Shelia Lewis: Smith County Extension

Parkinson's disease affects nerve cells in the part of the brain controlling muscle movement. Parkinson's disease is progressive, meaning the signs and symptoms become worse over time; however, the disease often progresses gradually and most people have many years of productive living after a diagnosis.

Parkinson's disease occurs when certain nerve cells in a particular area of the brain are damaged or destroyed. Normally, these nerve cells release dopamine which causes your muscles to make smooth, controlled movements. Everyone loses some dopamine-producing nerve cells as they grow older; but, people with Parkinson's disease lose half or more.

RISK FACTORS

Age is one of the main risk factors for Parkinson's disease and risk continues to increase with age. In fact, signs and symptoms of Parkinson's disease may be dismissed as the effects of aging, particularly in older adults with the disease. Other risk factors may include heredity, gender, exposure to pesticides and herbicides and/or reduced estrogen levels, among others. See your health provider if you have any of the symptoms associated with Parkinson's disease - not only to diagnose the illness but also to rule out other causes for your problem.

The earliest symptom of Parkinson's disease may be an arm that does not swing when you walk, a mild tremor in the fingers of one hand, soft, mumbling speech and/or difficulty swallowing. You may lack energy, feel depressed, have trouble sleeping, slowed motion, rigid muscles, loss of automatic movements and/or dementia.

As many as half the people with Parkinson's disease develop depression, sometimes occurring months or even years before Parkinson's disease is diagnosed. Although physical limitations resulting from Parkinson's disease can be frustrating and stressful, depression is not usually a reaction to physical disability. It more likely arises from underlying brain changes associated with the disease itself.

A diagnosis of Parkinson's disease is based on your medical history, observations of your signs and a neurological examination. As part of your medical history, your health provider will want to know about any medications you take and whether you have a family history of Parkinson's.

For many people with Parkinson's, the initial response to treatment can be dramatic. Over time, however, the benefits of drugs frequently diminish or become less consistent, although symptoms can usually still be fairly well controlled. Physical therapy may be helpful for people with Parkinson's disease. It may help improve mobility, range of motion and muscle tone. Although specific exercises cannot stop the progress of the disease, improving muscle strength may help you feel more confident and capable. When lifestyle changes are no longer enough, your health provider may recommend certain medications. Medications can help manage problems with walking, movement and tremor by increasing the brain's supply of dopamine.

DRUG THERAPIES

Levodopa is a natural substance found in plants and animals and is converted into dopamine by nerve cells in the brain. Treatment with dopamine itself is not possible because dopamine does not cross the body's blood-brain barrier. Today levodopa is combined with another drug, carbidopa that helps more levodopa to get to the brain and reduces some of the side effects of this therapy. During early treatment, side effects from carbidopa-levodopa therapy are usually not a major problem; however, the drug works less evenly and predictably as the disease progresses. Side effects may include hallucinations, a drop in blood pressure when standing and nausea.

Unlike levodopa, dopamine agonists are not changed into dopamine. Instead, they mimic the effects of dopamine in the brain and cause neurons to react accordingly. The side effects of dopamine agonists are similar to those of carbidopa-levodopa, although they are less likely to cause involuntary movements and more likely to cause hallucinations or sleepiness. If you are taking any of these medications and start behaving in a way that is not normal for you, talk to your health provider.

If you have received a diagnosis of Parkinson's disease, you will need to work closely with your health provider to find a treatment plan right for you. Certain lifestyle changes also may help make living with Parkinson's disease easier, such as eating a healthy diet and getting exercise.

Understanding this disease is important so we can help our loved ones if they have this disease. Although people with Parkinson's may experience different levels, we hope this general information has been beneficial.

This information was provided by Andrew Crocker, Extension program specialist for gerontology health.

Shelia Lewis
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