Carla Hay-Perdue, DNP, APRN, FNP, ANP-BC, NC-BC
Community Education Coordinator/ Family Nurse Practitioner at Palo Pinto General Hospital
What is Parkinson’s Disease?
Parkinson’s disease is a progressive nervous system disorder that affects movement. There are over 500,000 individuals currently diagnosed. However, experts believe that the disease is underdiagnosed, so the true incidence of the disease could be closer to one million. In addition, it is considered a disease of aging, with most people diagnosed after 60 years.
In Parkinson’s disease, specific nerve cells in the brain gradually break down or die. For example, many of the symptoms are due to a loss of dopamine neurons. When dopamine levels decrease, it causes abnormal brain activity leading to the symptoms of Parkinson’s disease.
Symptoms
Symptoms start gradually. Motor symptoms are the most common and can affect one side of the body and then progress to the other side.
- Tremors – An early symptom is resting tremors. It is a rhythmic shaking that occurs typically in one finger, hand, or arm. The tremors are at rest and go away when the person performs purposeful movements. Stress and anxiety make the tremors worse.
- Rigidity: There is muscle stiffness in any body part. The stiff muscles can be painful and limit the range of motion.
- Impaired posture and balance. The posture may become stooped, or there may be balance problems.
- Bradykinesia (slowed movement)– This is a slowness of movement experienced as reduced walking speed or arm swinging while walking, slowed rate of blinking, or decreased facial expression.
- Speech changes. You may speak softly, quickly, slur, or hesitate before talking. In addition, the speech may be monotone rather than having the usual inflections.
- Writing changes.
It may become hard to write, and the writing may appear small.
- Non-motor symptoms – Non-motor symptoms may precede the onset of motor symptoms. These include constipation, smell loss, sleep disorders, fatigue, memory or thinking problems, and mood disturbances, including depression.
The doctor bases the diagnosis on a person’s medical history and physical exam. Everyone experiences symptoms differently. No laboratory test or brain scan can confirm that a person has the disease. The tests exclude other conditions that look like Parkinson’s.
What causes Parkinson’s Disease?
Parkinson’s disease occurs due to the death of dopamine secreting neurons in the brain. What causes this damage is still unknown. However, research indicates that genes and environmental factors contribute to its development.
- Genes – Researchers have identified specific genetic mutations that contribute to Parkinson’s disease. These are uncommon except in rare cases. Certain gene variations appear to increase the risk of Parkinson’s disease.
- Environmental triggers causing inflammation and oxidative stress in the brain include head injury, toxins, and chemicals.
How do we lower the risk? Lifestyle!
Caffeine – Consumption of caffeine in coffee and tea may lower the risk of developing PD.
Anti-inflammatory drugs – Several studies have shown that people who regularly take anti-inflammatory drugs, such as ibuprofen have a lower risk of Parkinson’s disease.
Cholesterol Levels: — Some studies suggest that statin use is associated with reduced Parkinson’s disease risk.
Vitamin D: — Those with a higher Vitamin D level were less likely to develop Parkinson’s disease.
Exercise: Increasing physical activity early in life lowers the risk of developing Parkinson’s later in life.
Smoking—Many studies have associated cigarette smoking with a decreased risk of Parkinson’s disease, perhaps due to the protective factor of nicotine. Still, DON’T SMOKE! It will increase the risk of developing cancer, COPD, and heart disease.
Balanced diet- Doctors recommend a balanced diet with lots of fruits and vegetables, whole grains (whole wheat, quinoa, oats, brown rice), and healthy fats (avocado, nuts, and olive oil. For non-vegetarians, include more fish and poultry. Avoid or reduce processed and sugary foods. These foods are inflammatory. Research on The Mind Diet (Mediterranean-Dash Intervention for Neurodegenerative Delay) shows lower Parkinson’s and Alzheimer’s disease rates.
Other considerations are that Certain medications will require diet modifications. For example, the gut absorbs Levodopa/Carbidopa in the same area as protein. Therefore, taking the levodopa simultaneously as eating protein may absorb less medication.
For more information on Parkinson’s disease go to the Parkinson’s Foundation, or the American Parkinson’s Disease Association web page.
References:
Marshall, K., Hale, D. (2020). Parkinson’s Disease. Focus on Geriatrics. 38 (1), 48-49. Wolters, Kluwer Health, Inc.
Parkinson’s Foundation. Environmental Factors. Retrieved from Environmental Factors | Parkinson’s Foundation
Parkinson’s 360. (2016). Michael J Fox Foundation for Parkinson’s Research.