Black Americans And Parkinsons Disease
Most research suggests that Parkinsons disease is more likely to affect whites and Hispanics.
But, some studies have shown that Black patients may be less likely to receive proper care for the disease.
A review published in 2018 in Neurology found there are racial disparities when it comes to managing Parkinsons disease.
Researchers identified one study that showed Black patients were 4 times less likely than whites to be started on treatment for Parkinsons.
Another study found an average seven-year delay in diagnosis among Black patients.
Does Parkinson’s Disease Cause Dementia
The cells in the brain affected in PD are not in the ‘thinking’ parts of the brain and dementia is not a typical early feature of PD. However, if you have PD you have an increased risk of developing dementia. About half of people with PD develop dementia at some stage. If dementia occurs, it tends to develop in older people with PD . Early dementia in younger people with PD virtually never develops. It is thought that PD alone does not cause dementia however, other age-related factors in addition to PD may increase the risk of dementia developing.
Testing For Parkinsons Disease
There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.
A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.
The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.
The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
How Does Alcohol Affect Parkinsons Symptoms
In general, alcohol can be harmful to people with chronic conditions. According to the Centers for Disease Control and Prevention , overconsuming alcohol can be a long-term risk factor for a weakened immune system, learning and memory problems, high blood pressure, digestive issues, and various types of cancer. When looking specifically at Parkinsons symptoms, however, reports differ on how alcohol and PD may be linked.
The type of alcoholic beverage consumed may affect whether drinking has an impact on PD. A 2013 study found that the risk for developing Parkinson’s disease appeared to increase depending on the amount of liquor consumed, although no link was conclusively found between drinking wine and the development of PD.
In terms of how long-term alcohol use affects the risk of PD, one study published in 2013 followed people who had been admitted to the hospital with alcohol use disorders for up to 37 years. The study authors found that a history of alcohol abuse increased the risk of admission into the hospital for Parkinsons for both men and women. The study authors suggested that chronically drinking too much alcohol can have neurotoxic effects on dopamine, the neurotransmitter in the brain that is relevant to Parkinson’s disease.
There may also be factors other than observable symptoms such as how alcohol interacts with your medication that are important to consider when making decisions about your lifestyle and drinking habits.
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How Is Parkinson Disease Diagnosed
Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinson’s disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.
Bump Up Your Fiber Intake
A high-fiber diet is a proven way to avoid constipation, a common problem for people with PD.
Parkinsons can slow down the intestines and cause constipation, Dr. Gostkowski says. Fiber helps keep things moving. There are plenty of high-fiber foods out there, so choose your favorites. Women should aim for 25 grams of fiber per day, and men should get 38 grams.
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Support For People With Parkinsons Disease
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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Symptoms Of Parkinsons Disease
Parkinson’s disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
Dementia With Lewy Bodies
|Other names||Diffuse Lewy body disease, dementia due to Lewy body disease|
|of a in a neuron of the scale bar=20 microns|
|After the age of 50, median 76|
|Average survival 8 years from diagnosis|
|Frequency||About 0.4% of persons older than 65|
Dementia with Lewy bodies is a type of characterized by changes in sleep, , , movement, and . Memory loss is not always an early symptom. The disease and is usually diagnosed when cognitive decline interferes with . Together with , DLB is one of the two . It is a common form of dementia, but the is not known accurately and many diagnoses are missed. The disease was first described by in 1976.
in which people lose the that normally occurs during and act out their dreamsis a core feature. RBD may appear years or decades before other symptoms. Other core features are , marked fluctuations in or alertness, and . A presumptive diagnosis can be made if several disease features are present, such as symptoms or certain results of , , , and . A definitive diagnosis usually requires an .
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Patients With A Previous Diagnosis Of Parkinson’s Disease
The diagnosis of probable Parkinson’s disease was confirmed in 109 of the 131 patients with this diagnosis , including three in whom atypical features were found but were insufficient to invalidate the diagnosis of Parkinson’s disease . Two additional patients were found to have possible Parkinson’s disease. However, in 20 of the 131 patients the diagnosis of Parkinson’s disease was unequivocally rejected . The alternative diagnoses were non-parkinsonian tremor in four patients , vascular parkinsonism in six , progressive supranuclear palsy in four , and multiple system atrophy in three . Two patients received a diagnosis of idiopathic torsion dystonia, and one of dementia without parkinsonism. When only those patients who had seen a specialist at some point in the past were considered, the diagnosis was changed from Parkinson’s disease to a different diagnosis in 11%.
Patients with an initial diagnosis of Parkinson’s disease
What Is Parkinson’s Disease
Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.
What Is Parkinson’s Disease?
Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
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What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
What Causes Parkinson’s Disease
Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.
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Some Other General Points
Stay as active as possible. Exercise regularly as much as you are able. This may not be possible when the condition is more advanced. However, it is something to consider when symptoms are not too bad. You may walk more slowly than before but a daily walk is good exercise and may help to loosen up stiff muscles. Well-meaning relatives or friends may tell you to rest and take things easy. However, as much as possible and for as long as possible, resist the temptation for others to do things for you just because it may be quicker.
Constipation is common in people with PD. Help to reduce the chance of this by having lots to drink and eat plenty of vegetables, fruit, and foods high in fibre. Exercise can also improve constipation. Sometimes laxatives may be needed to treat constipation.
Some medicines taken for other conditions can interfere with dopamine and make PD worse. These may be prescribed for such things as mental illness, sickness, vertigo and dizziness. Check with your doctor if you are unsure about any medicines that you take.
Driving. If you are a driver you should tell the DVLA and your insurance company if you develop PD. Your insurance may be invalid if you do not. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.
History Of Parkinsons Disease
Symptoms and possible treatments for Parkinsons were discussed in texts related to Ayurveda, an ancient Indian medical practice thats been around since as early as 5,000 B.C. A Parkinsons-like condition was also mentioned in the first Chinese medical text, Huang Di Nei Jing Su Wen, more than 2,500 years ago.
Parkinsons disease was formally recognized in an 1817 paper, An Essay on the Shaking Palsy, by James Parkinson, MD, a London doctor and member of the Royal College of Surgeons.
Dr. Parkinson observed what are now known as the classic symptoms of Parkinsons disease, including tremors, rigidity, and postural instability. He theorized that the disease developed because of a problem in the brains medulla region.
Parkinsons essay received little attention until 1861, when French neurologist Jean-Martin Charcot and his colleagues distinguished the disease from other neurological conditions and termed it Parkinsons disease.
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Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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Who Is Affected By Parkinsons Disease
Parkinsons disease affects both men and women. Statistically, however, men have a slightly higher chance of developing the disease. The risk of developing Parkinsons disease also increases with age, with the average age of onset being 65 years old. Five to ten per cent of people develop the condition before the age of 40 years old. When symptoms appear in people aged 21-40, this is known as young-onset Parkinsons disease. Juvenile Parkinsons disease is the term used when symptoms appear before the age of 18 years old, although this is extremely rare.
To-date, no one knows exactly why people get Parkinsons disease, but viral infection or environmental toxins may play a role. People with a parent, sibling or child with Parkinsons disease, are twice as likely to get it as people in the general population.
Definition Of Terms Used In The Analysis
Sensitivity: Proportion of patients with a final diagnosis of Parkinson’s disease who were previously diagnosed as having Parkinson’s disease: A/.
Specificity: Proportion of patients without a final diagnosis of Parkinson’s disease who were previously diagnosed as not having Parkinson’s disease: D/.
Positive predictive value: Proportion of patients with a previous diagnosis of Parkinson’s disease who received a final diagnosis of Parkinson’s disease: A/.
Negative predictive value: Proportion of patients with a previous diagnosis of not having Parkinson’s disease who received a final diagnosis of not having Parkinson’s disease: D/.
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Progress Toward Fda Approval
It will be a while yet, however, before Hoque and his researchers can start seeking permission to analyze peoples selfies, or even before neurologists can deploy the five-pronged test that the researchers have developed.
An algorithm will never be 100 percent accurate, Hoque says. What if it makes a mistake? We want to be very careful and follow guidance from the FDA if we want anybody from any part of the world to try this and get an assessment.
Moreover, there is a whole family of movement disorders that are closely related to Parkinsons disease, including ataxia, Huntingtons disease, progressive supranuclear palsy, and multiple dystrophy.
They all share similar symptoms of tremor, but the tremors are very different in nature, Hoque says. However, even expert neurologists find it very, very difficult to distinguish among them.
The researchers have made great progress in detecting Parkinsons disease by automatically analyzing expressions, voice and motor movements. Yet further work is needed to develop algorithms to differentiate how these involuntary tremors differ across other movement disorders, including Ataxia and Huntingtons.
We cant tell that just yet, Hoque says. But we are in a pursuit of differentiating those tremors using AI to prevent the potential harm of misdiagnosis while maximizing benefit.