Parkinson’s Disease

What is Parkinson’s Disorder (PD)?

Parkinson’s Disorder (PD) is the second commonest neurodegenerative disorder in the United States, affecting approximately 1 in 300 people. It is named after Dr. James Parkinson who first described “the shaking palsy”.
The healthy brain produces a neurotransmitter called dopamine, which plays an important role in several functions including coordinating motor control. In Parkinson’s patients, 80% or more of these dopamine-producing cells degenerate, leading to a loss of dopamine. This results in the clinical symptoms of Parkinson’s Disease.

Symptoms

The presenting symptoms are quite variable, such that every patient’s experience is unique. Typical non-motor symptoms include apathy, depression, constipation, sleep behavior disorders, loss of sense of smell, and cognitive impairment for many years before motor symptoms become apparent.
Although motor symptoms are the most visible manifestation of PD, the disorder is characterized by a range of several non-motor symptoms. Movement-related (“motor”) symptoms usually manifest as one or more of the following symptoms:

Who Has Parkinson's?

Nearly one million people in the U.S. are living with Parkinson’s disorder (PD) and approximately 60,000 Americans are diagnosed with PD each year. There is no single cause of Parkinson’s discovered yet, however, several risk factors have been identified.

Advancing age

Parkinson’s generally manifests in middle to late years of life and the risk increases with age.

Gender

Men are 1.5 times likely to get Parkinson’s than women.

Genetics

Genetics cause about 10–15% of Parkinson’s cases and only slightly raise risk for relatives.

Environmental Factors

Risk factors associated with PD include head injury, exposure to pesticides, and more.

Stages of Parkinson’s Disease

Parkinson’s disease impacts people in different ways. Not everyone will experience Parkinson’s and if they do, they won’t necessarily experience them in the same order or at the same intensity. The typical progression of Parkinson’s are defined in stages. Parkinson’s stages correspond both to the severity of the movement symptoms and how much the disease affects the person’s daily activities.

Stage One

During the initial stages, a person has mild symptoms that generally don’t affect daily activities. Tremors and other movement symptoms occur on one side of the body only. Changes in posture, walking, and facial expressions occur.

Stage Two

Symptoms start getting worse. Tremors, rigidity, and movement symptoms affect both sides of the body. Walking problems and poor posture may be apparent. The person is still able to live alone but daily tasks become more difficult and lengthier.

Stage Three

Considered mid stage, loss of balance and slowness of movements are hallmarks. Falls are more common. The person is still fully independent, but symptoms significantly impair activities such as dressing and eating.

Stage Four

At this point, symptoms are severe and limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with daily activities and is unable to live alone.

Stage Five

This is the most advanced and debilitating stage. Stiffness in the legs may make it impossible to walk or stand. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is required. The person may experience hallucinations and delusions in addition to significant non-motor symptoms.

Diagnosing PD

There is no single way to diagnose Parkinson’s Disorder, but there is a range of diagnostic tests that can be done to determine a prognosis. It can be even more difficult to diagnose in the early stages when fewer symptoms are present. Our physicians also use scales that focus on motor symptoms to determine disease progression.
The Unified Parkinson’s Disease Rating Scale (UPDRS) is a more comprehensive tool used to account for non-motor symptoms, including mental functioning, mood, and social interaction. It accounts for cognitive difficulties, the ability to carry out daily activities, and treatment complications.
While symptoms and disease progression are unique to each person, knowing the typical stages of Parkinson’s can help you cope with changes as they occur. Some people experience the changes over 20 years or more. Others find the disease progresses more quickly.
Other diagnostic tests may include:

DaTscan

A DaTscan is an imaging technology that uses small amounts of a radioactive drug to help determine how much dopamine is available in a person's brain.

SPECT scanner

SPECT scanner is used to measure the amount and location of the drug in the brain.

While a DaTscan cannot diagnose PD, doctors use them to confirm a diagnosis. A negative DaTscan result does not rule out a Parkinson’s diagnosis, but a positive result helps confirm it.

Treating Parkinson’s Disease

There is no cure for Parkinson’s Disorder known today, nor is there a standard treatment for all PD patients. Treatment for each patient is based on his or her symptoms, and many measures can be taken to diminish and control symptoms that improve quality of life. Levodopa replacement (Sinemet) is currently considered the gold standard medication option to treat PD.
To discuss drug therapy options with one of our Parkinson’s Disease specialists, contact us at 404-351-0205.
Getting adequate sleep, sticking to a schedule, exercising regularly, and making accommodations as needed to your lifestyle can significantly benefit living a full life with PD.
There are some surgical options for treating PD that your physician may recommend. Some of these may include:
Other treatment options may include speech therapy to address difficulty speaking and difficulty swallowing.

Life with Parkinson's Disorder

Things to Consider When Dealing With Parkinson’s Disorder for a Better Life

Talk to Your Family

Help your loved ones understand your complications. Communication and honesty are important!

Stay in Contact with Your Doctor

They will be a great source of information and help throughout your illness.

Find a Support Group

A great place to find different perspectives related to the illness and probably some solutions.

Work through Relationship Challenges

Include your partner for support and to keep a growing relationship from a place of understanding.

Do The Right Changes at Work

Whether it is reducing your workload or working from home, ask about the changes you can make.

Frequently Asked Questions

When you or a family member is diagnosed with Parkinson's disease, it is normal to experience a range of emotions and go through several stages of adjustment to the disease. As PD progresses, bringing new challenges, you will go through many of the emotions and stages of adjustment anew. Each person experiences stages in their own order and at their own pace. In addition, there are many resources available within ANI and through our community partners to find PD education and opportunities to connect with other patients.

We encourage you to make an appointment with one of our Parkinson’s specialists, who remain on the cutting-edge of research and treatment for PD. Our comprehensive care team will help you with other aspects of your care, such as our Care Manager and Specialty Pharmacist.

You are not alone in your diagnosis! Here at ANI, we have a care team ready to create a treatment plan together. Many lifestyle choices that you make can make an impact, too. For example, exercise is incredibly important for improving mobility, stamina, mood, and quality of life. Adequate sleep and proper nutrition can also improve your day-to-day life.

Most people with Parkinson's (about 90%) have no known genetic link. Their children will likely never develop Parkinson's. Some known genetic variations increase the risk of getting Parkinson's, but most people with these variations do not get Parkinson's. Like many other diseases, Parkinson's is a result of a complex interaction between genes and environmental factors.

In a small number of people (up to 10%), Parkinson's is inherited and can affect multiple family members. Their children may have a higher risk of developing Parkinson's. However, there is no guarantee they will develop PD.

No, there are many non-motor symptoms that PD patients may experience such as apathy, depression, constipation, sleep behavior disorders, loss of sense of smell, and cognitive impairment. They are also often referred to as “invisible symptoms” and many of them are highly treatable.

PD symptoms fluctuate, and not all of them are visible. Over time, people with PD notice an increasing tendency for their medications to wear off between doses. For this reason, the way that they appear at one moment may not reflect the way that they feel most of the time. Also, they may not feel well because of non-motor symptoms. Let your doctor know if you are experiencing this so they can optimize your treatment plan.

No two people have the same Parkinson’s disease. With diverse symptoms and varying speeds of progression, PD does not affect every person the same way. However, people with Parkinson’s share many common symptoms and are at greater risk of developing some conditions. Talk with our healthcare team to help understand your risks and learn prevention strategies to help you lead your best life with PD.

No, PD cannot flare up unexpectedly. Although symptoms may fluctuate throughout the day, the progression of PD is very slow over time.

YOPD occurs in people younger than 50 years of age. It affects about 4% of the one million people with PD in the United States today. Symptoms are similar to late-onset PD, but it is important to understand the challenges YOPD individuals often face at financial, family, and employment levels.

In rare instances, Parkinson's-like symptoms can appear in children and teenagers. This form of the disorder is called juvenile Parkinsonism and is often associated with specific, high-PD risk genetic mutations.

Read more about YOPD here.