All You Need to Know About Parkinson’s Disease

Parkinson’s disease is an age-related degenerative brain condition, meaning it causes parts of your brain to deteriorate. It’s best known for causing slowed movements, tremors, balance problems and more. Most cases happen for unknown reasons, but some are inherited. The condition isn’t curable, but there are many different treatment options.

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurological disorder. The first signs are problems with movement.

Smooth and coordinated bodily muscle movements are made possible by dopamine, a substance in the brain. Dopamine is produced in a part of the brain called the “substantia nigra.”

In Parkinson’s, the cells of the substantia nigra start to die. When this happens, dopamine levels are reduced. When they have dropped 60 to 80 percent, symptoms of Parkinson’s start to appear.

What Does Parkinson's Do to the Brain?

Deep down in your brain, there's an area called the substantia nigra, which is in the basal ganglia. Some of its cells make dopamine, a chemical that carries messages around your brain. When you need to scratch an itch or kick a ball, dopamine quickly carries a message to the nerve cell that controls that movement.

When that system is working well, your body moves smoothly and evenly. But when you have Parkinson's, the cells of your substantia nigra start to die. There's no replacing them, so your dopamine levels drop and you can't fire off as many messages to control smooth body movements.

Early on, you won't notice anything different. But as more and more cells die, you reach a tipping point where you start to have symptoms.

That may not be until 80% of the cells are gone, which is why you can have Parkinson's for quite a while before you realize it.

Who does it affect?

The risk of developing Parkinson’s disease naturally increases with age, and the average age at which it starts is 60 years old. It’s slightly more common in men or people designated male at birth (DMAB) than in women or people designated female at birth (DFAB).

While Parkinson’s disease is usually age-related, it can happen in adults as young as 20 (though this is extremely rare, and often people have a parent, full sibling or child with the same condition).

How Does Parkinson's Affect the Body?

The telltale symptoms all have to do with the way you move. You usually notice problems like:

• Rigid muscles. It can happen on just about any part of your body. Doctors sometimes mistake early Parkinson's for arthritis.
• Slow movements. You may find that even simple acts, like buttoning a shirt, take much longer than usual.
• Tremors. Your hands, arms, legs, lips, jaw, or tongue are shaky when you're not using them.
• Walking and balance problems. You may notice your arms aren't swinging as freely when you walk. Or you can't take long steps, so you have to shuffle instead.

Parkinson's can also cause a range of other issues, from depression to bladder problems to acting out dreams. It may be a while before abnormal movements start.

How common is this condition?

Parkinson’s disease is very common overall, ranking second among age-related degenerative brain diseases. It’s also the most common motor (movement-related) brain disease. Experts estimate that it affects at least 1% of people over age 60 worldwide.

Symptoms of Parkinson’s disease

Some of the early symptoms of Parkinson’s can begin several years before motor problems develop. 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 associated 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

Early signs of Parkinson’s disease may go unrecognized. Your body may try to alert you to the movement disorder many years before movement difficulties begin with these warning signs.

Causes of Parkinson’s disease

The exact cause of Parkinson’s is unknown. It may have both genetic and environmental components. Some scientists believe that viruses can trigger Parkinson’s as well.

Low levels of dopamine and norepinephrine, a substance that regulates dopamine, have been linked with Parkinson’s.

Abnormal proteins called Lewy bodies have also been found in the brains of people with Parkinson’s. Scientists do not know what role, if any, Lewy bodies play in the development of Parkinson’s.

While there’s no known cause, research has identified groups of people who are more likely to develop the condition, which include:

• Sex: Men are one and a half times more likely to develop Parkinson’s than women.
• Race: According to researchTrusted Source, there’s a higher prevalence of Parkinson’s in white people compared with Black or Asian people. Geographic location may be one reason for a higher risk.
• Age: Parkinson’s usually appears between ages 50 and 60 years. It only occurs before 40 years old in about four percent of cases.
• Family history: People who have close family members with Parkinson’s disease are more likely to develop Parkinson’s disease.
• Toxins: Exposure to certain toxins may increase the risk of Parkinson’s disease.
• Head injury: People who experience head injuries may be more likely to develop Parkinson’s disease.

Is it contagious?

Parkinson’s disease is not contagious, and you can't contract it from another person.

Diagnosis of Parkinson’s disease

There’s no specific test for diagnosing Parkinson’s. Diagnosis is made based on health history, a physical and neurological exam, as well as a review of signs and symptoms.

Imaging tests, such as a CAT scan or MRI, may be used to rule out other conditions. A dopamine transporter (DAT) scan may also be used. While these tests do not confirm Parkinson’s, they can help rule out other conditions and support the doctor’s diagnosis.

Parkinson’s disease stages

Parkinson’s is a progressive disease, which means symptoms of the condition typically worsen over time.

Many doctors use the Hoehn and Yahr scale to classify its stages. This scale divides symptoms into five stages, and it helps healthcare professionals learn how advanced disease signs and symptoms are.

Stage 1

Stage 1 Parkinson’s is the mildest form. It’s so mild, in fact, you may not experience symptoms that are noticeable. They may not yet interfere with your daily life and 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 take months or even years. Each person’s experience will be different.

At this moderate stage, you may experience symptoms such as:

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

Muscle stiffness can complicate daily tasks, prolonging how long it takes you to complete them. However, at this stage, you’re unlikely to experience balance problems.

Symptoms may appear on both sides of the body. Changes in posture, gait, and facial expressions may be more noticeable.

Stage 3

At this middle stage, symptoms reach a turning point. While you’re unlikely to experience new symptoms, they may be more noticeable. They may also interfere with all of your daily tasks.

Movements are noticeably slower, which slows down activities. Balance issues become more significant, too, so falls are more common. But people with stage 3 Parkinson’s can usually maintain their independence and complete activities without much assistance.

Stage 4

The progression from stage 3 to stage 4 brings about significant changes. At this point, you will experience great difficulty standing without a walker or assistive device.

Reactions and muscle movements also slow significantly. Living alone can be unsafe, possibly dangerous.

Stage 5

In this most advanced stage, severe symptoms make around-the-clock assistance a necessity. It will be difficult to stand, if not impossible. A wheelchair will likely be required.

Also, at this stage, individuals with Parkinson’s may experience confusion, delusions, and hallucinations. These complications of the disease can begin in the later stages.

Treatments for Parkinson’s disease

Treatment for Parkinson’s relies on a combination of:

• lifestyle changes
• medications
• therapies

Adequate rest, exercise, and a balanced diet are important. Speech therapy, occupational therapy, and physical therapy can also help improve communication and self-care.

In almost all cases, medication will be required to help manage the various physical and mental health symptoms associated with the disease.

Medicines for Parkinson’s disease

Medicines can help treat the symptoms of Parkinson’s by:

• Increasing the level of dopamine in the brain
• Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells
• Helping control non-movement symptoms

Parkinson’s surgery

Surgical interventions are reserved for people who do not respond to medication, therapy, and lifestyle changes.

Two primary types of surgery are used to treat Parkinson’s:

Deep brain stimulation

During deep brain stimulation (DBS), surgeons implant electrodes in specific parts of the brain. A generator connected to the electrodes sends out pulses to help reduce symptoms.

Pump-delivered therapy

In January 2015, the Food and Drug Administration (FDA) approved a pump-delivered therapy called Duopa.

The pump delivers a combination of levodopa and carbidopa. In order to use the pump, your doctor will have to perform a surgical procedure to place the pump near the small intestine.

More about levodopa

The most common and effective treatment for Parkinson’s disease is levodopa. While this medication has greatly improved the treatment of Parkinson’s disease, providers use it cautiously because of how it works. They also commonly prescribe other medications that make levodopa more effective or help with side effects and certain symptoms.

Levodopa is often combined with other medications to keep your body from processing it before it enters your brain. That helps avoid other side effects of dopamine, especially nausea, vomiting and low blood pressure when you stand up (orthostatic hypotension).

Over time, the way your body uses levodopa changes, and levodopa can also lose its effectiveness. Increasing your dose can help with that, but that increases the chance and severity of side effects, and the dose can only go so high before it reaches toxic levels.

Other therapies

Other therapies that may help manage Parkinson’s symptoms include:

• Physical, occupational, and speech therapies, which may help with gait and voice disorders, tremors and rigidity, and decline in mental functions
• A healthy diet to support overall wellness
• Exercises to strengthen muscles and improve balance, flexibility, and coordination
• Massage therapy to reduce tension
• Yoga and tai chi to increase stretching and flexibility

Complications or side effects possible with treatments

The complications and side effects that happen with Parkinson's disease treatments depend on the treatments themselves, the severity of the condition, any other health problems you have, and more. Your healthcare provider is the best person to tell you more about the likely side effects and complications that you might experience. They can also tell you what you can do to minimize how those side effects or complications affect your life.

Parkinson’s dementia

Parkinson’s dementia is a complication of Parkinson’s disease. It causes people to develop difficulties with reasoning, thinking, and problem solving. It’s quite common — 50 to 80 percent of people with Parkinson’s will experience some degree 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 destroys chemical-receiving cells in the brain. Over time, this can lead to dramatic changes, symptoms, and complications.

Certain people are more likely to develop Parkinson’s disease dementia. Risk factors for the condition include:

• Sex: Men are more likely to develop it.
• Age: The risk increases as you get older.
• Existing cognitive impairment: If you had memory and mood issues before a Parkinson’s diagnosis, your risk may be higher for dementia.
• Severe Parkinson’s symptoms: You may be more at risk for Parkinson’s disease dementia if you have severe motor impairment, such as rigid muscles and difficulty walking.

Currently, there’s no treatment for Parkinson’s disease dementia. Instead, a doctor will focus on treating other symptoms.

Parkinson’s heredity

Researchers believe both your genes and the environment may play a role in whether you get Parkinson’s. How much of an impact they have, however, is unknown. Most cases occur in people with no apparent family history of the disease.

Hereditary cases of Parkinson’s are rare. It’s uncommon for parents to pass Parkinson’s to a child.

According to the National Institutes of Health, only 15 percent of people with Parkinson’s have a family history of the disease. 

Parkinson’s life expectancy

Parkinson’s disease is not fatal. However, Parkinson’s-related complications can shorten the lifespan of people diagnosed with the disease.

Having Parkinson’s increases a person’s risk for potentially life threatening complications, like experiencing:

• falls
• blood clots
• lung infections
• blockages in the lungs

These complications can cause severe health issues. They can even be fatal.

It’s unclear how much Parkinson’s reduces a person’s life expectancy. One study looked at the 6-year survival rates of nearly 140,000 people who had been diagnosed with Parkinson’s. In that 6-year span 64 percentTrusted Source of people with Parkinson’s died.

What’s more, the study found that 70 percentTrusted Source of people in the study had been diagnosed with Parkinson’s disease dementia during the span of the study. Those who were diagnosed with the memory disorder had lower survival rates.

Parkinson’s exercises

Parkinson’s often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.

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:

• Do not walk backward.
• Try to not carry things while walking.
• Try to avoid leaning and reaching.
• To turn around, make a U-turn. Do not pivot on your feet.
• Remove all tripping hazards in your house such as loose rugs.

When getting dressed:

• Allow yourself plenty of time to get ready. Avoid rushing.
• Select clothes that are easy to put on and take off.
• Try using items with Velcro instead of buttons.
• Try wearing pants and skirts with elastic waist bands. These may be easier than buttons and zippers.

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

For people diagnosed with Parkinson’s, diet can play an important role in daily life. While it will not treat or prevent progression, a healthy diet may have some significant impact.

Parkinson’s is the result of decreased dopamine levels in the brain. You may be able to increase levels of the hormone naturally with food.

Likewise, a nutrient-rich, balanced diet that focuses on specific nutrients may be able to help reduce some symptoms and prevent 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 contain levodopa, the same ingredient used in some Parkinson’s medications.

Omega-3s

These heart- and brain-healthy fats in salmon, oyster, flaxseed, and some beans may help protect your brain from damage.

In addition to eating more of these beneficial foods, you may want to avoid dairy and saturated fat. These food groups may increase your risk for Parkinson’s or speed up progression.

Parkinson’s and dopamine

Parkinson’s disease is a neurodegenerative disorder. It affects the dopamine-producing neurons (dopaminergic) in the brain. Dopamine is a brain chemical and neurotransmitter. It helps send electric signals around the brain and through the body.

The disease prevents these cells from making dopamine, and it may impair how well the brain can use dopamine. Over time, the cells will die entirely. The drop in dopamine is often gradual. That’s why symptoms progress, or slowly get worse.

Many Parkinson’s medications are dopaminergic drugs. They aim to increase the level of dopamine or make it more effective on the brain.

Parkinson’s  vs. MS

At first glance, Parkinson’s disease and multiple sclerosis (MS) may seem very similar. They both affect the central nervous system, and they can produce many similar symptoms.

These include:

• tremors
• slurred speech
• poor balance and instability
• changes in movement and gait
• muscle weakness or loss of muscle coordination

The two conditions are very different, however. The key differences include:

Cause

MS is an autoimmune disorder. Parkinson’s is the result of decreased dopamine levels in the brain.

Age

MS primarily affects younger individuals, with the average age of diagnosis being between ages 20 and 50 years old. Parkinson’s is more common in people over 60 years old.

Symptoms

People with MS experience conditions like headaches, hearing loss, pain, and double vision. Parkinson’s can ultimately cause muscle rigidity and difficulty walking, poor posture, loss of muscle control, hallucinations, and dementia.

If you’re showing unusual symptoms, your doctor may consider both of these conditions when making a diagnosis. Imaging tests and blood tests may be used to help distinguish between the two conditions.

Parkinson’s prevention

Doctors and researchers do not understand what causes Parkinson’s. They’re also not sure why it progresses differently in each person. That’s why it’s unclear regarding how to prevent the disease.

Each year, researchers investigate why Parkinson’s occurs and what can be done to prevent it. Recent researchTrusted Source suggests lifestyle factors — like physical exercise and a diet rich in antioxidants — may have a protective effect.

If you have a family history of Parkinson’s, you may consider genetic testing. Certain genes have been connected to Parkinson’s. But it’s important to know that having these gene mutations does not mean you’ll definitely develop the disease.

Talk with your doctor about the risks and benefits of genetic testing.

How long does Parkinson’s disease last?

Parkinson’s disease isn’t curable, which means it’s a permanent, life-long condition.

Support for people living with Parkinson’s disease

While the progression of Parkinson’s is usually slow, eventually a person’s daily routines may be affected. Activities such as working, taking care of a home, and participating in social activities with friends may become challenging. Experiencing these changes can be difficult, but support groups can help people cope. These groups can provide information, advice, and connections to resources for those living with Parkinson’s disease, their families, and caregivers. The organizations listed below can help people find local support groups and other resources in their communities.

What’s the outlook for Parkinson’s disease?

Experts are still unsure what causes Parkinson’s. It is a lifelong condition that can be managed with lifestyle changes and medical treatments. Talk with your doctor if you are experiencing symptoms of Parkinson’s or if you have been diagnosed and are looking for new ways to manage the condition.

Final Thought 

Parkinson's disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinson's isn't curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.