What I need to know about Parkinson's.

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Ruby Care Senior Living Advisors

For more information about the author, click to view their website: Ruby Care-Senior Living Advisors

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May 30, 2023

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Texas - Dallas, Collin, SE Denton & Rockwall Counties

Parkinsons: What do I need to know?

April is Parkinson’s Awareness month, with April 11 being World Parkinson’s Day.  Parkinson’s is a type of dementia that impacts motor function and is degenerative.  Currently there is still no known cure for Parkinson’s disease.   

What is Parkinson’s disease?

According to the International Parkinson and Movement Disorder Society (movementdisorders.org), Parkinson’s disease is a neurogenerative disorder characterized primarily by the loss of dopamine neurons in the substantia nigra part of the brain. 

Symptoms

Generally, symptoms develop on one side slowly over years, but the progression may differ due to the diversity of the disease.  People with PD may experience the following: 

·  tremor, mainly at rest (described as pill rolling tremor in hands

·  bradykinesia

·  limb rigidity

·  gait and balance problems.

Non-motor symptoms

Common Neuropsychiatric symptoms are: 

·  mood disturbances

·  cognitive changes

·  autonomic dysfunction

·  pain

·  sleep issues

·  anxiety

·  apathy

Prevalence is approx. 200 cases in 100K population, and about 25 cases per 100,000 population.  When motor manifestations appear, people with PD have lost more than 50% of nigral dopamine cells suggesting that pathological changes may begin several decades before the appearance of clinical signs.  

Causes of Parkinson’s disease

It is believed that Parkinson’s disease is multifactorial. Contributing factors are:

·  Hereditary predisposition

·  Environmental toxins

·  Aging

·  Genetic mutations (GBA, LRRK2, PRKN, SNCA)

Diagnosis

Diagnosis is still clinical and based on motor manifestations.  A brain MRI or CT and molecular imaging of the striatum may be performed to support clinical evaluation.

Treatment

Levodopa has remained the cornerstone of PD treatment for more than 50 years.  The challenge is after a few years of treatment the benefit lessons and motor complications appear in many patients due to disease progression.  The introduction of many other medications including inhibitors and dopamine agonists have been developed due to this decline.  

More recently, surgical and infusion therapies have become available to improve management in selective patients with motor complications. Surgery options include:

·  deep brain stimulation.

·  drug infusions based on the possibility to deliver continuously either levodopa or apomorphine.

Treatment noted is based on research according to Marcello Merello, MD Director of Neuroscience Dept. Head Movement Disorders Section Institute for Neurological Research Raul Carrea (FLENI) 2019 Updated by Angelo Antonini, MD, PhD Professor, Department of Neuroscience University of Padula, Italy.

Parkinsonism (movementdisorders.org)

A defining feature of Parkinsonism is bradykinesia (slowness with decrement and degradation of repetitive movements (Fatigue). Subtle bradykinesia is known to occur in the “normal elderly” population. The most common neuro degenerative cause of parkinsonism is Parkinson’s disease.  Other causes include multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration.  Often called “Parkinson-plus syndromes”, they do not respond as well to dopaminergic treatments and generally have worse prognosis compared to typical PD. Parkinsonism can also be symptomatic because of various vascular drug related, infectious, toxic, structural, and other known secondary causes.  Vascular Parkinsonism tends to have a lower body emphasis with gait disturbance and concomitant cognitive impairment.

Where to get help

We are fortunate to have a Dallas Area Parkinson’s Society (DAPS).  The DAPS provides not only information, but also hosts exercise groups and activities throughout the metroplex.  Several churches and senior centers also host Parkinson support groups and wellness classes. Dallas Area Parkinson Society | Home (daps.org)

Parkinson's Disease Support Groups (verywellhealth.com)

·  American Parkinson Disease Association

·  DailyStrength Parkinson’s Disease Support Group

·  Parkinson’s Foundation

·  PatientsLikeMe

·  Parkinson’s Movement Disorder and Alliance

·  Parkinson’s Community

·  NeuroTalk

Adult Day Cares and Assisted Living Communities often provide respite services for those with Parkinson’s or other conditions requiring activities of daily living (ADL) care support.

How can I help?

The Michael J Fox organization provides free scratch and sniff tests that help researchers learn more about Parkinson’s risks and contribute to research on the disease. (michaeljfox.org)

Regardless of if you are reading this because you or a loved one has been impacted by Parkinson’s disease or if you are just wanting to learn more, we hope that you are able to get the support you need and/or find ways to help cope 


Britt Hemsell – Ruby Care Senior Living Advisor & Blog Contributor


Resources:

International and Movement Disorder Society https://www.movementdisorders.org

7 Parkinson's Disease Support Groups of 2023 (verywellhealth.com)

American Parkinson Disease Association  https://www.apdaparkinson.org/community/

Dallas Area Parkinson Society | Home (daps.org)


Some Adult Day Cares in DFW:  

Friends Place Adult Day Care Richardson 972-437-2940



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