Asked & Answered: The Signs of Parkinson’s Disease

Nearly 90,000 people are diagnosed with Parkinson’s disease every year in the U.S. alone. For National Parkinson’s Awareness Month, we’re spotlighting the warning signs and causes of the disease.

What is Parkinson’s disease?
Parkinson’s is a progressive disorder that impacts the nervous system. It predominantly affects dopamine-producing neurons in a part of the brain known as the substantia nigra. It results in uncontrolled or unintentional movements, such as shaking, stiffness and difficulty with balance and coordination. As the disease progresses, it can lead to difficulty walking and talking, and patients can develop mental and behavioral changes.

Do we know what causes it?
The cause of Parkinson’s is still unknown. Research indicates that both genetic and environmental factors could play a part. About 15% of people with Parkinson’s have a relative with the disease. However, that doesn’t necessarily point to a genetic cause. It could be a reflection of exposure to similar environmental factors. It’s believed that around 10% of cases are inherited. Research has uncovered several gene mutations linked to the disease. The most common known genetic cause is mutation of the GBA gene. However, the increased risk that people with the mutation will develop Parkinson’s is less than 10%.

Who is impacted by Parkinson’s?
The American Parkinson Disease Association estimates that around 1 million people in the U.S. are impacted by the disease. Most people with Parkinson’s are over the age of 60. However, it can impact younger people. Between 4% and 10% of cases are considered early onset, meaning they manifest in individuals between the ages of 21 and 50. In early onset Parkinson’s, the progress of the disease is often slower, but the symptoms are the same. Due to the rarity of cases among younger people, it is often undiagnosed or misdiagnosed.

How is Parkinson’s disease diagnosed?
A Parkinson’s diagnosis is traditionally done by a physician evaluating symptoms, including looking for core motor disorders of the disease like slowness, rigidity and tremors. While that evaluation is usually enough to make a diagnosis, if more information is required, there may be a DaTscan. This imaging test shows if there has been a loss of dopamine nerve endings in a specific area of the brain called the striatum, which is a hallmark of Parkinson’s. Newer ways of testing for the disease include two biomarker tests. One looks at cerebral spinal fluid, and the other requires skin biopsies. A way to identify Parkinson’s through a blood test not available, but is currently being researched.

the symptoms 
The American Parkinson’s Foundation suggests people learn to look out for 10 early signs of Parkinson’s disease.

  1. Tremors: Shakiness can happen for a variety of reasons, including stress, injury and fatigue. However, tremors while at rest also are a common early sign of Parkinson’s. It usually begins in a limb, most often the hand or fingers.
  2. Smaller handwriting: Known as micrographia, abnormally small or cramped handwriting is an acquired disorder that is associated with Parkinson’s. If you notice changes to the way you write or it becomes more difficult, it could be an early indicator of the disease.
  3. Reduced sense of smell: Difficulty smelling foods like dill pickles, bananas and licorice are associated with the disease. Temporary loss of smell could be the result of a cold or other illness, but normal function should return following recovery. If it persists, consult your doctor about Parkinson’s.
  4. Trouble sleeping: The disease is associated with disordered sleep. Research has shown that people with Parkinson’s average around just over five hours of sleep a night, and throughout the night, they wake up twice as much as people their age who don’t have Parkinson’s.
  5. Difficulty moving or walking: Bradykinesia is a slowness of movement that is one of the most common manifestations of Parkinson’s. Your steps may become shorter when you walk or drag and shuffle your feet. You may also experience stiffness in your shoulders or hips. It can make simple tasks more difficult and time-consuming.
  6. Constipation: If you strain to move your bowels regularly, it can be an early sign of Parkinson’s. However, diet, medication and other factors also can cause constipation. Consult your physician to see if you can determine the cause.
  7. Softer speech: Parkinson’s can impact the way you speak. The disease is associated with soft, breathy or hoarse speech. If people are struggling to hear you, it could be a warning sign.
  8. Masked facial expressions: “Masked faces” refer to diminished facial expressions that are commonly associated with Parkinson’s. Individuals with the disease can often look expressionless or upset, even when they are not in a bad mood.
  9. Dizziness or fainting: Feeling dizzy or fainting is a sign of low blood pressure, which is linked to Parkinson’s. The disease also is associated with a loss of balance that can lead to falls.
  10. Stooping or hunching: Impaired posture is a common side effect. Muscle stiffness also can occur in any part of the body, which can limit your range of motion.

Sources: American Parkinson Disease Association, American Parkinson’s Foundation

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