Parkinson’s Disease affects the whole body
Parkinson’s Disease is an age-related neurodegenerative disorder which affects your brain, nervous system and many other parts of your body controlled by nerves.
Most people associate Parkinson’s with movement difficulties (or motor symptoms) such as shaking, stiffness and slow movement, balance or walking problems. However, Parkinson’s has many other symptoms not related to movement (non-motor symptoms).
These non-motor symptoms often appear earlier and can be more disabling than movement difficulties. Examples include mood and sleep disorders, memory and thinking problems, constipation, bladder or erectile problems.
Most people with Parkinson’s first develop the disease after age 60, but onset can be earlier. Parkinson’s generally develops slowly and grows progressively more complex over time. Symptoms vary from one person to another.
It’s important to work with experts to help you understand and manage Parkinson’s symptoms over time. With expert support, it is possible to have a good quality of life for a long time with Parkinson’s.
The earliest signs – smell and sleep
Not all people who lose their sense of smell will develop Parkinson’s, However, reduced sense of smell is a common early sign of Parkinson’s disease and is often not recognised by people’s doctors.
Sleep related difficulties are another common symptom of Parkinson’s and may develop long before movement difficulties show up. They can include difficulty sleeping; talking, yelling, or acting out dreams while asleep; or being very sleepy during the day.
Digestive system
The gut contains more neurons (nerve cells) than the brain so it makes sense that a brain disease like Parkinson’s should affect the digestive system too. In fact, researchers have found Parkinson’s damage in the nerve cells lining the digestive tract up to 10 years before the noticeable onset of the disease. It is possible that Parkinson’s Disease starts in the gut well before it has any impact on the cells in the brain.
As the disease progresses, constipation, difficulty swallowing, nausea, poor absorption of food and medications and excess salivary problems are common symptoms of Parkinson’s.
The mind
Parkinson’s affects the nerves cells in your brain, and this can lead to a variety of mild to serious symptoms as the disease progresses.
Subtle changes may go unrecognised in early stages of Parkinson’s. Changes in memory and thinking are common and for many people these are mild enough to carry on with everyday life. Anxiety and depression are not simply a reaction to having Parkinson’s but also caused by changes in the brain. Apathy - a loss of interest or motivation – is another symptom.
As the disease progresses, changes can become more difficult for people with Parkinson’s and their carers. Later in the disease, psychosis can range from severe confusion to hallucinations and delusions. Dementia – or severe memory and thinking problems - is also more common in later stage Parkinson’s.
Both dementia and psychosis are very challenging. They can significantly impact quality of life and independence for people with Parkinson’s and their partners, families, or carers.
The body’s automatic processes
Your autonomic nervous system controls your body's automatic functions such as your heart rate, blood pressure, bladder control and temperature control.
Parkinson’s disease can affect these automatic body functions causing a range of problems. For example, feeling faint, giddy, or headachy when moving from a lying to upright position are signs of a type of low blood pressure known as orthostatic hypotension. Other symptoms can include a frequent and urgent need to urinate, excess sweating, poor temperature control and erectile problems.
In general, these symptoms tend to occur later as the disease becomes more advanced. If it occurs earlier, your doctor could investigate other causes.
Falls
Falls are a real and high risk with Parkinson’s for several reasons, so preventing injury from falls is a major aim when managing the disease. Impaired balance and movement, dizziness and faintness, and cognitive impairment can all raise the risk of falls. In addition, some medications can increase the risk of falls.
Specialists required - geriatricians and neurologists
Parkinson’s Disease is complex and its symptoms incredibly diverse. No two people have the same experience. As it progresses and people age, medical problems and management complexities increase.
While there is no way to stop the disease’s progression, a specialist can diagnose, identify, and help manage the symptoms. The disease can follow some recognised patterns. Being able to map the future path of the disease is important for treatment planning. There are opportunities for a range of different treatments, from medication to devices to therapy-based treatments.
Both geriatricians and neurologists are skilled in managing Parkinson’s Disease. Each offer different knowledge and strengths. A neurologist is a specialist in conditions affecting the brain and nervous system, but a neurologist alone is not well suited to the comprehensive care of people with Parkinson’s. People with Parkinson’s need to be looked after by multidisciplinary teams.
Your geriatrician is a specialist in many age-related conditions, including Parkinson’s. Geriatricians are skilled at managing a broad range of complex problems simultaneously, including problems unique to Parkinson’s Disease such as falls, dementia and medication complexity. Geriatricians are also skilled in communicating with and co-ordinating a multi-disciplinary team including physiotherapy, occupational therapy, and psychiatry. This is very important, particularly in the late stages of disease.
