Frequently Asked Questions About Parkinson's Disease
How close are you to finding a way to slow the progression of and/or cure Parkinson’s disease? The good news is that there has been tremendous growth in our understanding of the nuts-and-bolts of Parkinson’s. We are close to honing in on effective ways to combat the critical flaws in the body and brain that lead to the disease. Understanding how cells die in gives us the entrée to actually stop this disease — not just treat it but nip it by stopping further degeneration — so it doesn’t progress any further. And, with the new field of biomarkers or chemical, neuroimaging or cellular “fingerprints” of the disease outside the brain there is the possibility that researchers may soon be able to identify the disease even before the classic signs appear.
These concepts and the current work in the field are revolutionary. These are the steps to a cure. When you participate in a clinical trial you’ll receive more professional attention, support from peers and a greater understanding of your disease and treatments. Further, findings from a clinical trial that you participate in may help improve the lives and health of other’s living with Parkinson's.
How will my Parkinson’s disease progress? Parkinson’s disease is a progressive neurologic disorder, so it is natural that one of the first questions patients want to ask is about disease progression. This is a difficult question to answer for an individual patient because there are many factors that determine how Parkinson’s disease progresses in a particular individual.
Overall, studies have shown that Parkinson’s is very slowly progressive. Furthermore, we have many medications to treat the symptoms. Many patients will have Parkinson’s disease for 10 to 25 years before they develop serious complications.
Although the disease will progress more rapidly in some patients, many will be able to live well with their Parkinson’s disease for many years with appropriate care. Although there is currently no medicine that can stop or slow progression, researchers at Rush are focused on this ultimate solution.
What factors affect Parkinson’s disease progression?
In general, in the absence of other illnesses, each patient seems to progress at a steady rate that is particular to each patient. Factors that are associated with a more rapid progression of disease include the following:
• Older age at onset of symptoms (over the age of 75-80 years)
• Lack of tremor
• Early walking and balance problems with falls within the first year
• Early speech and swallowing problems
• Early onset of cognitive and memory difficulties
In general, as patients get older they may also face other problems not related to their Parkinson’s disease. These may be more disabling than the symptoms caused by Parkinson’s disease and include the following:
• Significant medical problems such as hypertension, diabetes or heart disease
• Urinary problems
• Side effects from medications and other brain diseases
While motor symptoms (e.g., tremor and slowness) may be the most bothersome in early disease stages, there are other problems that can be seen in Parkinson’s disease as it advances. These include fatigue, apathy, depression, sleep problems, memory problems and gait freezing. These non-motor symptoms can be treated and often are best approached by a physician with experience in Parkinson’s disease.
In addition, there are several things that patients can do to improve their outcomes. Regular exercise is critical to maintaining physical function. Exercise improves the heart, memory and may even slow the progression of Parkinson’s disease symptoms. Continuing to be active and social helps with memory, depression, anxiety and other psychological issues.
Along with medications, are there any other ways to improve my symptoms?
Medications are only one component of a comprehensive treatment plan that can enhance a person’s quality of life with Parkinson’s. The following may also be beneficial:
1. Exercise is a key player in keeping people with Parkinson’s independent and mobile. Many studies have shown most types of exercise have beneficial effects on the motor symptoms of the disease.
Vigorous exercise for 30 minutes daily not only helps the neurological symptoms, but also improves cardiovascular disease risk factors, which are common in this age group. Exercise has been shown to improve memory and is directly relevant to people with Parkinson’s who are at risk for cognitive impairment.
Exercise is a treatment that patients must do for themselves. However, once the commitment is made to a regular exercise program, the results can be remarkable. It is important to do an exercise that is enjoyable, and to be sure that a primary care physician approves the program.
2. Physical therapy is often prescribed for patients for a variety of symptoms, including fall prevention, gait training and range of motion exercises.
3. Speech therapy can help with the low volume of speech or difficulties with swallowing that occur later in the disease.
4. Occupational therapy may be used to enhance people’s ability to work or maintain daily activities.
5. Staying engaged and challenged are very important in protecting patients from cognitive decline. Increasing social interaction by attending day programs, taking classes or learning new skills can help patients in the long term.
6. Complementary, alternative therapies can be beneficial, including acupuncture, which has been shown to reduce tremor, and massage therapy, which can help with muscle spasms.