Mate pākenetana Parkinson disease
Parkinson disease is a neurological condition, which means it affects your brain and nervous system. It is progressive, which means it gradually gets worse.
Causes of Parkinson disease
Parkinson disease develops slowly as nerves in a part of your brain (called the substantia nigra) degenerate or die. These nerve cells are responsible for producing a chemical called dopamine. Dopamine acts as a messenger between the parts of the brain and nervous system that help control and coordinate body movements.
We do not know what causes this to happen.
Parkinson disease usually happens to people over the age of 60, though it can start earlier.
Symptoms of Parkinson disease
The 3 main symptoms of Parkinson disease affect your physical movement (motor symptoms).
Tremor
About 70% of people with Parkinson disease have a tremor. The tremor involves shaking, particularly when resting. It often occurs in one hand or arm rather than both (at least to start with).
Stiffness
Rigid muscles can make it harder to do things like turn over in bed, get out of a chair and do up buttons. The stiffness can also affect your posture and facial expressions and lead to aches in your muscles.
Slowness of movement (also known as bradykinesia)
It can be hard to start a movement, or it might take you longer to do a task. This can also affect repetitive movements, like handwriting and getting dressed.
Other symptoms
You may also experience a range of other physical and mental symptoms (non-motor symptoms), such as:
- depression, anxiety or loss of interest in life
- sleep disturbance
- extreme tiredness
- lack of the sense of smell
- constipation
- trouble swallowing or speaking
- skin sensations and pain.
Diagnosing Parkinson disease
There are no specific tests to diagnose Parkinson disease. Your healthcare provider will base their diagnosis on:
- your symptoms
- your medical history
- a detailed physical examination.
It can be hard to diagnose Parkinson disease in the early stages because the symptoms are usually mild. If your healthcare provider thinks you might have Parkinson disease, they will refer you to a specialist. This will usually be a neurologist (a specialist in conditions affecting the brain and nervous system), but you might be referred to a geriatrician (a specialist in conditions affecting older people).
Treating Parkinson disease
There is currently no cure for Parkinson disease, but treatments are available to help reduce your symptoms and maintain your quality of life for as long as possible. These include:
- supportive therapies, such as physiotherapy, occupational therapy or speech-language therapy
- medication
- deep brain stimulation (DBS).
If you have mild symptoms of Parkinson disease, your healthcare provider might not recommend medication. They may suggest you focus on supportive therapy and lifestyle improvements such as physical activity and relaxation. As your symptoms get worse, they will prescribe medication.
There is also more information about Parkinson disease treatment on the Parkinson's New Zealand website.
Parkinson's treatment — Parkinson's New Zealand (external link)
There are several therapies that can make living with Parkinson disease easier and help you deal with your symptoms.
Physiotherapy
Physiotherapists can help relieve muscle stiffness or joint pain. They can help with changes to your mobility or walking (gait), including:
- slower walking pattern
- hesitation
- freezing of gait
- hurried gait.
Physiotherapists might also focus on specific exercises and activities using big movements, to improve your coordination and balance.
Occupational therapy
Occupational therapy can help you work out practical solutions to difficulties in your everyday life These may include using strategies, education or equipment to address your symptoms and maintain your independence.
Speech-language therapy
Speech-language therapy can provide help for swallowing difficulties and problems with speech.
Dietitian therapy
Dietitians can give advice and practical solutions for eating well and managing your weight.
Medicines do not prevent Parkinson disease, but they aim to improve your daily functioning. You will usually start taking medicines when the symptoms disrupt your daily life.
Everybody's experience of Parkinson disease is different. Your healthcare provider will work with you to find the best treatments for your particular symptoms. Depending on your symptoms and responses to medicines, you may need to try a combination of medicines. Your medicines may change over time as your symptoms change.
Your healthcare provider will also prescribe medication and other treatments as necessary. These will help you manage other symptoms, such as depression, pain and gut problems.
DBS is a therapy aimed at treating multiple symptoms in some people with late-stage Parkinson disease. It is only suitable for a small number of people.
Self care with Parkinson disease
Taking good care of yourself is the key to living well with Parkinson disease.
- Prioritise regular exercise and physical activity — find something you enjoy and try to do it every day. This has been shown to improve your overall health and wellbeing. It also may improve your body's reaction to dopamine. Other benefits include improving balance, coordination and mobility, and reducing stiffness.
- Eat well — there is no special diet for Parkinson disease but eating well may help slow its progression, improve overall wellbeing and keep some symptoms under control.
- Stay connected — continuing with regular groups and activities, or connecting with others who also have Parkinson disease, may reduce feelings of isolation, improve your mood, promote relaxation and provide support.
- Get good sleep — having a regular sleep schedule and creating a relaxing bedtime routine can improve sleep quality and reduce tiredness (fatigue).
Parkinson's New Zealand has a specific exercise programme for people living with Parkinson disease.
Parkinson's specific exercise — Parkinson's New Zealand (external link)
There a several apps for Parkinson disease, including exercise programmes.
Support for Parkinson disease
Some people find it helpful to talk to others with Parkinson disease, either at a local support group or online.
Parkinson's New Zealand provides support and information for people with any parkinsonism condition.