Parkinson's Disease symptoms

What Is Parkinson’s Disease?

Parkinson’s disease is a neurological disorder that causes patients to lose control over certain movements. Most patients with the disease show unintended movements such as shaking, poor balance and coordination, stiffness, and related actions. The symptoms of Parkinson’s disease gradually develop and worsen over time based on a patient’s health history and physical condition. [1]

The risk for developing Parkinson’s symptoms occurs in patients over 60 years of age. However, 5-10% of patients may experience the disease’s onset before the age of 50 [2].In most cases, Parkinson’s disease occurs due to inherited genes of a disease carrier. Some cases may be due to gene alteration.

Types of Parkinson’s Disease

Parkinson’s disease has different forms based on how it affects a patient. We have covered the types of Parkinson’s disease below to give you an idea of each.

Idiopathic Parkinson’s Disease

Idiopathic Parkinson’s disease is the most common type of Parkinsonism. This type develops onsets between 55 and 65 [3]. Some rare cases indicate disease development before the age of 50. Idiopathic Parkinson’s disease occurs when the cells in the substantia nigra die and leading to dropped levels of dopamine. The main symptoms of Idiopathic Parkinson’s disease include tremors, trouble balancing, rigid muscles, slowed movements, and walking difficulties.

Juvenile Parkinson’s Disease

Juvenile Parkinson’s disease is a rare type that onsets at younger ages. Typically, patients with this type develop symptoms before the age of 21. Juvenile Parkinson’s mostly occurs due to genetic causes. Patients often have a family history of the disease [4]. While it occurs at younger ages, the disease symptoms are similar to the late-onset form.

Drug-Induced Parkinsonism

Drug-induced Parkinsonism occurs due to drug interference with dopamine. Patients of this type may have drug interactions that affect dopamine transmission in their bodies. According to a research study, drug-induced Parkinsonism is more likely to develop with age, and the average age of disease carriers was 70.9 [5]. Like other types of Parkinson’s disease, drug-induced Parkinsonism has symptoms including tremors, slowed movements, rigid muscles, etc.

Moreover, this type of Parkinson’s occurs due to drugs like antipsychotics, antidepressants, gastrointestinal prokinetics, calcium channel antagonists, and antiepileptic drugs. [6]

How Is Parkinson’s Disease Diagnosed?

Unlike some neurological diseases, there are no specific tests (blood or lab) to diagnose the non-genetic forms of Parkinson’s. Doctors diagnose the disease by thoroughly studying a patient’s medical history, followed by neuro exams. They prescribe patients with certain medicines to check if they notice improvements. While valid, improvements with medication may indicate the presence of the disease. [6]

Parkinson’s Disease Staging

While finding obvious signs of Parkinson’s disease can be challenging, the disease may worsen over time due to advancing stages. We have covered the five stages of the disease below for your understanding.

Stage I

The first stage is the mildest form of Parkinson’s with less obvious symptoms. Patients in the initial stage may develop symptoms but not severe enough to hinder a healthy lifestyle. Many patients go unnoticed due to minimal symptoms. However, family members and friends may notice a few changes upon frequent interactions with the disease carrier. A direct symptom in most stage I patients is tremors and movement difficulties in one side of the body.

Stage II

The second stage of Parkinson’s shows moderate symptoms in patients. This form is much more noticeable than the first stage. Patients at stage II may notice tremors, muscle stiffness, and changing facial expressions. Despite the moderation of symptoms, this stage does not impair neuro balance. Moreover, patients may notice the effects on both body sides.

Stage III

Stage III is often regarded as the middle stage of the disease. Patients at this stage may be at the turning point in disease progression. While many symptoms are similar to those at stage II, patients at stage III are more likely to notice a loss of balance and slowed reflexes. Patients in stage III may fall more often and face difficulty accomplishing daily tasks.

Stage IV

Stage IV Parkinson’s patients may be able to stand alone but need walking assistance. Most patients at this stage cannot live alone due to significant decreases in balance and slowed movements.

Stage V

Stage V is the most advanced form of Parkinson’s. Patients at this stage may require around-the-clock assistance to prevent falls and physical accidents. The symptoms at stage V include frozen legs (when standing), frequent falls, dementia, hallucinations, and delusions. [7]

Is Parkinson’s Disease Hereditary?

Parkinson’s disease is mysterious in terms of disease development. The disease is common among patients over 60 years. According to research, only 10-15% of Parkinson's carriers have a family history of the disease. Generally, the combination of environmental factors and genetic mutations leads to Parkinson’s disease. [8]

Parkinson’s Disease Symptoms

As a neurological disorder, Parkinson’s symptoms can vary from physical challenges to interpretative issues. Most patients with Parkinson’s develop the following symptoms.

  • Tremors
  • Stiff Muscles
  • Slowed Movements
  • Impaired Coordination and Balance

It is worth noting that the disease’s symptoms may have varying forms based on its progression. Patients at early stages may not experience the severity of symptoms. As the disease advances to later stages, patients may develop additional symptoms that may create other health problems.

What Are the Symptoms of Parkinson’s Disease?

The symptoms of Parkinson’s disease may include the following. [9]

Tremors

One of the classic Parkinson’s disease symptoms is tremors. Patients may notice tremors in their arms, jaws, legs, and heads. The severity of tremors may vary on the progression of the disease.

Muscle Stiffness

Parkinson's carriers experience muscle stiffness whether or not engaged in physical activity. Family members or friends of patients may notice contracted muscles of arms, legs, neck, shoulders, and other body parts (based on the disease’s stage).

Slowed Movements

A common symptom of Parkinson’s disease is slowed movement. Patients may experience delayed responses to certain stimuli, delaying their task completion time.

Impaired Balance

Parkinson’s patients have impaired balance and coordination, which exposes them to physically dangerous situations, including sudden (and frequent), falls.

Depression

As the disease advances, Parkinson’s carriers may develop depressive symptoms and other emotional changes [10]. Since Parkinson’s occurs in older people, the chances of depression hitting them as a side-influence increase.

Chewing Difficulty

Some Parkinson’s patients face difficulty when chewing and swallowing food. This symptom occurs due to impaired balance and poor brain and body coordination.

What Are Some Signs of Parkinson’s Disease?

Since Parkinson’s disease mostly occurs as a surprise to most patients, determining the signs of Parkinson’s disease can be challenging for doctors. While true, neurologists conduct a few physical exams to check the disease's signs. [11]

Bradykinesia Examination

Bradykinesia is the slowness of movement in Parkinson’s carriers. Doctors conduct the following exams to rule in or out this Parkinson’s disease sign.

  • Tapping the Finger
  • Opening and Closing the Fist
  • Pronation and Supination of the Hand
  • Tapping the Toe
  • Tapping the Heel

Rigidity Examination

Rigidity refers to the increased resistance to a joint’s passive movement in a Parkinson’s carrier. Doctors conduct the following tests to determine Parkinson’s disease signs.

  • Upper Extremity of Joints
  • Lower Extremity of Joints

Tremor Examination

Tremor examination allows doctors to thoroughly check the progression signs of Parkinson’s disease. Doctors perform the following physical exams for tremor testing.

  • Checking Resting Tremors
  • Checking Kinetic Tremors
  • Checking Postural Tremors

Gait Examination

Gait instability is one of the common symptoms of Parkinson’s diseases signs. Doctors perform the following physical tests on patients to evaluate gait and balance problems.

  • Standing Up (from a chair)
  • Walking Freely
  • Pulling Back (for testing balance)

Symptoms of Parkinson’s Disease in Women Vs. Symptoms of Parkinson’s Disease in Men

Research shows that the chances of developing Parkinson’s symptoms are twice as high in males than in females. However, the disease progresses faster in females than in males. [12]

According to a research study of non-motor Parkinson’s disease symptoms, females were more likely to experience the following symptoms. [13]

  • Fatigue
  • Pain
  • Feelings of Sadness or Nervousness
  • Constipation
  • Restless Legs

On the contrary, males were more likely to develop the following non-motor symptoms of the disease.

  • Sexual Dysfunction
  • Tiredness in Daytime
  • Drooling

Note that here, we are using the terms “women” and “men” to refer to female and male biological sex at birth, respectively.

Risk Factors for Parkinson’s Disease

Although the causes of Parkinson’s disease remain unknown in most cases (doctors rely on obvious signs for diagnosis), many disease researchers identified a few risk factors that may increase the chances of developing the symptoms. We have mentioned these factors below.

  • Specific gene mutations (linked with Parkinson’s disease)
  • Family history
  • Older age (over 60 years)
  • Exposure to pesticides and herbicides
  • Brain injury history

Parkinson’s Disease Prevention

There are no particular prevention methods for Parkinson’s. However, modifying your diet by limiting red meat and dairy can help you lower the risk of developing the disease’s symptoms. Here is the diet you can focus on to prevent Parkinson’s disease. [14]

  • Vegetables
  • Fruits
  • Whole Grains
  • Fruits
  • Olive Oil
  • Nuts
  • Fish
  • Seeds

Parkinson’s Disease Prognosis and Treatment

The prognosis for Parkinson’s disease majorly depends on the stage and type of the disease. Generally, Parkinson’s disease diagnosed at earlier stages have a better outlook. If advanced to later stages, the treatment can be difficult. However, it is important to maintain hope.

Parkinson’s Disease Survival Rate

Generally, Parkinson’s disease does not have fixed survival rate figures. However, studies show that life expectancy for Parkinson’s patients is relatively lesser than for healthy people. Moreover, the most prominent decrease in life expectancy is observed if the patients are diagnosed before 70. [15]

Parkinson’s Disease Treatment Options

Currently, Parkinson’s disease has no cure. However, several medications can help improve the disease’s symptoms. The most common drug is Levodopa (L-DOPA) which facilitates nerve cells to make dopamine. Other drugs that can improve symptoms are mentioned below. [16]

  • Amantadine
  • Dopamine Agonists
  • Monoamine Oxidase Inhibitor B Inhibitors (MAO-B Inhibitors)
  • Catechol-O-methyltransferase Inhibitors (COMT)
  • Anticholinergics

Conclusion

Takeaway

The above comprehensive guide on Parkinson’s disease symptoms can help you understand the different stages of Parkinsonism, its symptoms, risk factors, and treatment options. You can consult a healthcare expert for a thorough examination if you notice any common symptoms.