Living well with Parkinson’s takes a team, and some of the most valuable members may not be who you would typically expect. Healthcare professionals, such as physical and occupational therapists, are essential members of your Parkinson’s care team. They help you maintain mobility, independence and communication, working hand-in-hand with movement disorders specialists and neurologists to create a comprehensive, well-rounded care plan that supports your individual needs and overall well-being. 

To showcase these key members of your Parkinson’s care team, we’re highlighting recent podcast episodes that explore the unique benefits of working with a diverse group of medical specialists.

Who should we talk to next? Let us know

Speech-Language Pathologist

Episode 176: The Challenges of Speech and Swallowing Issues

Parkinson’s affects more than just movement, it can also impact the small muscles in the face, mouth, throat and chest. These changes may impact your ability to eat, speak and swallow, and can influence your confidence in conversations.  A speech-language pathologist will assess speech and swallowing challenges and create a treatment plan to help manage these symptoms.

Melissa Grassia Chisholm, MS, CCC-SLP, a licensed speech pathologist and a voice-swallow airway expert, talks about the importance of getting a baseline evaluation with a speech-language pathologist early on in your PD diagnosis and explains how personalized treatment plans can help address speech and swallowing challenges as your needs evolve.

Physical Therapist

Episode 171: Physical Therapy Recommendations for Exercising Safely

As Parkinson’s progresses, overall movement, balance, and coordination may become more challenging. A physical therapist helps you stay active by developing a custom training plan that meets your goals and physical needs.

Patricia S. Brown, PT, DPT, NCS, of Chapman University in California, a physical therapist who specializes in neurological diseases, shares her recommendations on staying motivated and choosing an exercise program that matches your lifestyle goals.

Pharmacist

Episode 167: Exploring Carbidopa-Levodopa for Treating Parkinson’s Symptoms

Managing Parkinson’s symptoms often involves taking multiple medications, making ongoing conversations with your doctor essential. When questions arise, pharmacists can be readily accessible experts who can help address concerns, identify potential drug interactions, and make you feel more confident about your medications.

Emily Peron, PharmD, MS, and Leslie Cloud, MD, MSc, from Virginia Commonwealth University, a Parkinson’s Foundation Center of Excellence, explain the long-term use considerations of carbidopa-levodopa, the different formulations available, and how to recognize when medication adjustments may be needed.

Episode 181: What to Know Before Taking Nutritional Supplements for Parkinson’s

In addition to prescribed Parkinson’s medications, people with PD may explore complementary or alternative therapies, such as herbs or nutritional supplements. Although often available without a prescription, these supplements can pose risks, especially when taken alongside PD medications. That’s why it’s always advisable to speak with your healthcare provider before starting a new medication or over-the-counter supplement.

Angela Hill, Pharm. D., CRPh, a pharmacist and professor at the University of South Florida, a Parkinson’s Foundation Center of Excellence, talks about the potential side effects and drug interactions that can happen with nutritional supplements, and offers tips for reading and evaluating food labels so you can better understand what you’re taking.

Social Worker

Episode 179: Understanding Depression, Anxiety, and Apathy

Social workers are often the go-to resource for connecting you with specialists and services that can help you navigate the day-to-day realities of Parkinson’s. They offer a wealth of guidance and support to ensure that your voice is heard.

Lauren Zelouf, MSW, LCSW from Penn Medicine’s Parkinson’s Disease & Movement Disorders Center, a Parkinson’s Foundation Center of Excellence, tackles the often-overlooked topic of mental health. She breaks down the differences between depression, anxiety and apathy, and offers coping strategies for managing symptoms and finding support.

Managing Parkinson’s involves a team-based approach. Each healthcare professional brings specialized expertise that can help you move better, speak more confidently, and feel better supported throughout your Parkinson’s journey.

Coming Soon: We’re excited to feature another essential member of the Parkinson’s care team—an occupational therapist—in an upcoming episode.

Subscribe to our podcast. Search for “Substantial Matters: Life and Science of Parkinson’s” on your favorite podcast platform.

Listen to every episode at Parkinson.org/Podcast.

Environmental factors, such as chemical exposure, likely contribute to Parkinson’s disease (PD) risk. Golf courses consume large quantities of these chemicals, including herbicides, pesticides and insecticides. A new study from researchers using the Mayo Clinic–driven Rochester Epidemiology Project shows that living near golf courses could increase the risk of Parkinson’s.

Over the last 20 years, evidence has linked certain chemicals used in agriculture to PD. Farm-workers exposed to the weed-killer paraquat or the insecticide rotenone, for instance, develop Parkinson’s at rates two- to three-times higher than people who have never handled those chemicals. In lab settings, research shows that low doses of these compounds can damage dopamine-producing neurons in the brain — the same cells that are impacted in Parkinson’s.

While golf courses are known to be heavily treated with similar chemicals, no research has directly investigated the potential relationship between PD risk and proximity to golf courses.

This new study on golf courses and chemicals covers 25 years of medical data, from 1991 to 2015, and examines residents of several counties in southeastern Minnesota — a region where there are detailed municipal records, well‐depth charts and groundwater maps. Investigators used this information to study whether people who live close to golf courses face higher Parkinson’s risk. Additionally, they explored whether nearby public water systems explain any extra risk.

Study Results

The research team identified 419 men and women whose Parkinson’s diagnosis occurred during the study window (from 1991 to 2015) and matched them with more than 5,000 people of the same age, sex, race and neighborhood who did not have Parkinson’s.

Researchers then calculated the straight-line distance from each participant’s home to the nearest golf course on the date of PD diagnosis. Those addresses were added on maps of municipal water-service areas, the locations and depths of public wells, and geological charts highlighting regions where groundwater is considered “vulnerable,” meaning the soil or bedrock allows surface chemicals to migrate quickly downward.

Overall, the analysis revealed that people who lived within one mile of a golf course were 126% (or 2.26 times) more likely to receive a Parkinson’s diagnosis than those whose homes were six or more miles away. Being farther from the fairway seemed to help; risk steadily tapered off beyond one mile, with the odds of PD diagnoses decreasing by 9% for each mile of distance from a golf course.

Distance is only part of the story. When researchers looked at households served by a public water system that contained at least one golf course, Parkinson’s risk was 96% higher compared to households whose water systems did not have a golf course within their boundaries, and about 50% higher than people who use private wells. Additionally, when a golf course was in an area with groundwater vulnerable to contamination, the risk of Parkinson’s was 82% higher than in less vulnerable areas with a golf course.

Taken together, the findings suggest that the pesticides and herbicides used to keep putting greens immaculate may be leaching into drinking water, increasing Parkinson’s risk for the surrounding area.

Highlights

• Using medical records from 1991 to 2015, researchers pinpointed 419 Minnesotans with a Parkinson’s diagnosis and compared them to a group of more than 5,000 neighbors who were alike in age, sex, race, and residential area with no history of PD.

• For every person in the study, researchers measured how close they lived to the nearest golf course, then overlaid addresses onto maps showing city water-service districts, well water depths and locations, and areas where groundwater is more easily polluted.

• Those living within one mile from a golf course were 2.26 times more likely to be diagnosed with PD compared to those living 6 or more miles from a course. The odds of PD diagnosis decreased by 9% for each mile of distance from a golf course.

• People living in a public-water district with one or more golf courses had almost double the odds of developing Parkinson’s compared to those without a course, and about 50% higher odds than those using private wells.

• When a course was on land more vulnerable to pesticide contamination into the community water source, the risk of Parkinson’s was 82% higher compared to regions with a golf course located on more protective geology.

What does this mean?

This study suggests a strong association between living within close proximity to a golf course with an increased risk of developing PD. Additionally, it highlights water sources surrounding golf courses as a primary means of exposure to the chemicals routinely used on golf courses.

However, this study does not prove cause and effect, and the investigators emphasize that more work is needed before drawing firm conclusions. The research lacks direct measurements of pesticide levels in the water over time, and it cannot rule out the impact of other environmental factors related to golf courses, such as higher-income neighborhoods or traffic patterns.

Still, the clear patterns drawn from this study — highest PD risk closest to golf courses, next-highest in the water systems that share ground with a course, and more risk in areas where contaminants travel easily — gives researchers more compelling evidence about how environmental risks play a role in Parkinson’s. 

What do these findings mean to the people with PD right now?

The connection between golf courses and increased PD risk may help some people living with Parkinson’s better understand one cause — exposure to environmental contaminants, potentially through drinking water. However, the environmental risk factors for PD that golf courses present are potentially preventable, by individuals and regulators. People can choose not to live near golf courses, knowing that it may put them at an increased risk for developing PD. On the other hand, regulators can also acknowledge the potential risks and improve safety measures surrounding golf courses and water sources.

The prevalence of Parkinson’s is on the rise. These findings — and new, similar studies that will most likely result from this one — highlights the need to push for mitigating risk factors for PD. Studies like this one that tie environmental factors to increased risk are shaping the future of PD research by helping people trace a contributor to their diagnosis — and help identify ways to reduce risk for future generations.

Learn More

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and the topics in this article through our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.

• Environmental factors

• Episode 122: Environmental Factors and Parkinson’s

• Plastic Waste Contaminants Could Promote Parkinson’s