Dr. James Beck 00:00:00
Two of the hallmark symptoms of Parkinson's disease are tremors and slowed movement. They often appear after a person with PD has already lost up to sixty percent of their dopamine neurons.
Hi, I'm James Beck, Chief Scientific Officer of the Parkinson's Foundation. The first step to living well with Parkinson's disease is to understand the disease and how it progresses. While symptoms and disease progression are unique to each person, knowing the typical stages of Parkinson's can help you cope with changes as they occur. I'm going to discuss what to expect from Parkinson's disease progression, as well as strategies for living well at all stages.
Parkinson's disease is a neurodegenerative disorder that predominantly affects the dopamine-producing neurons in a specific area of the brain called the substantia nigra. Neurons are specialized cells in the brain that are crucial for maintaining a balanced and functioning nervous system. At the heart of Parkinson's disease is a protein called alpha-synuclein that clumps and accumulates in certain areas of the brain. This process kills neurons and depletes a brain chemical called dopamine, which is critical to many body processes, including smooth, coordinated movements that impact how we walk and move. The loss of dopamine-producing neurons causes a variety of symptoms, which generally develop slowly over years.
Two of the hallmark symptoms of Parkinson's disease are tremors and slowed movement. They often appear after a person with PD has already lost up to sixty percent of their dopamine neurons. Dopamine declines for everyone who lives with Parkinson's. Each person's experience is a unique combination of symptoms and disease progression.
Dr. James Beck 00:01:42
Diagnosing and treating Parkinson's disease early can help control symptoms for years. In the early stages of Parkinson's, symptoms are often mild. Tremor and other movement symptoms tend to initially appear on one side of the body only. Non-movement symptoms often present in early stages and can include mental health changes such as anxiety and depression. Exercise and physical therapy can help address movement and non-movement symptoms of Parkinson's disease.
In mid-stage Parkinson's, most people are independent, but daily activities can become more difficult. Movement symptoms progress and may include loss of balance and an increased risk of falls. You may also notice that medications may not be as effective as when you were first diagnosed. This can lead to motor fluctuations, known as on-off fluctuations, which change your ability to move. On-off fluctuations often occur when medications kick in or start to wear off.
Your care team can recommend medication changes to control symptoms, as well as lifestyle adjustments, such as seeing an occupational therapist to help with everyday tasks. In general, when a person with Parkinson's disease is no longer physically independent, the disease is considered advanced. Thinking and memory changes often appear in this stage, including forgetfulness and confusion. A person living with advanced PD will often need significant help with activities of daily living, such as bathing and dressing. Remember that Parkinson's impacts people in different ways during all stages of the disease.
Not everyone will experience all the symptoms of PD, and they won't necessarily experience symptoms in the same order or with the same intensity as others. Work with your care team to determine the best treatment plan for you.
Dr. James Beck 00:03:20
Unfortunately, there are no tools besides assessing symptoms to diagnose or predict the course of the disease. While it's not possible to stop Parkinson's from progressing, there are many ways to live well. Our research shows that engaging in moderate exercise for at least two and a half hours per week can slow the decline in quality of life. Exercise benefits people with Parkinson's at all stages of their disease.
Regular physical activity can address many Parkinson's symptoms by boosting balance, increasing memory, and minimizing depression. In addition, exercise can help lower a person's risk of falling, which becomes more common in people living with advanced Parkinson's. Studies also show that targeted nutrition is linked to slowing Parkinson's disease progression.
Eating a whole-food, plant-based diet, often called a Mediterranean diet, can help you live well with Parkinson's. Incorporate foods like fresh vegetables, fruits and berries, and nuts and fish into your meals to help improve health. There are new medications underway, some funded through our Virtual Biotech Initiative, that are aiming to slow or reverse Parkinson's. Some of these medications have already entered clinical trials. To learn more about Parkinson's disease progression and strategies for slowing the disease, visit Parkinson.org/Stages.
