April is Parkinson's Awareness Month: How Informed Are You?

Caregiver, patient expert

There are many neurological diseases that can affect people as they age. Alzheimer's, of course, is one of the most feared because it is so well known. However, while not as common, Parkinson's disease is also prevalent. This neurological disorder affects an estimated 2 percent of people older than 65. Like Alzheimer's disease, Parkinson's is progressive and it involves changes in the brain that can become debilitating.

The National Parkinson Foundation estimates that one million Americans have the disease. Of those who develop Parkinson's disease, 50 to 80 percent will eventually experience Parkinson's disease dementia.

How is Parkinson's disease diagnosed?

The National Parkinson's Foundation states that the diagnosis of Parkinson's disease (PD) depends upon the presence of one or more of the four most common motor symptoms of the disease:

Resting Tremor: In the early stages of the disease, about 70 percent of people experience a slight tremor in the hand or foot on one side of the body, or less commonly in the jaw or face.

Bradykinesia: Bradykinesia means slow movement. A defining feature of Parkinson's, bradykinesia also describes an overall   reduction of spontaneous movement, which can give the appearance of abnormal stillness. There is also a decrease in facial expressivity.

Rigidity: Rigidity causes stiffness and inflexibility of the limbs, neck and trunk. Normally, muscles stretch when they move, and then relax   at rest. In Parkinson's rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes contributing to a decreased range of motion.

Postural Instability: One of the most important signs of Parkinson's is postural instability, a tendency to be unstable when standing upright. A person with posturalinstability has lost some of the reflexes needed for maintaining an upright posture and may topple backwards if nudged or bumped even slightly.

How does Parkinson's affect the brain?

According to the national Alzheimer's Association, the brain changes caused by Parkinson's disease begin in a region that plays a key role in movement. As the brain changes gradually spread, they often begin to affect mental functions as well as physical functions. These changes can include memory and the ability to pay attention, the ability to make sound judgments and the ability to plan the steps needed to complete a task.

The key brain changes linked to Parkinson's disease as well as Parkinson's disease dementia are abnormal microscopic deposits composed chiefly of alpha-synuclein, a protein that's found widely in the brain though the normal function isn't yet known. These deposits are called Lewy bodies.

Lewy bodies are also found in several other brain disorders, including dementia with Lewy bodies (DLB). Evidence suggests that dementia with Lewy bodies, Parkinson's disease and Parkinson's disease dementia may be linked to the same underlying abnormalities in brain processing of alpha-synuclein.

Diagnosis is tricky - see a specialist

Proper diagnosing of neurological diseases is vital for treatment. Many people who have dementia with Lewy bodies or Parkinson's disease dementia also have the plaques and tangles consistent with Alzheimer's disease. Because of this, diagnosis can be difficult. People should see a neurologist to make sure that the most helpful treatment is being prescribed. Perhaps even more important than the positive effects of the right treatment is the fact that the wrong treatment could be detrimental. An experienced specialist - in this case a neurologist - is the person to see.

Interested in a Parkinson's disease trial?

Deep brain stimulation (DBS) has been used in trials for Alzheimer's disease as well as Parkinson's. A trial using DBS for Parkinson's is now recruiting. For more information about the trial go to Taking Aim At Parkinsons.

Carol is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. She runs award winning websites at _ www.mindingourelders.com  and_ www.mindingoureldersblogs.com. On Twitter, f_ollow Carol @mindingourelder and on Facebook:_ Minding Our Elders

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