What Is The Prognosis And Life Expectancy For Parkinsons Disease
The severity of Parkinsons disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinsons disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
What Are The Risk Factors For Parkinsons Disease
Risk factors for Parkinsons disease include:
People with a first-degree relative with Parkinsons are at an increased risk for the disease possibly as much as 9 percent greater.
Fifteen to 25 percent of people with Parkinsons have a known relative with the disease, but a condition called familial Parkinsons, which has a known genetic link, is relatively rare.
The average age of onset is 60 years, and the incidence rises with advancing age. About 10 percent of people have early-onset or young-onset disease, which begins before age 50.
Parkinsons affects about 50 percent more men than women, for unknown reasons.
Exposure to some pesticides has been shown to raise the risk of developing Parkinsons.
Problematic chemicals include organochlorine pesticides like DDT, dieldrin, and chlordane. Rotenone and permethrin have also been implicated.
Fungicide and Herbicide Exposure
Exposure to the fungicide maneb or the herbicides 2,4-dichlorophenoxyacetic acid , paraquat, or Agent Orange may raise the risk of Parkinsons.
The U.S. Veterans Health Administration considers Parkinsons to be a possible service-related illness if the person was exposed to significant amounts of Agent Orange.
Head injuries may contribute to the development of Parkinsons in some people.
Coffee and Smoking
People who drink coffee or smoke tobacco have been found to have a lower risk of Parkinsons disease, for reasons that remain unclear.
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.
Symptoms Of Parkinson’s Disease
You can attribute the symptoms of Parkinson’s to a deficiency of a chemical in your brain called dopamine. The four classic motor symptoms of Parkinson’s include:
Shaking and tremors while you are resting is typically the first sign of Parkinson’s disease, but about one-third of patients won’t experience those symptoms. These symptoms tend to be worsened by emotional and physical stress. Sleep or moving can help reduce these issues.
Parkinson’s disease is both chronic and progressive with symptoms generally getting worse as time goes on. As it progresses, other disabilities can develop, including:
- Difficulty talking and swallowing
- A sudden inability to move,
Some sufferers also have symptoms that don’t affect their motor skills, including:
- Mental health issues such as anxiety, depression and memory loss
- Loss of smell
- Trouble sleeping, including thrashing and other sudden movements
- Change in blood pressure
Young Onset Parkinsons : An Introduction
Although the average age to develop Parkinsons is around 60, young onset Parkinsons occurs in 5-10% of people diagnosed. 20% are under the age of 50. Some challenges in Parkinsons are universal, regardless of age, but there are a number of issues specific to younger people.
Generally, Parkinsons proceeds more slowly in younger people. While no two people are the same, someone whose onset age is 40 can expect to work for another 15-20 years on average. For someone with an onset age of 60, the average figure would be half that. These figures are based on the kinds of treatment available today. Future treatment will be even more effective in prolonging the productive life of people with Parkinsons.
Larry Gifford hosts a panel discussion on Living Well with Young Onset Parkinsons in May of 2020.
The following characteristics tend to be present in young onset Parkinsons:
- Young onset Parkinsons is less likely to lead to dementia and balance problems
- It is more likely to include focal dystonia, which is cramping or abnormal posturing of one part of the body.
- Younger people are more sensitive to the benefits of Parkinson medications, but they tend to experience the dyskinetic side effects of levodopa sooner than older people.
- They also tend to experience dose-related fluctuations at an earlier stage of the disease, including wearing off* and the on-off effect. See Parkinson Canada Information Sheet, Parkinsons Medications: What you need to know!
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Circumstances And Societal Engagement In Yopd And Implications For Management
In general, people with YOPD tend to have different family and societal engagements to those with late-onset PD. For example, most people diagnosed with YOPD will have a job, whereas some people with late-onset PD have already retired. Additionaly, it is not unusual that people with YOPD have young children , or may want to start a family.
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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Some Parkinson’s Treatment Options
Parkinson’s disease has no cure, but there are treatment options to control your symptoms and improve your quality of life which include:
- Medication. Levodopa and other medications, which are trying to boost dopamine . There are number of those medications which can be used alone or in combination. Although many of those medications can help you significantly control your motor symptoms , you might also experience side effects and diminished efficacy over time.
- Physical, occupational, and speech therapy are usually part of your treatment plan and can improve your balance, mobility, ability to do daily tasks, and speech.
- Deep brain stimulation is a surgery performed by a neurosurgeon, and in indicated patients can help with motor symptoms, though non-motor symptoms, such as falls, constipation, low blood pressure and incontinence do not improve.
- Tai Chi is a Chinese martial art that may help sufferers regain some of their balance and strength, as well as decrease the risk of falling. Dance, such as a Zumba, may also help, as can using a stationary bicycle and rock steady boxing.
Many treatment options for Parkinson’s are most effective when used in conjunction with others such as taking medication and doing physical therapy.
Seven Signs Of Early Onset Of Parkinsons
There are a number of symptoms that can warn us about early onset of Parkinsons. There are several characters, but we will focus on these seven:
- Sleep disorders. The most common sleep disorders are insomnia , restless legs syndrome and REM sleep behavior syndrome.
- Depression. It is one of the first symptoms that occurs and it is actually considered as an early indicator of this disease.
- Other mood swings. In addition to depressive symptoms, anxiety and apathy are very common. These symptoms can affect the desire to seek help and a solution in a negative way.
- Cognitive changes. Many people with early-onset Parkinsons usually find it difficult to do more than one thing at a time. Poor performance of tasks, slow thinking, difficulty focusing and concentrating, memory problems and dementia are all symptoms of early onset of Parkinsons.
- Tremors. Although they usually begin in the hands, they start in other patients in the jaw or in the feet. The most characteristic of these tremors is that they occur when resting.
- Bradykinesi. This is a gradual loss of spontaneous movement. In general, movements simply become slower. This is one of the most debilitating and frustrating symptoms for the people affected.
- Exhaustion. With early onset of Parkinsons, the patient feels tired all the time without having exhausted himself.
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Genetics In Yopd And Its Implications For Management
The genetic background of PD is gradually being revealed and consists of the spectrum from common variants that have small contributions to an increased vulnerability, to true monogenic forms . Some of the genes that previously received a PARK locus symbol are in fact unconfirmed, are risk alleles, or if mutated give rise to a more complex phenotype. A new nomenclature of genetic movement disorders, including PD, was recently proposed and has tried to deal with these complexities . Here, we focus on the confirmed genes that can be considered monogenic forms of PD. These mainly include the dominant genes SNCA, LRRK2, GBA, and VPS35, and the recessive genes Parkin, PINK1, DJ1. The common picture from the literature is that PD patients with a mutation in one of these genes present at an earlier age, particularly for the recessive genes and SNCA . So, vice versa, if a PD patient presents at a young age, the option of a genetic etiology is often considered. While next generation sequencing platforms have simplified screening the relevant genes, we have to critically address the question: what is the actual benefit of genetic testing in YOPD?
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Csf And Serum Biomarkers
Table e-2 shows characteristics of CSF and serum biomarkers. Across the whole population, the levels of CSF -syn, total tau , and tau phosphorylated at Thr181 were reduced in the patients compared with HCs, while levels of CSF -amyloid 142 and serum urate were not different between groups . In HCs, all biomarkers increased with the age except for A142 . In patients with PD, only -syn and t-tau increased with the age but not p-tau181 , A142 , or serum urate . In older age subgroups, the reduction of -syn and t-tau were greater compared with younger age subgroups .
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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.
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.
Complications Related To Parkinson’s Can Affect Survival
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.
Parkinson’s is a common neurodegenerative disease, and although it is not fatal, research suggests it may influence life expectancy.
A 2012 study in Archives of Neurology examined the six-year survival of nearly 140,000 Medicare beneficiaries with Parkinson’s disease in the United States. During the six-year period, 64% of the participants with Parkinson’s disease passed away.
The risk of death of those with Parkinson’s was then compared to Medicare beneficiaries who did not have Parkinson’s or any other common diseases, including:
When controlling for variables like age, race, and gender, the six-year risk of death among people with Parkinson’s was found to be nearly four times greater than those Medicare beneficiaries without the disease or other common diseases.
At the same time, the rate of death among those with Parkinson’s disease was similar to those with hip fracture, Alzheimer’s dementia, or a recent heart attackalthough it was higher than those who had been newly diagnosed with either colorectal cancer, stroke, ischemic heart disease, or chronic obstructive pulmonary disease.
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Possible Risk Reduction Factors
While age, genetics, and being a man make it more likely you’ll develop Parkinson’s disease, some factors make it less likely. It is generally believed that Asian-Americans and African-Americans seem to have a lower risk of developing Parkinson’s as compared to Caucasians. Drinking coffee may lower risk, as a 30-year study of Japanese-American men found the greater amount of coffee they drank, the lower their risk of Parkinson’s disease became.
Signs Of Early Onset Of Parkinsons Disease
Early onset of Parkinsons disease begins before the age of 50. It is a neurodegenerative disorder that affects the nervous system. It causes damage and subsequent deterioration of the neurons located in the black matter. The average age for onset of Parkinsons is 60, and the cases increase significantly with age. However, about 5 to 10 percent of people with Parkinsons disease experience early onset of Parkinsons before they turn 50.
Mutations of certain genes, such as the Parkin gene, can contribute to its early onset. People with one or more close family members with Parkinsons are at greater risk of developing the disease.
Overall, the risk of developing the disease is only 2 to 5 percent, unless the disease is part of family history. It is estimated that between 15 and 25 percent of people with Parkinsons know that they have a family member with the disease.
In very rare cases, the symptoms of Parkinsons may occur in people under the age of 20. This is known as youthful Parkinsons. It usually begins with the symptoms of dystonia and bradykinesia. The drug, levodopa, can often improve these symptoms.
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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.
Prevention Of Parkinsons Disease
Researchers dont know of any proven ways to prevent Parkinsons disease, but avoiding certain risk factors and adopting a healthy lifestyle may help reduce your risk.
Some studies have shown a diet high in antioxidants along with regular exercise may play a role in preventing Parkinsons. Other findings have suggested that compounds like caffeine, niacin, and nicotine may have a protective effect against Parkinsons disease.
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Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
How Is Parkinsons Diagnosed
Doctors use your medical history and physical examination to diagnose Parkinson’s disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.
Researchers believe that in most people, Parkinson’s is caused by a combination of environmental and genetic factors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.
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Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinsons disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.
What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.