What is Parkinson's?

Around 153,000 people in the UK live with Parkinson's. It's the fastest growing neurological condition in the world, and two more people are diagnosed every hour. Most common in the over 50's (with only one fifth of those diagnosed under 40), Parkinson's develops when cells in a region of the brain responsible for the production of Dopamine stop working properly. Dopamine is considered a neurotransmitter, and is used by the brain to help control movement by carrying messages to nerve cells. Studies have shown that symptoms of Parkinson's develop when there has been an 80% or greater loss of dopamine-producing cells in the Substantia Nigra, which is located in the midbrain.

We don't yet know exactly why people get Parkinson's. Researchers think it's a combination of age, genetic, and environmental factors that cause the dopamine-producing cells to stop working, but every year we are making new discoveries, improving our understanding of Parkinson's and the brain, and with new treatments such as Stem Cell and Gene Therapies being tested in clinical trials, treatments to slow, stop, and even reverse Parkinson's could be available in the near future!

Symptoms

There are over 40 symptoms of Parkinson’s, from tremors and stiffness, to problems with sleep and mental health. Everyone’s experience is different, but the most common symptoms of Parkinson’s include:

• Involuntary shaking of particular parts of the body (tremors)

• Stiff and inflexible muscles

• Slowness of movement

• Problems with balance

• Memory problems

• Decline in thinking and problem solving skills

• Sleep problems

• Loss of sense of smell (anosmia)

• Changes in speech

• Changes in handwriting

• Mental health problems, including increased levels of anxiety and depression
  

Not everyone gets these symptoms, and everyone diagnosed will have different experiences of how their condition changes or progresses. How Parkinson’s affects someone can change from day to day, and even from hour to hour.

You may hear Parkinson’s symptoms referred to as motor symptoms and non-motor symptoms. 

Motor symptoms affect your movement and balance. They include tremors, stiffness and slowness of movement. 

Non-motor symptoms affect you in other ways that may not be easily seen by other people. They include sleep problems and mental health issues.

Types of Parkinson's

Parkinsonism is an umbrella term used to cover a range of conditions that share similar symptoms to Parkinson's such as slow movement, rigidity (stiffness) and problems with walking.

The most common form of parkinsonism is Idiopathic Parkinson’s. Idiopathic means the cause is unknown. 

Common symptoms include:

• Slowness of movement (bradykinesia)

• Tremor

• Stiffness

• Fatigue

• Having smaller handwriting

Typical early symptoms which you might notice include:

• A reduced sense of smell

• Depression

• Anxiety

• Tiredness

• Problems with sleep

• Constipation

Vascular Parkinsonism

Vascular parkinsonism affects people whose blood supply to their brain is limited - if you have had a mild stroke, for example. A stroke usually happens suddenly, so vascular parkinsonism symptoms can develop quickly, but not always.   

The symptoms of vascular parkinsonism include slowness of movement and stiffness. Vascular parkinsonism is also known as ‘lower body parkinsonism’ because it usually affects your mobility.

People can have problems when walking, becoming unsteady on  their feet, walking with short shuffling steps, or have balance problems.  

Vascular parkinsonism can also cause bladder problems, communication problems and thinking and memory problems.

How is Vascular Parkinsonism managed?

Your specialist will normally suggest you start taking Parkinson’s medication to see how your symptoms respond, but there are therapies and lifestyle changes that specialists and researches recommend, such as:

• Physiotherapy and occupational therapy - a physiotherapist can show you ways to help improve your confidence and reduce any fear of falling. They can also teach you techniques to help you get down safely on to the floor and up again if you do fall. An occupational therapist can show you ways to help reduce your risk of falling. To help with this, they might ask you to keep a falls diary to record when, where and how you fall.

• Lifestyle changes - if you have experienced a stroke in the past, your doctor will advise you to make changes to your lifestyle. This can help lower your risk of having another stroke. These may include stopping smoking, eating a low-fat diet, and being physically active.
  

Drug Induced Parkinsonism

The symptoms of drug-induced parkinsonism include slowness of movement, tremor, stiffness and difficulty walking. Symptoms usually appear quickly and tend to stay the same, it’s rare that symptoms progress.

Neuroleptic drugs (used to treat schizophrenia and other severe mental health conditions) are the biggest cause of drug induced parkinsonism. They block the action of the chemical dopamine in the brain.

Most people will recover from drug induced parkinsonism, often within days or weeks of stopping taking the drug that has caused the symptoms.

Treatments

Although there's currently no cure for Parkinson's disease, treatments are available to help reduce symptoms and maintain quality of life for as long as possible. These include:

• Supportive treatments, such as physiotherapy and occupational therapy

• Medication

• Physical activity

How do Parkinson's Medications work?

The symptoms of Parkinson’s appear when dopamine (a chemical messenger made in the brain) levels drop by 80% or more due to cells in the brain not working properly. The drugs given for Parkinson's will do one or more of the following:

• Increase the amount of dopamine in the brain

• Act as a dopamine substitute; stimulating the parts of the brain where dopamine works

• Block the action of other factors (enzymes) that break down dopamine

You may not need any treatments during the early stages of Parkinson's disease as symptoms are usually mild, but you should still have regular appointments with your specialist so your condition can be monitored.

As the condition progresses, the symptoms of Parkinson's tend to worsen, and it can become increasingly difficult to carry out everyday activities without help. Many people respond well to treatment and only experience mild to moderate disability, whereas some can, in time, become more severely disabled.

Parkinson's disease does not cause death directly, but the condition can place great strain on the body, and can make some people more vulnerable to serious and life-threatening infections, but with advances in treatment, most people with Parkinson's disease have a normal or near-normal life expectancy.

If you have recently been diagnosed, here are some tips to help you keep living your life, whilst keeping safe and healthy!

1. Make sure your friends, family, neighbours and co-workers are aware of your diagnosis and any struggles you may have so they can check in on you regularly and offer assistance when needed.

2. Have an occupational therapist visit your home where they can make recommendations on reducing the risk of falls and slips, such as handrails on staircases and tape at the end of rugs.

3. Keep a daily journal where you can keep track of your condition, how it's progressing, and any changes that may be happening to your mental health and focus. This will also help you keep an eye on any handwriting changes you may have.

4. Don't push yourself! Keep doing the things you can do, but if there's something you now find difficult, such a carrying a basket of laundry up the stairs, allow someone else to assist you.

5. Stay physically active, whether it's a weekly swim down the local pool or some armchair workouts in your front room, anything that gets the blood pumping is good for you!

6. Be honest about your feelings. Anxiety, depression, stress and confusion can all be a part of the journey, and bottling it up won't do any good! Talk to your friends and family, or even a local therapist. There are also charities with volunteers who are available for advice and friendly conversation.

7. Stay informed! With new advances in medicine and research into the brain, our understanding of Parkinson's is changing every year! Make sure you stay up to date with new information and guidance on your condition, and talk to your doctor about any possible treatments that may work for you.

Useful Links and Services:

Parkinson's UK is the main Parkinson's support and research charity in the UK.

They can help if you're living with the disease and let you know about support groups in your area.

Find out more about support groups in your local area from the Parkinson's UK website.

You can contact them by:

• Calling their free helpline on 0808 800 0303 (Monday to Friday, 9am to 6pm, and 10am to 2pm on Saturdays)

• Sending an email to hello@parkinsons.org.uk

You can also talk to others about your experiences on the community forum on the Parkinson's UK website.

Cure Parkinson's is a UK lead charity working to fund research into new treatments that may slow, stop and even reverse the symptoms of Parkinson's! Their twice yearly newsletter 'Cure InSight' highlights the latest Parkinson's research, fundraising events and opportunities, and the many ways supporters can get involved.

Parkinson’s Care and Support UK is the only UK charity which focuses on Integrative Healthcare, Wellness and Complementary therapies to improve life with Parkinson’s and to ensure that people live better for longer.

Friends of PCSUK will receive several benefits, including access to all live and face to face exercise classes, free or subsidised therapies, special concessions on products and services to help improve life with Parkinson’s, access to highly regarded Parkinson’s therapists, healthcare professionals and more!