Parkinson's disease

Parkinson’s disease is a neurodegenerative disorder that affects multiple body systems, resulting in a broad range of movement and other symptoms that worsen with disease progression.^a

Approximately¹ in every 350 persons in Australia lives with Parkinson’s disease.¹ While over 80% of people with Parkinson’s disease in Australia are above the age of 65 years, the disease can also affect young people: almost one-fifth of people with Parkinson’s disease are between the ages of 15 to 64,¹ and one-tenth are diagnosed before the age of 40.²

The hallmark characteristic of Parkinson’s disease is the gradual loss of nerve cells that produce a brain chemical that relays signals between nerve cells, called “dopamine”.^a Loss of dopamine is a key driver of the movement difficulties that people with Parkinson’s disease experience.^a

In Parkinson’s disease, widespread changes in other regions of the brain affect other brain chemical messengers, such as serotonin and acetylcholine.^b Dysfunction of these messengers affects functions of the body relating to sleep, mood, cognition, involuntary control, and the gastric system.^b

https://shakeitup.org.au/understanding-parkinsons/

Age is one of the key risk factors for Parkinson’s disease – the prevalence and incidence of Parkinson’s disease increase with age, peaking after the age of 80.^a

Males are also more likely to develop Parkinson’s than females: the male-to-female ratio is approximately 3:2 in Parkinsons’s disease.^a

In addition to age and gender, people who are exposed to certain environmental exposures (eg. pesticides, rural living or agricultural occupation) or who have different forms of certain genes (eg. LRRK2, Parkin) may be more likely to develop Parkinson’s disease.^a

https://www.parkinsons.org.au/what-causes-parkinsons

The symptoms that manifest in Parkinson’s disease can broadly be classified into two categories: symptoms related to movement (motor symptoms), and other symptoms that are not related to movement (non-motor symptoms).

The four classic movement symptoms of Parkinson’s disease are tremors, rigidity, bradykinesia and postural instability.

• Tremors: These are involuntary, rhythmical movements that occur when the affected part of the body, such as the hand, is relaxed.^c

• Rigidity: People with Parkinson’s disease may complain of stiffness due to rigidity,^d or increased muscle tone.^c This can be uncomfortable,d or even painful.³

• Bradykinesia: Bradykinesia means slowed movements, which can manifest as difficulties with writing, buttoning a shirt or tying shoes,^e a loss of facial expression, a softer voice or small handwriting.^c

• Postural instability: In later stages of Parkinson’s disease,^e the person may struggle with balance, which can lead to falls.^c Walking and turning become difficult, so people with late-stage Parkinson’s disease often walk in short, shuffling steps.^c

Non-motor symptoms are common in Parkinson’s disease.³ These include:^c

• Pain and fatigue
• Mood and psychiatric symptoms (eg. depression, anxiety, hallucinations)
• Problems with cognition, ranging from mild impairment to dementia
• Problems with involuntary control (eg. sexual dysfunction, urinary dysfunction, constipation, drooling)
• Sensory and sleep disturbances

Many people with Parkinson’s disease experience more than one non-motor symptom at the same time during the early stages of the disease.^f Some people may experience non-motor symptoms more than a decade before the onset of motor symptoms.^a Non-motor symptoms typically worsen with disease progression, and contribute to considerable disability.^a

http://www.parkinsons.org.au/specific-problems

https://shakeitup.org.au/understanding-parkinsons/symptoms-of-parkinsons/

There are currently no standard diagnostics tests (eg. blood tests, imaging scans) for Parkinson’s disease;^g as such, a clinical diagnosis is made based on the presence of the four classic movement symptoms of tremor, rigidity, akinesia and postural instability.^h

https://shakeitup.org.au/understanding-parkinsons/sharing-parkinsons-diagnosis/

http://www.parkinsons.org.au/recently-diagnosed

General Information about Parkinson’s disease:

• Parkinson’s disease (Brain Foundation): http://brainfoundation.org.au/disorders/parkinsons-disease

• What is Parkinson’s (Parkinson’s Victoria): http://www.parkinsonsvic.org.au/parkinsons-and-you/what-is-parkinsons/

• Parkinson’s disease (Better Health Channel and Parkinson’s Victoria):      

 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/parkinsons-disease

Patient Organisations:

• Parkinson’s Australia is the national peak body and charity representing Australians living with Parkinson’s. Parkinson’s Australia’s regional organisations promote the well-being and interests of people with Parkinson’s disease and their families, friends and carers in various regions across Australia. Please select one of the following:

1. Parkinson’s New South Wales

2. Parkinson’s Australian Capital Territory (ACT)

3. Parkinson’s South Australia

4. Parkinson’s Queensland

5. Parkinson’s Tasmania

6. Parkinson’s Victoria

7. Parkinson’s Western Australia

Other resources:

• HealthDirect Australia  is a public company that delivers health services by contracting with service providers, managing ongoing operations and implementing governance structures so that health services are provided safely and efficiently. The Parkinson’s disease webpage provides information on Parkinson’s-related health services and information.
• Dance for Parkinson’s offers dance classes for people with Parkinson’s disease in ACT, Queensland, New South Wales, Tasmania and Victoria. In Dance for Parkinson’s classes, participants are empowered to explore movement and music in ways that are refreshing, enjoyable, stimulating and creative.     
• Parkinson’s Well-Being Map™  is a freely-available tool that helps people with Parkinson’s disease prepare for consultations with their healthcare team.
• Parkinson’s disease NMS Questionnaire is a questionnaire available for people with Parkinson’s disease to complete before a doctor’s visit to help flag any non-motor symptoms to the physician.
• Parkinson’s Xplained is a free app written by doctors for people with Parkinson’s disease, developed in collaboration with Parkinson’s Australia.
• Shake It Up Australia Foundation is a non-profit organisation established in 2011 in partnership with The Michael J. Fox Foundation to promote and fund Parkinson’s disease research in Australia. Read stories of other people living with Parkinson’s disease and their caregivers at the Shake It Up Australia Foundation Blog.

Before you begin any exercise programme, be sure to consult with your doctor or medical professional to make sure exercise is appropriate for you.

For more information about Parkinson’s disease, please consult a healthcare professional.

1. Deloitte Access Economics. Living with Parkinson's disease - update. Parkinson's Australia: October 2011. Available from: http://www.parkinsonsnsw.org.au/wp-content/uploads/2015/03/AE-Report_2011.pdf

2. ShakeItUp. What is Parkinson's. Available from: https://shakeitup.org.au/understanding-parkinsons/ 

3. Jankovic J. Journal of Neurology, Neurosurgery and Psychiatry. 2008; 79: 368-376.

a. Kalia L and Lang A. The Lancet. 2015; 386: 896-912.

b. Halliday G, Lees A, Stern M. Movement Disorders. 2011; 26(6): 1015-1021.

c. Massano J and Bhatia K. Cold Spring Harbor Perspectives in Medicine. 2012; 2: a008870.

d. Mazzoni P, Shabbott B, Cortes J. Cold Spring Harbor Perspectives in Medicine. 2012; 2: a009282.

e. Mhyre T, Boyd J, Hammill R, Maguire-Zeiss K. Subcellular Biochemistry. 2012; 65: 389-455.

f. Martinez-Martin P. Movement Disorders. 2014: 29(2): 166-168.

g. Postuma R, Berg D, Stern M, Powew W, Olanow C, Oertel W et al. Movement Disorders. 2015; 30(12): 1591-1599.

h. Beitz J. Frontiers in Bioscience. 2014; S6: 65-74.