Parkinson Disease: Stages, Diagnosis, and Treatment

Have you ever feared what can happen if you do not be able to do basic everyday tasks like walking, standing, difficulty in balancing, and coordination?

This disease occurs with shaking, stiffness, and difficulties in walking, balancing, and coordination. The smooth and coordinated bodily muscle movements are usually because of a substance called dopamine that is present in the brain. It is produced in a part of the brain called

Parkinson’s is a disease of progression, therefore with each stage, the symptoms are likely to get worse over time. With the progression starts the difficulties in your body. Mental and behavioral changes, like sleeping problems, depression, memory difficulties, and fatigue are significant with Parkinson’s.

Parkinson’s disease usually starts appearing in old age, most people aged around 60. However, early symptoms and appearance can be seen among 5 to 10% of patients, usually in people before they enter their 50s.

Parkinson’s Disease Cause

Parkinson’s disease emerges when nerve cells, or neurons, in an area of the brain that controls movement develop into impaired and the result can be fatal. These neurons play a vital role in producing the important brain chemical called dopamine. If produced less dopamine, more problems arise.

The real cause of the disease Parkinson’s remains uncertain and can depend on genetic as well as environmental mechanisms. Scientists have also come up with the theory that viruses can trigger Parkinson’s disease as well.

A substance that regulates dopamine is called norepinephrine and low levels of dopamine can be associated with Parkinson’s.

Abnormal proteins called Lewy bodies have also been found in the brains of people with Parkinson’s, though the role of Lewy remains a mystery as scientists are uncertain about it.

Although there is ambiguity with the cause, some studies reflect on a group of people who are likely to be on a risky side and might develop this disease:

• Sex: Men are one and a half times more likely to develop Parkinson’s than women.

• Race: Geographic location may be one reason for a higher risk as there’s a higher pervasiveness of Parkinson’s in white people compared with Black or Asian people.

• Age: This disease usually affects people between the age group of 50 and 60years. There are only four percent chances to get associated with the disease before 40years.

• Family history: Genetics plays a crucial role while developing this disease. Having a family history of Parkinson’s disease can make you more likely to develop the disease.

• Toxins: Toxins are bad for the environment as well as us. Exposure to certain toxins may amplify the threat of Parkinson’s disease.

• Head injury: History of head injury can lead to the development of Parkinson’s disease.

Parkinson’s Disease Symptoms

The disease can knock on your door several years before motor problems begin. These earliest signs include:

• Decreased ability to smell (anosmia)
• Constipation
• Small, cramped handwriting
• Voice changes
• Stooped posture

The four major motor problems seen are:

• Tremor (shaking that occurs at rest)
• Slow movements
• Stiffness of arms, legs, and trunk
• Problems with balance and tendency to fall

Secondary symptoms include:

• Blank facial expression
• A tendency to get stuck when walking
• Muffled, low-volume speech
• Decreased blinking and swallowing
• Tendency to fall backward
• Reduced arm swinging when walking
• Parkinsonian gait, which is the tendency to take shuffling steps while walking

Other allied symptoms may include:

• Flaky white or yellow scales on oily parts of the skin, known as seborrheic dermatitis
• Increased risk of melanoma, a serious type of skin cancer
• Sleep disturbances including vivid dreams, talking, and movement during sleep
• Depression
• Anxiety
• Hallucinations
• Psychosis
• Problems with attention and memory
• Difficulty with visual-spatial relationships

These early signs are not easy to detect and often go camouflaged despite your body alerting you several years prior to the movement disorder warning with these signs before the movement difficulties commence.

Diagnosis of Parkinson’s Disease

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s disease. However, some methods that can be useful:

• Diagnosis is based on a person’s medical history
• Neurological examination.
• Improvement after starting medication is an additional significant hallmark of Parkinson’s disease.

Parkinson’s Disease Treatment

The world is still looking for a cure to fight back from Parkinson’s disease, however, some medicines, surgical treatment, and other therapies come to the rescue and provide relief for some symptoms.

Medicines for Parkinson’s Disease

Medicines used for the treatment include:

• Drugs that increase the level of dopamine in the brain
• Drugs that affect other brain chemicals in the body
• Drugs that help control non-motor symptoms

The most effective therapy of Parkinson’s lies in levodopa, also known as L-dopa. Nerve cells make use of levodopa to create dopamine to restock the brain’s diminishing supply. Generally, carbidopa is also prescribed along with levodopa. The main role of carbidopa is prevention or reduction of some side effects caused by levodopa therapy—such as nausea, vomiting, low blood pressure, and restlessness. It also declines the usage of levodopa required for the treatment to improve symptoms.

People diagnosed with Parkinson’s should always consult their doctors to stop or reduce the dosage of levodopa. As sudden stopping of the drug can lead to serious side effects like having difficulties in moving and issue with breathing.

Other medicines that can be prescribed to treat Parkinson’s symptoms include:

• Dopamine agonists imitate the role of dopamine in the brain
• MAO-B inhibitors slow down an enzyme that breaks down dopamine in the brain
• COMT inhibitors to help break down dopamine
• Amantadine, an old antiviral drug, to reduce involuntary movements
• Anticholinergic drugs to reduce tremors and muscle strictness

Deep Brain Stimulation

There are chances when some people diagnosed with Parkinson’s may not respond effectively to the medications, deep brain stimulation, or DBS may be suitable. Now, what is DBS? DBS is a surgical practice that surgically implants electrodes into a fraction of the brain and connects them to a tiny electrical device implanted in the chest. The device and electrodes work by painlessly stimulating the brain in a way that might help to stop several movement-related symptoms of Parkinson’s, like tremors, slowness of movement, and rigidity.

Other Therapies

There are some other therapies as well which might be able to assist with Parkinson’s disease symptoms. It includes physical, occupational, and speech therapies, which help with gait and voice disorders, tremors and rigidity, and decline in mental functions. Other helpful therapies consist of a healthy diet and exercises to strengthen muscles and improve balance.

Stages of Parkinson’s Disease

Parkinson’s is a progressive disease, where symptoms get worse over the period.

Doctors find use the Hoehn and Yahr helpful to classify its stages. This scale divides symptoms into five stages, and it provides healthcare professionals become skilled at identifying the advanced disease signs and symptoms.

Stage 1

This stage is the mildest form of Parkinson’s disease. It is so mild that even the symptom goes unnoticeable as they might not yet interfere in your daily tasks.

If you do have symptoms, they may be isolated to one side of your body.

Stage 2

The progression from stage 1 to stage 2 can stretch for months or even years. Each person’s experience will vary.

At this moderate stage, symptoms that can be experienced are:

• muscle stiffness
• tremors
• changes in facial expressions
• trembling

At this stage, balance problems are unlikely to occur. However, muscle stiffness can make life hard and it will prolong the time you require to tick off your daily tasks.

Symptoms are likely to emerge on both sides of the body. A significant change in posture, gait, and facial expressions may be more obvious.

Stage 3

Now you are at this middle stage where symptoms reach a turning point. The symptoms become more noticeable; however, no new symptoms emerge. It may also affect your life by interfering with your day-to-day tasks.

At this stage, movement is visibly slower, which slows down activities. Balance issues arise becoming more significant resulting in the occurrence of falls more common. Surprisingly the people affected with these symptoms do not require much assistance as there are capable to maintain their independence.

Stage 4

The progression from stage 3 to stage 4 brings about significant changes. This stage differs from stage 3 as you will require more assistance or a walker to even stand or walk.

Dealing alone with this treacherous disease can be impossible when you reach stage 4 as reactions and muscle movements gradually slow down.

Stage 5

When you reach stage 5 your independence reaches rock bottom and you require a necessity of around-the-clock assistance. At this stage, people find it hard to stand, if not impossible, and adhere need of a wheelchair is required.

Confusion, delusions, and hallucinations are common experiences faced by people diagnosed with Parkinson’ at stage 5. These complications of the disease can commence shortly.

Parkinson’s Dementia

Parkinson’s dementia is caused by the obstacle Parkinson’s disease brings with itself. It often causes people to grow difficulties with analysis, thinking, and problem-solving. It’s quite ordinary — around 50 to 80 percent of people suffering from Parkinson’s will experience some extent of dementia.

Symptoms of Parkinson’s disease dementia include:

• depression
• sleep disturbances
• delusions
• confusion
• hallucinations
• mood swings
• slurred speech
• changes in appetite
• changes in energy level

Parkinson’s disease can wipe out chemical-receiving cells in your brain which can lead to dramatic changes, symptoms, and complications over a period.

Parkinson’s Exercises

Parkinson’s is a disease that plays with your morals and causes issues with daily activities. However, effortless exercises and stretches may help you move around and walk more comfortably.

To improve walking

• Walk carefully.
• Pace yourself — try not to move too quickly.
• Let your heel hit the floor first.
• Check your posture and stand up straight. This will help you shuffle less.

To avoid falling

• Never walk backward.
• Avoid carrying things while walking.
• Try not to lean and reaching.
• To turn around, make a U-turn. Do not pivot on your feet.
• Eradicate all tripping hazards in your home such as loose rugs.

When getting dressed

• Allow yourself plenty of time to get ready. Avoid rushing.
• Select clothes that are comfortable and easy to put on and take off.
• Items like Velcro instead of buttons can be a great help.
• Pants and skirts with elastic waistbands should be preferred as it is easier to wear.

Yoga uses targeted muscle movement to build muscle, increase mobility, and improve flexibility. People with Parkinson’s may notice yoga even helps manage tremors in some affected limbs.

Parkinson’s Diet

If you are diagnosed with Parkinson’s disease then keep your diet in check as it plays a crucial role in your life. A healthy diet is always good for your body whether it prevents progression or not.

With a healthy meal, you may be able to achieve increased hormone levels. As we are aware of the decreased dopamine level caused by Parkinson’s disease, a healthy meal with bringing a significant impact on your body.

Similarly, a nutrient-rich, balanced diet that focuses on specific nutrients may be able to provide a balance in reducing some symptoms and prevent the progression of the disease. These foods include:

Antioxidants

Foods high in these substances may help prevent oxidative stress and damage to the brain. Antioxidant-rich foods include nuts, berries, and nightshade vegetables.

Fava beans

These lime green beans are magical as it contains the same levodopa ingredients used in some Parkinson’s medications.

Omega-3s

Omega-3s is a great source of heart- and brain-healthy fats that are present in salmon, oyster, flaxseed, and some beans that prevent the brain from any kind of damage.

Keep in mind if you are consuming this beneficial food then you must avoid dairy and saturated fat as it can higher the risk of Parkinson’s if grouped.