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 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
