude other conditions rather than to confirm PD. In some cases, a clinician may prescribe a PD medication to see if symptoms improve. If the medication leads to improvement, this can further support the diagnosis.
Treatment and management of Parkinson’s disease
Unfortunately, there is no cure for PD. Treatment focuses on alleviating symptoms and may involve:9
- Medications, Drugs that boost or replace dopamine can ease symptoms; these may be administered orally, by injection, or via a tube into the small intestine
- Surgery, Deep brain stimulation can lessen tremors for some patients, though it is not appropriate for everyone
- Lifestyle interventions, For example:
1. Consuming a balanced diet rich in fibre and fluids to help manage constipation 2. Engaging in regular exercise to support strength, balance, and mobility
Can you prevent Parkinson’s disease?
Regrettably, the exact causes and variable progression of PD remain unknown. As a result, clear prevention strategies have yet to be established. Nonetheless, research efforts worldwide continue to seek answers.
When should you see a doctor?
If you experience any of the symptoms linked to PD, consult your doctor. Since other disorders can present similarly, it is wise to have any concerning signs evaluated. An accurate diagnosis ensures appropriate treatment.