Parkinson’s disease is a neurodegenerative disorder with no cure that affects older people, causing slow movements, tremors, and other symptoms.
Estimates say that this disease affects 1% of the population over 60 years old. This disorder has a slow onset, but it is progressive. Within this article, you will find answers to the most common questions on this topic, like what organs this disease affects, what makes this disease deadly, and many more. But before reaching that point, there will be brief explanations of the basic concepts of this disease.
By reading this article, you will obtain key insights about Parkinson’s disease, its causes, and symptoms, its complications, and many others. Please continue reading to get pearls on this specific topic by the hand of a Doctor.
What is Parkinson’s Disease?
The disease predominantly affects the basal ganglia, a group of nuclei at the base of the brain, and the substantia nigra. Nerve cells in the substantia nigra produce the neurotransmitter dopamine. They are responsible for relaying messages that plan and control body movement.
Furthermore, body movement is controlled by a complex chain of decisions involving many groups of nerve cells. These are the ganglia. Information comes to the striatum, a central area of the brain that works with the substantia nigra to send impulses back and forth from the spinal cord to the brain.
When dopamine receptors in the striatum receive an inadequate stimulus, parts of the basal ganglia are under or over-stimulated. Depending on the stimulation, this can cause movement symptoms like tremor or rigidity.
In Parkinson’s disease patients, the nerve cells that produce dopamine are dying. Parkinson’s disease symptoms occur when the nerve cells emit an impulse, and there is not enough dopamine to transmit it.
The 2 significant body findings in Parkinson’s disease are the loss of pigmented dopaminergic nerve cells of the substantia nigra and the presence of Lewy bodies in the brain. Before the movement or motor signs of Parkinson disease emerge, approximately 60-80% of dopaminergic neurons are already lost.
Some studies reveal that the presence of Lewy bodies represents the presymptomatic phase of Parkinson disease. In other words, they could be present without symptoms. A Lewy body forms when a protein named alpha-synuclein goes into the neurons.
Importantly, the presence of incidental Lewy bodies increases with age. However, the presence of them is not specific to Parkinson disease as they appear on other neurodegenerative disorders.
Does Parkinson’s run in families?
Genetics cause about 10% to 15% of all Parkinson’s cases. Studies reveal that the appearance of Parkinson’s disease is a mix of genetics and environmental factors that induce the development of the disease.
In some families, changes in specific genes are passed down from generation to generation. Yes, Parkinson’s disease can run in families, but it is rare. Despite that, if someone is positive for gene mutations directly correlated to Parkinson’s disease, that does not mean that the patient will surely develop Parkinson’s.
It is possible for people who inherit these genes not to develop the disease if there is no environmental factor that triggers it and a healthy lifestyle.
There are ongoing clinical trials testing therapies to treat people with Parkinson’s that carry specific gene mutations. For doctors, it is essential to know which gene mutation does the patient carries.
What is the mortality rate for Parkinson’s?
Parkinson’s disease is the most common movement disorder. It represents the second most common degenerative disease of the central nervous system.
Studies show that this disease affects around 1-2 people out of 1000. 1% of the population over 60 years old suffers from this disease. Nonetheless, Parkinson’s is very rare before 50 years old.
The disease’s appearance varies considerably on different reports, probably due to discrepancies in methodological concerns or diagnostic criteria. There is an appearance of approximately 5 to 21 new cases every year per 100.000 people. Also, statistics show that there are from 18 to 328 people with this condition per 100,000 population. Still, most of the studies estimate 120 cases per 100,000 people. Parkinson’s disease is about 1.5 times more common in men than in women.
Before introducing Levodopa, Parkinson’s disease caused severe disability or death in 25% of patients within five years of onset, 65% within ten years, and 90% within 15 years. After introducing levodopa, the mortality rate drops approximately 50%, and longevity extends by many years.
Nonetheless, statistics from 1999 to 2017 reveal there is an increase in deaths from this cause. In adults over 65 years, old death rates increased from 42 to 65 per 100,000 population from 1999 to 2017.
Among men, the death rate went from 65 per 100,000 in 1999 to 98 per 100,000 people in 2017. Among women, the rate goes from 28 to 43 per 100,000. Throughout 1999-2017 the death rates for Parkinson’s disease for men were higher than those for women.
However, it is essential to mention that patients with Parkinson’s disease do not die from Parkinson’s per se. Patients die from complications that directly correlate with the effects of Parkinson’s on the body.
What organs does Parkinson Disease affect?
Parkinson’s disease is characteristical, a movement disorder responsive to dopaminergic medication. But it does not only affect the movement or body motor system. It changes as well the autonomic nervous system that controls the involuntary actions of the body.
These automatic actions of the body include some like a heart beating, sweating, swallowing, and bowel movements for digestion. The autonomic nervous system has two subdivisions, the sympathetic system, and the parasympathetic system.
The sympathetic system functions apply when the body enters in an alert state and the parasympathetic when the body relaxes. Of course, both are in balance through a typical day accomplishing physiological functions of the body.
There is mounting evidence that PD patients have affection in neurons of the autonomic pathways. Consequently, autonomic physiology may serve as a window into non-motor PD onset and progression of the disease. These are the most common systems that Parkinson’s disease affects:
Cardiovascular autonomic dysfunction is widespread in Parkinson’s disease. The autonomic nervous system through sympathetic and parasympathetic fibers innervates blood vessels.
The heart has a direct correlation to blood pressure. Blood pressure responses predominantly to sympathetic nerves that cause constriction on blood vessels and heart rate to parasympathetic fibers.
In Parkinson’s disease, there is an impairment of these systems, causing dizziness or orthostatic hypotension. This is a quick fall of blood pressure when the patient stands up from the bed or a chair. Approximately one out of two patients experience this symptom.
Skin and Sweat Glands
The autonomic nervous system also controls the sweat glands of the skin. Both excessive sweating (Hyperhidrosis) and a decrease in sweating are common Parkinson’s symptoms. This may be due to a compensatory reaction to a decline of nervous function in extremities. However, Parkinson’s patients with anhidrosis (No sweating) are rare, but it can happen.
There is a high prevalence of symptoms in the lower urinary tract (bladder and urethra). Both of these structures directly correlate with the autonomic nervous system.
Almost 60% of patients experience ailment of these organs. Among the symptoms, there can be incontinency, a rise in frequency, and urgency attributable to bladder overactivity. That is to say, the patient will be feeling the compulsive need to urinate, and will do it many times more than normal throughout the day.
The gastrointestinal tract has special relevance within the Parkinson’s disease as the entire tract has a direct innervation from the autonomic nervous system.
It affects the upper tract, including mouth esophagus and stomach, and the lower tract that includes the small and large bowel.
Patients have trouble with defecation, whether it is fecal incontinence, diarrhea, or constipation due to abnormal motility.
Other body parts
Other structures that Parkinson’s disease affects are the pupillary system as the pupils fail to contract or dilate to stimulus. Endocrine organs like Pancreas and Ovaries, as well as work with the autonomic nervous system.
What are the symptoms of Parkinson’s?
When talking about Parkinson’s symptoms, a word comes to mind, Parkinsonism. Parkinsonism is the hallmark of this disease. It encloses the most common motor symptoms of this disease in a clinical syndrome.
Parkinson’s disease has a wide variety of symptoms. This condition affects the brain, causing not only motor symptoms but also other kinds of symptoms.
Nonmotor symptoms are very variable as not all of them may be present. Still, they can affect the life quality of the patient.
Parkinson’s involves many more organs than just the brain and extremities. Symptoms often begin on one side of the body. Usually, they remain worse on that side, even after symptoms begin to affect both sides. The most common symptoms are the following.
- Tremor: Tremors or shaking usually begins in a limb, often hands or fingers. One classical sign is rubbing the thumb and the forefinger back and forth; this sign receives the name of pill-rolling. Hands can tremble as well when they are at rest.
- Slow Movements (Bradykinesia): Parkinson’s overtime may slow movements making it hard to complete simple tasks. For example, walking may be slower as steps become shorter as well. It can be difficult to get up of a chair, or patients can drag their feet as they try to walk.
- Rigid Muscles: Muscle stiffness may occur on any part of the body; it can be very painful and limit the range of motion.
- Impairment in posture and balance: Parkinson’s affects the brain in a way that may induce the balance loss and a posture alteration in patients causing them to fall repeatedly.
- Loss of automatic movements: Patients often experience a decrease in the ability to perform unconscious movements like blinking, smiling or waving arms while they walk. They can experience loss of facial expressions and have a resting poker face.
- Speech changes: Patients may speak softly, quickly, slur, or hesitate before talking.
- Writing changes: People often experience difficulty in writing, and writing may appear small.
Parkinsonism includes tremors, bradykinesia, rigidity, and postural instability. These are the 4 motor symptoms that are the hallmark of the disease. However, a wide range of causes may lead to this set of symptoms, including other neurodegenerative diseases, drugs, toxins, and conditions other than Parkinson’s.
- Mood disorders: It includes depression, anxiety, and irritability.
- Cognitive changes: Patients often have trouble focusing and paying attention, they experience slowing of thought and memory difficulties.
- Hallucinations and delusions, often due to medications.
- Orthostatic hypotension: A sudden drop in blood pressure when standing up that causes dizziness.
- Sleep disorders: People with Parkinson’s often experience sleep problems, including waking up frequently throughout the night, waking up early, or falling asleep during the day. People may also experience rapid eye movement (REM) sleep behavior disorder, which involves acting out dreams.
- Constipation, and early satiety.
- Excessive sweating, especially in hands or feet with no or little exercise.
- Urinary urgency, frequency, and incontinency
- Loss of sense of smell
- Sexual problems
- Weight loss
Do all Parkinson’s patients develop dementia?
Dementia describes a set of symptoms that cause is a significant loss in brain function. It produces a greater impact on patients on patients with Parkinson’s than in Alzheimer’s patients as they have to deal with motor and cognitive impairment.
Alzheimer’s affect memory and language in general terms. Still, in Parkinson’s, it affects problem-solving capacity, speed of thinking, memory, and they run with mild cognitive impairment.
Notably, Parkinson’s disease dementia is a common thing among patients with this condition. The vast majority of them may experience some form of cognitive impairment over time.
Though it is a unique process for each person, several risk factors may lead to dementia symptoms and dementia itself.
- Increasing age.
- Psychotic symptoms while receiving treatment with levodopa
- Having visual hallucinations
- The family history of dementia
- Severe motor symptoms
- Exposure to psychological stress
- Low education level and low socioeconomic status
Disease duration has as well a direct correlation with the development of dementia on these patients. The more time the patient has this disease, the risk of developing dementia increases.
Also, Parkinson’s dementia has a direct correlation with Lewy bodies. Most people develop dementia as a progression of the disease rather than having Parkinson’s and Alzheimer’s. Nonetheless, a doctor with a neurology specialist should examine the patient to give an assertive diagnosis to the condition.
Why do Parkinson’s patients lose weight?
Several causes may induce weight loss. Weight loss is a non-specific symptom and could be a sign of a wide variety of medical problems, including cancer. Therefore, acute weight loss is an entity that a physician should examine to identify its cause.
Suppose the patient suffers from Parkinson’s disease, and the physician does not find any other possible cause. In that case, the weight loss shall be attributed to Parkinson’s.
Among PD patients, many possible causes may lead to weight loss. The reasons vary from people to people, but each one can contribute to developing weight loss. People with Parkinson’s disease have a decrease in appetite, and it has various possible causes.
- The alteration, in the sense of smell, disables them from tasting food and reducing the amount of food.
- Apathy and depression
- Nausea due to medications
Asides from the appetite loss, other possible causes go along with the motor symptoms of the disease. These motor symptoms may induce an increase in energy expenditure.
- Dyskinesias are pointless and involuntary movements that can be a side effect of the treatment with levodopa.
- Essential tremor, resting tremor, and as well as muscle stiffness can be causes of excessive energy consumption and subsequent weight loss.
Other causes that may play a major role in weight loss can be that people with Parkinson’s disease have difficulty swallowing. The affection of the gastrointestinal tract slows down the eating. It reduces consumption in an attempt to eat without coughing or choking. It can cause as well as slow transit of food through the gut, impacting absorption, and weight loss.
How quickly does Parkinson’s progress?
Parkinson’s disease is slowly progressive, and each case may be different. People may have symptoms for a year or two before a doctor makes a diagnosis.
The longer the symptoms are present, the easier it is to predict how a person with Parkinson’s disease will do. In those with tremors and symptoms on one side of the body, the disease typically advances more slowly than in those without tremors who have symptoms that affect both sides of the body.
While the life expectancy of these patients reduces, people with Parkinson’s disease usually function quite well for many years. However, these patients are at risk of suffering dementia, or from developing instability that could lead to falls.
This condition is by far the most treatable of all neurodegenerative disorders. A doctor may indicate treatment to help control symptoms.
For example, there are cases where people can function better in their daily lives five years later after they start medication.
The treatment includes exercise and changes in lifestyle. As well as medication with carbidopa-levodopa or dopamine agonists to improve body functionality.
There are surgical options as well, like deep brain stimulation, surgeons implant electrodes in the brain, and they receive electrical pulses, which reduces symptoms.
However, symptoms and responses to treatment vary from person to person, so it is not possible to accurately predict how Parkinson’s disease will progress.
For some people, it may take many years for the condition to develop and reach a point in which it is obvious. For others, it may take less time.
What happens if Parkinson’s is left untreated?
Despite being a neurodegenerative disease with no cure, Parkinson’s disease is the most treatable of them.
However, if a patient decides not to receive treatment or does not know he has the disease, things can progress in a very severe way.
Parkinson’s disease that does not receive treatment worsens over the years; it may damage all brain functions and early death.
Patients may experience a rapid decline in cognitive brain functions. They can experience short-term memory deficits and abnormal central processing speed.
These patients as well, may develop neuropsychiatric symptoms in the early and later stages of the disease that can get worse. Symptoms like anxiety, apathy, and depression become troublesome on these patients as well as a rapid onset of psychotic symptoms.
These patients may present as well as serious motor symptoms that may disable them to perform daily tasks. Tremor and muscle stiffness may become difficult to control without proper treatment.
Furthermore, patients will experience difficulties for eating as they cannot chew and swallow properly; drooling is common on these patients. A slower digestive tract may lead to constipation and abdominal pain. These patients will have bladder problems too, which can make daily life very difficult.
Daily life for patients with untreated Parkinson’s disease can become challenging. It can reach the point where these patients should remain at home.
Parkinson’s patients should receive nursing care at home to help them avoid falls or any other complications. If the symptoms become too severe, patients shall receive palliative care to control pain and psychotic symptoms.
How does Parkinson’s kill you?
Most of the patients that have Parkinson’s disease do not die specifically from it. Please, allow me to explain better.
As it is an affection that compromises several organs, it may trigger inadequate responses in each one of them. Nonetheless, the same diseases that cause death on healthy patients cause death on these patients.
- Falls: Patients with Parkinson’s disease have an increased risk of falling due to impairment in balance and posture. These falls often can be bad falls that may lead to death. Death usually occurs as a complication of a fall that requires hospitalization, mainly if it involves surgery. The most common cause of death for these patients is hip fractures. Hip surgery is a major surgery that may carry a risk of infection, blood clots in legs that go to lungs, heart failure, and others. These patients also may fracture ribs leading to an increase of lung infections and chronic pain. However, it is surprisingly uncommon for Parkinson’s disease patients to die from brain injuries related to falls, but it still may occur.
- Aspiration Pneumonia: As Parkinson’s progress, these patients begin to have trouble with swallowing and drooling. Aspiration refers to food or liquid going the wrong way down the windpipe. These patients have an increase in the tendency for this to happen; they as well do not cough as strong as before, disabling them from coughing up the food or liquid. When this happens, some liquid or food remains in the lung, setting up an infection or pneumonia. These infections can be fatal as these patients cannot cough up and clear the lungs out of purulent material.
What other conditions have similar symptoms and signs of Parkinson’s disease?
Other neurological diseases may cause symptoms similar to Parkinson’s disease. The term Parkinsonism refers to a patient that has symptoms similar to Parkinson’s.
Early in the disease process, it can be tough to make an assertive diagnosis and difference between Parkinson’s and Parkinson-like diseases.
Often the correct diagnosis is made after further symptoms develop, and the physician can monitor the course of the disease.
The development of additional symptoms and the course of the illness generally points towards the correct diagnosis. These are the most common neurological diseases that can produce Parkinson-like symptoms.
- Progressive Supranuclear Palsy
- Multiple System Atrophy
- Lewy Body disease or Dementia with Lewy bodies
- Corticobasal degeneration or corticobasal ganglionic degeneration
Nonetheless, doctors should think of other causes rather than Parkinson’s disease when events like this happen.
- Poor response to dopamine
- Early loss of balance or vision problems
- Prominent intellectual decline – dementia
- Rapid onset or progression of the disease
Actually, though it is a disease that is not clearly understood, there are specific organizations like Parkinson’s UK that dedicate themselves to doing research.
These organizations look forward to following the natural course of the disease and developing clinical trials for patients in an attempt to find a cure.
They also look forward to understanding the similarities and differences between these neurodegenerative diseases and whether it is possible to prevent them.
Are you having symptoms of Parkinson disease?
This tool is a Parkinson disease symptoms checker. It gathers the most important signs, symptoms, and risk factors for this condition. Therefore, anybody who uses the tool. It will help in determining the likelihood of having Parkinson disease. The most important feature of this tool is that it is free and would only take you a few minutes.