According to Parkinson’s UK, Parkinson’s disease is the fastest growing neurological condition in the world, with an estimated 153,000 people affected in the UK. Causing symptoms such as tremors, muscle stiffness, and slow movement, Parkinson’s can have a significant impact on a person’s quality of life.
However, while there’s currently no cure, many people with Parkinson’s find that with the right treatment and support they’re able to manage their symptoms.
Here, we’ll take a closer look at what Parkinson’s disease is – including symptoms, causes, treatment, and ways to cope.
What is Parkinson’s disease?
Parkinson’s disease is a progressive neurological condition that affects the brain. It develops when nerve cells in an area of the brain called the substantia nigra begin to die.
Nerve cells in this area of the brain produce dopamine chemicals. Dopamine acts as a messenger between the brain and nervous system, helping to control and coordinate body movements. So, when these nerve cells begin to die or become damaged, the brain produces less dopamine – and this can make carrying out movements, such as walking, talking, writing, and smiling, difficult.
According to the NHS, symptoms of Parkinson’s disease usually start when around 50% of nerve cell activity in the substantia nigra have been lost. Because Parkinson’s disease is progressive, symptoms usually intensify with time.
‘Parkinsonism’ is an umbrella term that covers several conditions. This includes…
- Idiopathic Parkinson’s
- Drug-induced parkinsonism
- Multiple system atrophy
Idiopathic Parkinson’s (idiopathic means the cause is unknown) is the most common form of parkinsonism and is what we’ll refer to in this article when using the term ‘Parkinson’s’. You can read more about the different types of parkinsonism on the Parkinson’s UK website.
What are the symptoms of Parkinson’s disease?
Symptoms of Parkinson’s disease start when the brain is no longer producing enough dopamine to control movement properly. Symptoms can be subtle at first – for example, trouble sleeping and handwriting becoming smaller. And, for some people, symptoms can take months, or even years, to become obvious.
According to Parkinson’s UK, there are over 40 symptoms of Parkinson’s disease. However, the three most common of these are shaking (a tremor), rigidity (caused by muscle stiffness), and slow movement.
Some people may also experience symptoms such as falls, pain, anxiety, difficulty swallowing, bowel issues, and restless leg syndrome. That said, it’s important to note that everyone’s experience will be different.
What causes Parkinson’s disease?
Experts are currently unsure what causes the brain’s dopamine-producing nerve cells to die. However, it’s believed to be a combination of age, genetics, and environmental factors.
We’ll cover these below.
Environmental factors
There’s some evidence that environmental factors may cause dopamine-producing cells to die.
Environmental factors include things like viruses, bacteria, toxic chemicals, and heavy metals in the world around us. Researchers are particularly interested in the potential link between industrial pollution, and the herbicides and pesticides used in farming and traffic, in the development of Parkinson’s.
However, further research is needed to confirm the role of environmental factors in the development of Parkinson’s disease.
Genetic factors
According to Parkinson’s UK, Parkinson’s can be a hereditary condition.
Changes in certain genes – known as mutations – have been found to increase a person’s risk of Parkinson’s. The most common of these is a mutation to the LRRK2 gene (a type of protein found in nerve cells in the brain, as well as the heart, lungs, and kidneys), which experts believe may raise a person’s chances of developing Parkinson’s by the age of 80 by around 75%.
Research estimates that around one in 100 people carry the LRRK2 gene mutation. However, it’s important to note that carrying these mutations doesn’t necessarily mean you’ll develop Parkinson’s.
Only a small percentage of Parkinson’s cases have been reported as hereditary and it’s considered rare.
Age and gender
According to research, ageing remains the biggest risk factor for developing Parkinson’s disease. Although younger people can get Parkinson’s, most people diagnosed with the condition are over 50. Men are also more likely to develop Parkinson’s than women.
It’s normal for cells in the substantia nigra to die as we age. However, experts are currently unsure why this process happens so rapidly in some people and why it’s more common in men.
Causes of non-idiopathic parkinsonism
As we know, ‘parkinsonism’ is the umbrella term used to describe symptoms of tremors, muscle stiffness, and slow movement. While idiopathic Parkinson’s is the most common type of parkinsonism and refers to cases where the cause is unknown, there are some rarer types for which a specific cause has been identified.
According to the NHS, this includes parkinsonism caused by…
- Medication (drug-induced parkinsonism) – where symptoms develop as a result of taking certain medications. This includes some types of antipsychotic medications. Symptoms usually improve once medication is stopped.
- Other progressive brain conditions – including multiple system atrophy, corticobasal degeneration, and progressive supranuclear palsy.
- Cerebrovascular disease – where a series of small strokes cause several areas of the brain to die.
How is Parkinson’s disease diagnosed?
If you suspect you may have Parkinson’s, it’s important to book an appointment with your GP. During your appointment, they’ll ask you about your symptoms, including how your daily life and physical and mental health are affected.
For an accurate assessment, it’s important to be as honest as possible. If you struggle with this, Parkinson’s UK has a useful guide on their website. This offers advice about questions to ask your GP and how you can prepare for your appointment.
If your GP suspects you have Parkinson’s, they’re recommended under the NICE clinical guidelines to refer you to a specialist with experience in diagnosing the condition. Diagnosing Parkinson’s isn’t always straightforward because there’s currently no single or definitive test, and several other conditions can cause similar symptoms.
To help with an accurate diagnosis, specialists will often take a detailed medical history and ask you to carry out tests, such as walking, speaking, writing, or drawing something. In some cases, other medical tests such as an MRI or CT scan may also be used.
You can read more about how Parkinson’s is diagnosed on the Parkinson’s UK website.
How is Parkinson’s disease treated?
There’s currently no cure for Parkinson’s disease. However, there are treatments available to help people manage their symptoms and improve their quality of life. It’s important to note that the right treatment for Parkinson’s will vary from person to person.
Treatment isn’t always necessary during the early stages of Parkinson’s when symptoms tend to be milder. But, you’ll need regular check-ins with your specialist, who can monitor your condition and make necessary changes as the condition progresses. For some people, this might include wearing a device at home that monitors symptoms.
According to the NHS, treatment for Parkinson’s can include supportive therapies, medication, and surgery. We’ll cover these below…
Supportive therapies
Physiotherapy
Physiotherapy can be effective for helping to relieve joint pain and muscle stiffness.
The aim of physiotherapy is to make movement easier by improving flexibility, fitness levels, and the ability to manage daily tasks yourself.
Occupational therapy
Occupational therapists work with people to identify areas of their everyday life which are particularly difficult, such as getting out of bed and cooking a meal.
They work to provide practical solutions – for example, by adjusting your home environment – to help people maintain their independence for as long as possible.
You can find more in our article; What is occupational therapy and when can it be useful?
Speech and language therapy
Some people with Parkinson’s struggle with their speech and have difficulty swallowing (dysphagia).
Speech and language therapists can help to improve these issues with speaking and swallowing exercises, or through the use of assistive technology.
Dietary changes
Some people with Parkinson’s find that dietary changes help to improve their symptoms.
Common examples include increasing fibre intake (to reduce constipation) and eating small, frequent meals to avoid problems caused by low blood pressure – for example, feeling dizzy when you stand up quickly.
However, it’s important to speak to a healthcare professional before making any significant changes to your diet.
You can read more about therapies for Parkinson’s on the Parkinson’s UK website.
Medication
Medication is often used to improve the main symptoms of Parkinson’s, such as tremors and problems with movement.
The three main types of medication used for Parkinson’s include levodopa, dopamine agonists, and monoamine oxidase-B inhibitors. According to Parkinson’s UK, these drugs work by doing one or more of the following…
- Increasing the amount of dopamine in your brain
- Acting as a dopamine substitute, and helping to stimulate areas of the brain that need dopamine to function properly
- Blocking the action of enzymes that break down dopamine
Medication won’t be useful or suitable for everyone, and whether or not you need it and which type, will often depend on the severity of your symptoms. Your specialist will be able to explain your options and help you determine what’s best for you. People on Parkinson’s medication will also need regular reviews as the condition progresses.
Parkinson’s UK has more information about the different medications used to treat Parkinson’s on their website.
Surgery
Most people with Parkinson’s are treated with medication. However, a type of surgery called ‘deep brain stimulation’ is used in some cases.
Deep brain stimulation involves surgically implanting a pulse generator, similar to a heart pacemaker in your chest. This is connected to one or two fine wires, placed underneath the skin, which are then linked to specific areas of the brain. The pulse generator produces a tiny electrical current to stimulate areas of the brain affected by Parkinson’s.
Surgery doesn’t cure Parkinson’s and won’t be suitable for everyone, but it can help to ease symptoms for some people. You can read more about deep brain stimulation surgery for Parkinson’s on the Parkinson’s UK website.
What support is there for people with Parkinson’s disease?
Whether you’ve been diagnosed with Parkinson’s or suspect you may have symptoms, it’s normal to feel overwhelmed. However, it’s important to remember that you’re not alone and there’s support available.
Parkinson’s UK has a collection of support resources on their website, including practical tips, guidance, a confidential telephone helpline, and opportunities to connect with others, such as through local support groups and online community forums. You can also find advice for those supporting and caring for someone else with Parkinson’s.
Other support resources include Parkinson’s Care and Support UK, The Brain Charity, and Parkinson’s Foundation.
You might also like to read Maura’s story. After being diagnosed with Parkinson’s in 2013, Maura remained determined to live life to the full, and celebrated her 70th birthday by climbing Mount Fuji.
Final thoughts…
Parkinson’s disease can be difficult to live with and, because it’s a progressive condition, it’s normal to feel overwhelmed if you’ve been diagnosed. However, the good news is that with the right support and treatment, many people find that they’re able to manage their symptoms.
For further reading, head over to the general health section of our website. Here, you’ll find information on everything from longevity tips to important health checks.
Do you have any experience of Parkinson’s disease that you’d like to share? We’d be interested to hear from you in the comments below.
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