There are nearly one million people in the U.S. living with Parkinson’s disease, which is more than those diagnosed with multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease (or Amyotrophic Lateral Sclerosis) combined.

What is the difference between Parkinson’s and Alzheimer’s? What are the best ways for doctors to help patients slow down progression of the disease? And how can family members take care of loved ones living with the disease? Dr. Sunny Pak, Associate Medical Director of On Lok, helps answer these questions.

“First, to understand how to treat Parkinson’s, it is important to understand what it is,” says Dr. Pak. “Parkinson’s is a progressive brain dysfunction caused by the degeneration of dopamine-producing neurons in the mid-brain. It usually manifests as impaired motor function, characterized by a resting Tremor, generalized slowness of movement, rigidity, and postural instability.”

Parkinson’s typically affects older adults age 60+. Risk increases with age, with 5% of adults aged 85+ impacted by the disease. “It also tends to present 50% higher in men and in persons with one or more family member with a history of the disease,” adds Dr. Pak.

Early detection can help control symptoms and support a person’s quality of daily living.

“Most Parkinson’s patients have trouble controlling their muscles in general. Other symptoms include the inability to relax their muscles normally, reduced body reflexes, slower activity, and a gradual decrease in speaking volume leading to communication difficulties,” says Dr. Pak. But there are other symptoms family members should be aware of in loved ones. “Stiff facial expressions, such as blinking, swallowing, and getting up from a chair or bed are early signs and changes in physical coordination, such as difficulty playing cards, writing, and simple movements such as brushing your teeth.” If two to three of these symptoms occur, Dr. Pak advises seeing a doctor.

Parkinson’s can affect a patient’s sleep quality and sexual function. Changes in one’s cognitive ability can also increase the risk of other health problems. “Patients with Parkinson’s will often feel fatigued and weak. A decline in health can lead to depression, anxiety, tension, and lack of interest in activities,” explains Dr. Pak.

Also, in Parkinson’s patients, more serious problems may lead to a series of seemingly unrelated issues. “Constipation, sweating, loss of smell, low blood pressure, dizziness, and even fainting spells can occur, which can be life-threatening and requires medical attention,” says Dr. Pak.

Dopamine supplementation therapy is currently the first-line treatment for Parkinson’s. During later stages of the disease, changes in a patient’s walking posture and gait will occur, leading to more frequent falls and injuries. Regular daily exercises are essential to maintaining strength, tone, and flexibility for the torso and extremities. Other common co-treatments to help improve a patient’s quality of life include physical therapy, occupational therapy, speech therapy, and antidepressant therapy.

While the cause of Parkinson’s is unclear, research shows that regular aerobic exercise and maintaining a green and healthy diet can reduce the risk and delay the progression of the disease. However, if a caregiver has concerns about Parkinson’s, Dr. Pak suggests speaking first with a primary care provider. After a detailed assessment, the PCP can make a referral to a neurologist when appropriate.

It is important to remember that as Parkinson’s Disease progress, caring for an affected loved one can become more difficult for the family. Caregivers should not face it alone. Working with a professional care team to develop a comprehensive care plan that includes 24/7 care will benefit the patient and the family.

Source: Sing Tao, April 29, 2022

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