Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 30 April 2019 Next review due: 30 April 2022
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Who Gets Parkinsons Disease
Parkinsonâs disease, documented in 1817 by physician James Parkinson, is the second most common neurodegenerative disease after Alzheimerâs disease. Estimates regarding the number of people in the United States with Parkinsonâs range from 500,000 to 1,500,000, with 50,000 to 60,000 new cases reported annually. No objective test for Parkinsonâs disease exists, so the misdiagnosis rate can be high, especially when a professional who doesnât regularly work with the disease makes the diagnosis.
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Autosomal Dominant Genetic Features
People have two copies of each gene. In autosomal dominant inheritance, a child can inherit either a healthy gene or one that is not working correctly. They will have a 50% chance of inheriting a faulty gene.
Autosomal dominant genes that have associated with Parkinsons disease include:
- SNCA, or PARK1
- DJ-1
- PRKN
It is important to note that inheriting any of the genes that scientists have identified as being related to Parkinsons disease does not necessarily mean that a person will develop the condition.
Is Parkinsons Disease Fatal
It is important to understand that PD is not considered a fatal condition. As is the case with Alzheimers disease and other forms of dementia, complications and a patients comorbid conditions are more life-threatening than PD itself. For example, because Parkinsons affects movement, balance and coordination, a patients risk of falling increases as the disease progresses. Falls are notoriously dangerous and a leading cause of injury and death among older adults. Difficulty swallowing, known as dysphagia, is another complication that can develop at any point throughout ones journey with PD, and this can cause aspiration pneumoniaanother leading cause of death in patients.
Read:Dysphagia: How to Help a Loved One Eat and Drink Safely
Because a persons overall health is an important factor in how Parkinsons progresses, lifestyle choices are vitally important for prolonging both functionality and longevity. Regular exercise, a healthy diet, careful management of preexisting conditions and prevention of new medical issues is crucial.
It is important to work with a well-rounded medical team to understand PD symptoms, explore treatment options and devise a personalized care plan for improving ones overall health, maintaining a high quality of life, and preventing complications.
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Memory Or Thinking Problems
Having issues with thinking and processing things could mean your disease is progressing. Parkinsons is more than a movement disorder. The disease has a cognitive part as well, which means it can cause changes in the way your brain works.
During the final stage of the disease, some people may develop dementia or have hallucinations. However, hallucinations can also be a side effect of certain medications.
If you or your loved ones notice that youre getting unusually forgetful or easily confused, it might be a sign of advanced-stage Parkinsons.
How Often Does Parkinsons Run In The Family
Most Parkinsons cases have no connection to a genetic cause, but scientists have found that some gene mutations can heighten an individuals risk. Researchers believe that a better understanding of these genes may improve ways of identifying and treating the illness.
The National Institute of Neurological Disorders and Stroke reports that an estimated 15 to 25 percent of people with Parkinsons have a family history of the disorder. The Michael J. Fox Foundation for Parkinsons Research estimates that about 10 percent of cases are linked with a genetic cause.
Parkinsons doesnt stand out as a hereditary disease over and above any other chronic diseases that people deal with, says Rebecca Gilbert, MD, PhD, chief scientific officer for the American Parkinson Disease Association in New York City. But if you have a parent with Parkinsons disease, you have about a fourfold greater risk over the general population.
Still, that risk is relatively small. About 1 percent of the population over 60 has Parkinsons, according to the Michael J. Fox Foundation, and that number rises to about 4 percent for those who have a mother or father with the illness, according to Dr. Gilbert. The overall message is: Just because you have a gene linked to Parkinsons does not mean you will get the disease.
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Social Security Disability Insurance
SSDI, often referred to as simply Disability, is assistance intended for those individuals who are of working age and cannot work as a direct result of their medical condition. The SSA does not provide care assistance but instead provides financial assistance that can be used for care. To be eligible one must both have a written diagnosis of Parkinsons Disease and have earned monthly income of less than approximately $1,000.
No Time For Parkinsons Disease
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I am 62 and feel 42 on my good days. Thats my brain speaking. Not my body. Not now. I was diagnosed with Parkinsons disease about 4 months ago. I knew I had PD long before it was diagnosed. However, I had work to do and simply could not have Parkinsons disease until I was ready. On my terms. Let me explain..
I was raised poor but had a mother who had more courage and stamina than anyone I have ever met. She taught me that honesty, compassion, and old fashioned hard work would take me far in this world. She encouraged me to always be the best I could be and to always conduct myself as I wanted to be seen because someone would always be watching me. She was right. I didnt always have my mother beside me but I had her in my heart.
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Cutting Back My Schedule
One day I got up, got ready, began walking to my car and fell. I could not blame it on tripping. Shortly thereafter, I fell one evening after work breaking 2 toes. One toe was shattered into 7 pieces requiring surgery. But the fatigue? It was bad. I started having to really push myself to get out of bed when I was used to jumping up, drinking coffee, and hitting the shower. Not now. I got up at 5 to get to the office by 8:30.
My staff started noticing the slowness of movement and thought I was exhausted. I didnt have a tremor except when my blood sugar was low. Parkinsons disease didnt even cross my mind.
Then one Saturday I had just moved into my new home and I was moving boxes. What is that jerky feeling I am having in my arms as I lifted the box? I sat the box down and stood next to the kitchen counter and did the ratcheting test for PD. Sure enough. It was there. But I decided to ignore it.
I kept working, but I had to cut my schedule back. I had over 10,000 patients. Thats right. 10,000 patients for one health care provider. I had a busy practice.
One day, I simply could not go in to work. I could barely move to walk to the bathroom and to the kitchen. I was single and incredibly independent. So I made an appointment with a neurologist in Nashville, Tn which was an hour away. Certainly not in my home town where people would know I was having issues.
What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
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What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
How Is Parkinsons Treated
Doctors, nurses, physical and occupational therapists, social workers, speech therapists, and other professionals work with people with Parkinsons to help them enjoy happy, active lives.
There are many kinds of medications that can help people with Parkinsons. These medications make it easier to walk, stand up and sit down and do other things that are part of a normal day. Sometimes the medications that help with Parkinsons can make people dizzy, tired or have an upset stomach. But most of these problems can be improved by finding the right combination of medications.
In addition to medications, we are learning more through research and the experiences of other people with PD about how exercise can help people manage their symptoms and might even slow the progression of the disease! Your parent will want to talk to their doctor before starting anything new, but you can feel good about continuing to engage in active sports/activities with your parent.
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Research Into Genes And Parkinsons
Our major effort now is understanding how mutations in these genes cause Parkinsons disease, says Dawson. SNCA, the gene responsible for making the protein that clumps in the brain and triggers symptoms, is particularly interesting.
Our research is trying to understand how alpha-synuclein works, how it travels through the brain, says Dawson. The latest theory is that it transfers from cell to cell, and our work supports that idea. Weve identified a protein that lets clumps of alpha-synuclein into cells, and we hope a therapy can be developed that interferes with that process.
Targeting Parkinsons-Linked Protein Could Neutralize 2 of the Diseases Causes
Researchers report they have discovered how two problem proteins known to cause Parkinsons disease are chemically linked, suggesting that someday, both could be neutralized by a single drug designed to target the link.
I Spent Three Weeks Alone With My 89
When youre taking care of an aging parent, particularly one who suffers from multiple health challenges, it can be incredibly difficult. But this summer, I learned to savor every moment.
Emilie Brzezinski, my 89-year-old mom, lovingly known as Bamba, has had a tumultuous past few years. Her extraordinary husband my dad passed away four years ago. She survived two heart attacks. And she was diagnosed with both dementia and Parkinsons. During the pandemic, we moved her from her Virginia farm house and art studio she spent half a century raising our family in, to my home in Florida so I could take care of her.
Bamba has mostly adjusted to life in Florida. But it’s a life that’s physically and emotionally detached from the life she knew. And as much as we all try, it can be disorienting for her at times.
So when my husband Joe suggested Bamba and I travel together to Northeast Harbor, Maine, where our family has spent 54 consecutive summers together, I leaped at the chance. Just the two of us mom and daughter for three weeks without him, our kids, their friends or our friends. Its too disorienting for her if theres too many people, Joe told me. Let Bamba be in her house and in her element with just you.
I did host Morning Joe, but I didnt take a primary role. And anything work-related, I did very lightly.
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Key Gene Mutations Associated With Parkinson’s
There are forms of Parkinson’s that appear to be influenced by genetic defects that run in families. We tend to see this with early-onset forms of the disease wherein symptoms being to appear far earlier than average onset age of 60.
One type of genetic mutation associated with familial parkinsonism is in the so-called SNCA gene. This is the gene linked with the production of alpha-synuclein protein, a biomolecule which can contribute to abnormalities in nerve cells. While rare in the general population, the SNCA gene mutation has been identified in around two percent of families affected by Parkinson’s.
In 2004, scientists discovered a similar genetic mutation in a number of families in whom multiple members had been affected. The so-called LRRK2 mutation is today linked to about one to two percent of all Parkinson cases, mostly affecting people of Jewish, Ashkenazi, North African Arab-Berber, or Basque origin.
Another mutation involving the GBA gene is already known to cause Gaucher’s disease . Research has since shown that the GBA mutation is present in a significant number of people with Parkinson’s, suggesting a causal link between the mutation and the disease.
Increased Feelings Of Anxiety Or Depression
Anxiety and depression have been linked to Parkinsons. In addition to movement problems, the disease can also have an impact on your mental health. Its possible that changes in your emotional well-being can be a sign of changing physical health as well.
If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.
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Who Should Get Genetic Testing
Two groups might consider getting genetic testing, according to Gilbert:
- People with Parkinsons who want to know if they have a mutation they may pass along to their children
- Children and siblings of family members with Parkinsons who want to determine their genetic risk for the disease
Right now its not standard of care for everyone with Parkinsons to get genetic testing, she says. The likelihood that were going to find one of these mutations that is known already is small, and even if you have a mutation associated with Parkinsons, it doesnt mean that youre going to get the disease.
So, at this point, the value of getting tested depends on the individual. Doctors can provide this type of genetic evaluation, or people may turn to direct-to-consumer genetic testing, such as 23andMe. These tests, however, can be limited.
You have to be careful with those panels because theyre not very comprehensive, says Gilbert. They may test for only one or two gene variations.
Currently, 23andMe analyzes DNA from spit samples for a variant in LRRK2 and a variant in the GBA gene associated with the disorder. The company makes it clear that the exam does not diagnose the disease, and there are many other mutations to consider.
Parkinsons patient Paul Cannon, PhD, who works for 23andMe as its Parkinsons research community manager, took the test and found that he had neither of the genetic variations.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
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