Parkinson's Disease in the Elderly
Parkinson’s disease (PD) is a progressive neurological disorder. This means symptoms continue and worsen over time. There are no cures--only treatment options to manage the symptoms.
PD occurs when cells in the brain’s substantia nigra begin to die. The cells in the substantia nigra produce a chemical called dopamine. Dopamine sends signals to the brain that control movement and coordination.
With Parkinson's disease, the cells that produce dopamine begin to die, thus decreasing dopamine in the body. The messages to the brain controlling movement are slowed. This leaves a person incapable of controlling movement.
PD is high on the senior living communities’ radar because of the toll it takes in the elderly community.
Who Has Parkinson’s?
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- One million Americans
- About 60,000 people are diagnosed with PD each year. And thousands of cases that go undetected each year.
- About 10 million worldwide live with Parkinson’s Disease.
- Men are 1 ½ times more likely to have Parkinson's than women.
- Parkinson's disease in the elderly: the mean age of PD onset is 60-years-old,
- Approximately 1% of the population over age 60 has PD. About 10% of all patients develop symptoms before age 50.
What are the Primary Symptoms of Parkinson's?
- Tremor usually of the hands and progressing to the arms
- Rigidity or stiffness in the arms, legs, or neck; muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak
- Bradykinesia or slowness of movement; could include delays in starting to move, frequent stoppages, fatigue and inability to perform two movements at once.
- Akinesia or lack of spontaneous movement
- Postural instability or loss of balance and walking problems; can cause patients to develop a forward or backward lean.
In addition to the above main symptoms, many PD sufferers have the following symptoms:
- Anxiety occurs in about 70% of those with Parkinson’s develop anxiety.
- Depression occurs in 40-70% of those with PD. About 90% of patients with pre-existing anxiety develop depression.
- Dementia occurs as a later issue in 20-40% of Parkinson’s patients. This starts slowly but progresses.
- Sleep disturbances such as insomnia, daytime somnolence, disturbances in REM sleep and disturbingly vivid dreams.
- Slowed reaction time
- Memory loss and slow thinking
- Impairment of sexual arousal, orgasm, and sex drive
- Difficulty swallowing; drooling; dizziness on standing; impotence, urinary frequency and constipation
- Apathy or absence of feeling or desire
Because there is no Parkinson’s disease cure, the treatment options are used only to alleviate some of the symptoms.
One of the most profound symptoms of PD is tremors. This is caused by a reduction of the movement-controlling chemical, dopamine. To counteract this, patients can take dopamine agonists. These drugs mimic the effects of dopamine in the brain.
Common dopamine agonists are Pramipexole, Ropinirole, Rotigotine, and Apomorphine.
Possible side effects include:
- Daytime sleepiness
- Visual hallucinations
- Swelling of the ankles
- Compulsive behaviors such as eating, shopping, gambling and sexual urges.
Other treatment drugs options include Levodopa, Amantadine, Anticholinergic drugs, COMT-inhibitors, and MAO-B inhibitors.
Some surgical treatment options include deep brain stimulation (DBS). In DBS, surgeons implant a battery-operated device called a neurostimulator. This device delivers an electrical charge to areas in the brain that control movement. They block the abnormal nerve signals that cause tremors.
Exercise is another way to address the symptoms of PD. Activities like bicycling, yoga and tai chi can improve your motor coordination, balance, and flexibility. Experts recommend regular exercise with intense efforts worked in a few times a week.
The effect of Parkinson’s disease on senior living communities is acute. But as our understanding of the disease continues to grow, so will the effectiveness of the treatment options.
For tips on how to live healthy and reduce your risk of Parkinson's Disease, check out "Aging Well".
Updated: Apr 04, 2011
|Tina Doggett On Feb 26, 2014
Hsve to do an assignment on my care of a patient with Parkinsons, I am a healthcare Assistant any help would be appreciated. Thank u. This article above was an excellent introduction. Thank you.