Michael J. Fox has spent much of his long television career living with Parkinson’s disease. While fans may recognize the symptoms in Fox’s shaky hands and jerky movements, that may be all they know about this surprisingly common neurological disorder.
That’s why Fox has spent decades helping the world understand that this disease is serious, disabling and incurable, but also treatable, and that patients like him can expect to live well with the condition.
The Prevalence of Parkinson’s Disease
Like Alzheimer’s disease and Huntington’s Disease, Parkinson’s disease is a slow-progressing neurodegenerative disorder. According to the Alliance for Aging Research, as many as 1 million Americans live with Parkinson’s disease. It’s estimated that about 50,000 new cases of Parkinson’s disease are diagnosed in the US every year, and that the prevalence of the disease will more than double by 2040 as the elderly population grows.
The disease itself isn’t fatal; the average life expectancy of people who have Parkinson’s disease is usually the same as those who live without the disease. However, complications from the disease can be serious. Falls are a significant problem among those living with Parkinson’s. A study published in Neurology, found that close to half — 48% — of the Parkinson’s participants studied reported having suffered a fall.
What Causes Parkinson’s Disease?
Parkinson’s disease causes the brain to slowly stop producing dopamine, a neurotransmitter that helps conduct nerve impulses that control movement. The less dopamine a person has, the less they’re able to regulate their movements. When 60-80% of the brain’s dopamine-producing cells become damaged, Parkinson’s hallmark symptoms, such as tremors of the hands, arms, legs, jaw and face; slow, rigid movements and balance instability, begin to appear.
And while researchers don’t know what causes people to develop the disease, they suspect a combination of genetic and environmental facts are involved.
Statistics show that women are less likely to have Parkinson’s disease than men, and though the cause of Parkinson’s disease is unknown, it’s estimated that only 10-15% of cases of Parkinson’s are hereditary. And while researchers have identified specific genes that can be passed from one generation to the next, they say that hereditary cases of Parkinson’s disease are rare.
Scientists believe that most patients develop the disease as a result of injury or extended exposure to toxins. Recent research has shown that certain pesticides and insecticides, especially among people who live in rural areas and drink well water, have been linked with the disease. In 2009, the U.S. Department of Veterans Affairs also added Parkinson’s to the list of diseases linked with exposure to Agent Orange.
Longstanding exposure to certain metals, like lead, have also been linked to Parkinson’s disease development. And patients who have experienced a traumatic brain injury, especially later in life, were found more likely to develop the disease, possibly caused by inflammation in the brain.
How is Parkinson’s Disease Diagnosed?
The disease doesn’t affect all patients in the same way, and patients can have different symptoms and levels of physical impairment. That’s why Parkinson’s disease can be difficult to diagnose.
There’s no single or specific diagnostic test that determines if a patient has Parkinson’s, though a physician might order blood or imaging tests to rule out other conditions with similar symptoms. Usually, physicians make the diagnosis based on a combination of factors, including the patient’s neurological and family history as well as their physical symptoms.
Stages of Parkinson’s Disease
If a Parkinson’s diagnosis is made by your family physician or another primary care physician, you should also ask to see a neurologist, a doctor who specializes in brain health and neurological disorders.
Once diagnosed, a physician will conduct a series of exams that will help determine which of the five stages of the disease you’re in currently. Your doctor may refer to this as Hoehn and Yahr Scale, a scale that ranges from one to five and designates the severity of the disease — five being the most severe.
Parkinson’s Disease Treatment
Joseph Quinn, MD, is director of the Oregon Health & Science University Parkinson Center and Movement Disorder Program, and director of the Portland VAMC Parkinson’s Disease Research, Education and Clinical Center. He says that that most important thing a newly diagnosed patient should know is that, “Parkinson’s disease is treatable. It isn’t curable, but in contrast to many other neurological diseases, there’s an array of treatment options that allow patients to maintain a good quality of life.”
This includes medications that replenish or act like dopamine to improve motor function, and medications to help patients deal with other physical symptoms. Many people also find alternative therapies like massage, acupuncture, meditation and physical therapy to be beneficial.
Once diagnosed, the single most important thing a patient can do is exercise, adds Quinn. The benefits of exercise are unequivocal and wide ranging. While balance and strength training exercises are important, aerobic exercise is especially important for Parkinson’s patients.
Research from the Parkinson’s Outcomes Project found that people with the disease who exercise at least 2.5 hours a week experienced a slower decline in quality of life.
Proper nutrition is also essential for maintaining head-to-toe health and for boosting immune, neurological and musculoskeletal function. Studies show that vitamins C and E may be especially important for reducing the damage free radical cells can cause to nerves. We also know that many patients with Parkinson’s have a hard time getting all the nutrients they need. Tremors can make food preparation challenging, and many patients limit their protein intake because certain types can inhibit their ability to absorb dopamine. Consulting with a nutritionist or naturopath once diagnosed is a good idea for Parkinson’s patients.
Editor’s note: If you think you or a loved one may have early-stage Parkinson’s disease, make an appointment with your primary care physician or a neurologist and share your concerns. Then, log on to the National Parkinson Foundation and the Parkinson’s Disease Foundation to learn more.