What is Parkinson’s disease?

Parkinson’s is a progressive neurological condition

One person in every 500 has Parkinson’s. That’s about 127,000 people in the UK

Most people who get Parkinson’s are aged 50 or over, but younger people can get it too. One in 20 is under the age of 40

People with Parkinson’s don’t have enough of a chemical called Dopamine, because some nerve cells in their brain have died

Without Dopamine, people can find that their movements become slower, so it takes longer to do things

The loss of nerve cells in the brain causes the symptoms of Parkinson’s to appear

There’s currently no cure for Parkinson’s and we don’t yet know why people get the condition

Parkinson’s doesn’t directly cause people to die, but symptoms do get worse over time

What are the symptoms of Parkinson’s?

The main symptoms of Parkinson’s are tremor, rigidity and slowness of movement

As well as affecting movement, people with Parkinson’s can find that other issues, such as tiredness, pain, depression and constipation can have an impact on their day-to-day lives

 Bladder and bowel problems

Bladder problems may occur in Parkinson’s, affecting the nerves that control emptying the bladder. This can lead to an overactive bladder and the need to pass urine more often and quickly

Some people with Parkinson’s may get constipation. It may make them feel unwell, lethargic and even nauseous, but it rarely leads to serious complications

Increasing the amount they drink and how much fibre they eat, eating a balanced diet and taking regular exercise will stimulate their bowel to help prevent constipation

Swallowing and saliva control

Some people with Parkinson’s may find they have problems when eating and saliva may build up in the mouth, which can sometimes overflow

Practising keeping lips together, learning tips on tongue control and exercises may help with any difficulties in swallowing and may also help to control drooling

In some cases, by just changing posture and sitting more upright can help improve things

Falls and dizziness

Loss of balance and falling can be common in Parkinson’s. Falls are caused by many factors, such as the changes in posture that may happen as Parkinson’s progresses

Freezing

Some people with Parkinson’s will experience freezin stopping suddenly while walking and feeling like their feet are ‘glued’ to the ground they may then be unable to move forward again for several seconds or minutes

It is not known exactly what causes freezing, but it may happen when movements are interrupted, or when the movement is just starting

Freezing doesn’t just affect walking, it can occur during repetitive movements, like writing or brushing teeth

Speech and communication

There maybe  problems with different kinds of communication, including speech, facial expressions and writing

Many people with Parkinson’s have some speech problems when they first develop the condition. These may make everyday activities, such as talking to friends or using the phone, difficult

The speech problems that some people with Parkinson’s can have may be helped by speech and language therapy

Eye problems

Eye problems, such as blurred or double vision, dry eyes or excessive watering can be common for people with Parkinson’s

Some of these issues will be due to Parkinson’s, or the treatment they are receiving

If they experience any eye problems, see your GP, specialist or Parkinson’s nurse

Skin, scalp and sweating problems

Parkinson’s can cause the sweat glands to overreact. That can lead to too much or too little sweat, or to extremely dry skin

Changes to medication can often reduce excess sweating and ensure that the body produces enough perspiration

Dry skin and scalp problems can be irritating, but are often manageable with creams and medicated shampoos

Dietary problems

Having a balanced diet is an important part of looking after health

With Parkinson’s they may need to take a little extra care as some symptoms and side effects of treatment can limit or upset the appetite

Being underweight or overweight can have an impact on health generally

Pain and Parkinson’s

There are many different types of pain, for example, experience headaches, or muscular and joint pain

Not everyone with Parkinson’s experiences the same symptoms. For some people, pain can be the main symptom of their condition, although not everyone will experience this problem

It is important that both people with Parkinson’s and their carers are aware of the problems pain may cause

To be able to treat pain in Parkinson’s, the GP, specialist or Parkinson’s nurse, need to find out what’s causing the pain

The symptoms someone has and how quickly the condition develops will differ from one person to the next

Mild memory problems

In the earlier stages of Parkinson’s, many people complain of certain difficulties in thinking and memory that can interfere with day-to-day life

This can be experienced as a slowing down of thinking, much in the same way as they might experience slowing down of movement

While some people do complain of forgetfulness, memory problems are not usually a significant complaint in the early stages of Parkinson’s

It is more likely that other factors, such as stress, depression and poor general health will have an impact on the ability to think, recall and process information efficiently

Parkinson’s Dementia

A diagnosis of Parkinson’s Dementia is given if the symptoms of dementia appear after those of Parkinson’s

Symptoms of dementia can include:

  • Slowness of thinking
  • Poor recall
  • Executive dysfunction (poor planning, multi-tasking)
  • Impaired concentration and attention
  • Talking less

Memory problems, such as forgetfulness and repetitive questioning, can also be experienced. However, some people can have dementia with hardly any memory problems

In general, people with Parkinson’s dementia find they have problems with judgment and problem solving. This means it is difficult for them to make complex decisions, such as financial decisions and choice of medical treatment

Activities of daily living, such as dressing, hygiene, cooking and cleaning may also become increasingly difficult. Extra help from carers may be necessary


Depression

Depression is more than feeling sad or unhappy now and then. A diagnosis of depression will be made if someone has been in a low mood for a long time, usually at least 2 weeks

When someone is depressed, they may experience a loss of pleasure or interest in their usual activities

A depressed person might also experience feelings of hopelessness, helplessness, low self-esteem and inappropriate guilt

Other symptoms can include problems with thinking, sleep, appetite, energy and sexual drive. Anxiety, panic attacks and feelings of being ‘wound up’ often accompany depression

Sleep changes include excessive sleeping and not wanting to get out of bed, or having difficulty falling asleep, accompanied by waking up in the early morning

In some cases, depression may be particularly severe and may be accompanied by suicidal ideas, or abnormal changes in perceptions (hallucinations) and beliefs (delusions). In such cases, it is called ‘psychotic depression’ and may require hospitalisation

Treatment can include medication or ‘talking therapies’, such as cognitive behavioral therapy

It can be very difficult for someone to recognise depression in themselves. Therefore, if you think the person you care for is depressed, it’s important to let their healthcare professionals know

Anxiety

Anxiety can be an entirely normal feeling, ranging from worry and stress to the bodily symptoms, including sweating, pounding of the heart, shortness of breath and unpleasant feelings in the stomach

Some people with Parkinson’s have anxiety related to the ‘on/off’ state of their motor symptoms. When ‘off’ and less able to move well, they may develop significant anxiety symptoms and, at times, may even have panic attacks

If anxiety is related to movement problems, then talking to a doctor about altering anti-Parkinson’s medication can help

For anxiety symptoms which do not respond to changes in anti-Parkinson’s medication, a trial of either talk therapy, such as cognitive behavioural therapy, or medications, may be helpful

For those who experience mild anxiety every now and then, avoiding stimulants, such as caffeine, alcohol and cigarettes, can help

Some people find relaxation tapes, yoga, massage, acupuncture and complementary therapies beneficial.

Hallucinations

When a person hallucinates they may see, hear, feel, smell or taste something that, in reality, does not exist

Hallucinations are rare, but some people with Parkinson’s may experience complex visual hallucinations

Typically, these involve seeing small animals, insects, or other people in the room. The length of the hallucination varies and is usually visual

Auditory hallucinations are rarer for people with Parkinson’s

Sometimes, when people with Parkinson’s hallucinate, they experience a feeling that an animal or object is present, just next to them, but they do not actually see it

Hallucinations are caused partly by Parkinson’s itself and partly by the medication that is prescribed to treat it. Dopamine agonists and anticholinergic drugs are more likely to cause hallucinations

If you are experiencing hallucinations, it is important that you visit your doctor, so that the cause can be identified and any appropriate treatment given

The symptoms can be controlled using a combination of drugs, therapies and occasionally surgery

  • As Parkinson’s progresses, an increased amount of care and support may be required, although many people maintain a good quality of life with limited care or treatment

www.parkinsons.org.uk

www.parkinsoninfo.org


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