Parkinson’s disease is a neurological disorder that can cause muscles to become rigid and tight, making it difficult to walk. It may cause noticeable tremors and, over time, progress into dementia.
It affects over one million Americans, but not all of them experience dementia. Between 50% to 80% with the disease develop dementia an average of 10 years after their diagnosis. If dementia develops a year or more after motor symptoms begin to appear, the diagnosis is Parkinson’s dementia. If cognitive problems start before the movement issues, it’s called dementia with Lewy bodies.
Beyond motor issues, Parkinson’s can lead to trouble with memory, problem-solving and language. People with Parkinson’s may struggle to find the right words. Parkinson’s disease is most common in those who are 50 and over. The average age of someone who receives a Parkinson’s diagnosis is 60, and greater age equates with greater risk.
Symptoms of Parkinson’s Disease
Physical changes caused by Parkinson’s disease begin in the part of the brain that regulates movement. This leads to early symptoms like shakiness, tremors, muscle stiffness and a shuffling step. The second set of symptoms involves non-motor skills and may include pain, loss of smell and dementia.
People with Parkinson’s may not experience all of these symptoms. They may have only slight tremors but more serious dementia. Or, they may have tremors without any memory or cognitive problems.
If mental processes are affected, there’s difficulty concentrating, planning and making sound decisions. Cognitive symptoms may include:
- Problems with concentration, memory and judgment
- Muffled speech
- Hallucinations and delusions, including paranoid thoughts
- Depression, irritability and anxiety
- Disturbed sleep and daytime drowsiness
The Stages of Parkinson’s Disease
Parkinson’s disease is chronic and progressive, which means it gets worse over time. Below is a broad outline of how the disease progresses, although the timeline can vary with each person.
- Stage one involves only mild symptoms that don’t interfere with daily activities. There will be tremors and movement problems on only one side of the body, along with changes in posture, facial expressions and walking.
- In stage two, tremors and rigidity affect both sides of the body. Walking problems and poor posture become more apparent. The person can live alone but can struggle with daily tasks.
- During mid-stage Parkinson’s, there’s a greater loss of balance and a slowing down of movements. Falls may become more frequent. During this stage, people with Parkinson’s can maintain independence but may have difficulty while eating, bathing and dressing.
- Symptoms are severe in stage 4, and the ability to complete daily tasks becomes limited. People may stand without help, but they’ll need a walker. They can’t live alone at this stage and will need assistance with activities of daily living.
- During the final stage, stiffness makes it impossible to stand or walk, and the person is bedridden. They require around-the-clock nursing care and are unable to perform daily tasks. Hallucinations and delusions may trouble their thoughts.
Causes and Risk Factors of Parkinson’s
Parkinson’s disease is caused by a loss of nerve cells that infuse the brain with dopamine. It’s cause is still unknown by researchers. With less dopamine, the brain can’t coordinate muscles or regulate thinking.
The death of nerve cells is thought to be related to proteins deposited in the brain called Lewy bodies. Sometimes there are also brain plaques and tangles, similar to those found in Alzheimer’s disease.
Risk factors for Parkinson’s include:
- Genes: Early-onset Parkinson’s disease is often inherited and genetic
- Gender: Men are twice as likely as women to get Parkinson’s
- Environmental toxins: Exposure to toxins in the environment may increase the risk of Parkinson’s disease, but the risk is relatively small
- Age: The risk of Parkinson’s increases with age
- Hallucinations: You’re more at risk for Parkinson’s if you’ve had hallucinations
Diagnosis and Treatment
Parkinson’s disease can be difficult to diagnose. A doctor won’t use a single test but will look into your family’s medical history and perform neurological examinations.
Often, the family doctor is the first to notice signs of Parkinson’s disease. They’ll refer the patient to a neurologist to confirm the diagnosis. The neurologist will diagnose Parkinson’s if two out of the four main symptoms are present:
- Shaking or tremors
- Slowness of movement, known as bradykinesia
- Stiffness or rigidity in the arms, legs or trunk
- Trouble with balance, including falls, which is called postural instability
The doctor will want to know about any family history of Parkinson’s. They will also do medical imaging scans, such as a CT scan or MRI, to rule out other diseases.
Because there is no definitive test for Parkinson’s disease, the best option is to consult with a movement disorder specialist (MDS). This is a doctor who specializes in the diagnosis and treatment of movement disorders such as Parkinson’s.
There’s no way to stop the progression of Parkinson’s disease, but consulting with a neurologist or movement disorder specialist is key to managing it. The doctor has many tools to relieve symptoms, tackle depression and foster a good quality of life for as long as possible.
- Medications used to treat Parkinson’s help balance dopamine in the brain. This can reduce many of the worst symptoms.
- Cholinesterase inhibitors are drugs that help with cognitive changes in diseases such as Parkinson’s and Alzheimer’s. They limit visual hallucinations and sleep disturbances. They can take the edge off thinking and behavior problems.
- Anti-depressants such as selective serotonin reuptake inhibitors (SSRIs) help lift the mood of those with depression. Sleep disorders are often treated with clonazepam.
- Antipsychotic drugs should be used with extreme caution, as they’re linked to unwelcome side effects in almost half of those with Parkinson’s dementia. These could include worsening of symptoms, extreme confusion, trouble swallowing, changes in consciousness, delusions and hallucinations.
- Deep brain stimulation is a procedure in which electrical impulses are sent to the brain to control tremors and twitches
- Some people choose surgery to manage unwelcome movements. It may include destroying the brain tissue that is causing the tremors. Surgery is an option only when the symptoms are disabling, like rigidity, slow movement and problems with walking.
Lifestyle Changes to Help with Parkinson’s Disease
Holistic lifestyle changes can help people stay healthier with Parkinson’s disease:
- Exercise keeps muscles more flexible for better movement. It also releases brain chemicals like endorphins to boost mood.
- High protein meals help the brain function better
- Physical, occupational and speech therapy will improve the ability to communicate and tackle daily tasks
Parkinson’s Disease Care Options
To measure the amount of help someone with Parkinson’s needs, evaluate how well they’re doing with the activities of daily living, known as ADLs. These include:
- Going to the bathroom
- Transferring in and out of bed
- Bowel and bladder control
Facing challenges in multiple ADLs means the person will require a greater level of assistance. For instance, if they can handle only one or two out of the six, they need a lot of extra care. If they are handling most of them well, they can live more independently.
It’s also helpful to see how they’re managing complex, but necessary, tasks. Are they letting these things slide or requiring a lot of help in the process?
- Paying the bills
- Keeping the house clean
- Cooking a meal
- Being able to drive
Assisted Living and Memory Care Options
In-home care – such as a visiting nurse – can help someone with Parkinson’s during the early stages of the disease. Home help can prepare meals, clean, help bathe and dress, and keep track of medications.
If closer monitoring eases your mind, assisted living communities such as The Cabana at Jensen Dunes provide a welcoming place to enrich health and well-being for those with Parkinson’s. Assisted living provides skilled medical help, personal care and security, but also much more. Modern assisted living communities offer a wide range of amenities that include beautiful apartment suites, restaurant-style dining and fun wellness activities.
Such communities can expand social circles, hobbies, outings, and food choices. They also manage the symptoms of Parkinson’s disease while giving the latest treatments for the best outcomes.
As the disease progresses, behavior changes and limited movement can make independence harder to achieve. These can take a toll as the person may become agitated, have delusions or behavior changes, and be unable to move around on their own.
At this stage, a structured memory care community with 24-hour nursing care, nourishing meals, and physical therapy is a good option. Steady routines are comforting at this stage. Communities such as The Cabana at Jensen Dunes, which includes a Memory Care neighborhood, are ideal because they remove the burden of home maintenance, assist with personal care, and understand how to manage a progressive disease.