April has been designated Parkinson’s disease (PD) awareness month. James Parkinson, who was born in the month of April, was the English physician that first clinically defined this condition in 1817 and called it the “Shaking Palsy.”
Since then, neurologists have classified PD as a movement disorder, characterized by four key movement (motor) symptoms that include the “shaking” (tremor) described by Dr. Parkinson in addition to muscle rigidity and stiffness, slowness of movement (bradykinesia) and impaired balance and coordination (postural instability).
In the 1960s it was discovered that these motor symptoms were caused by the death and malfunction of nerve cells in a section of the brain that produces a chemical called dopamine. This chemical sends messages that control movement and coordination. However, more recently it has been determined that many other parts of the brain and nervous system are affected by this chronic and progressively disabling disorder.
Today, PD is considered much more than just a movement disorder. Non-motor symptoms of this disease may include pain, dementia or confusion, fatigue, sleep disturbances, dizziness, depression, constipation, cognitive changes, fear and anxiety and urinary problems.
Like many other neurological disorders, the precise cause(s) of PD are not known, but both environment and genetic factors are thought to be involved. There currently is no cure for PD, but numerous medications and other treatment options, including surgery, are available to improve symptoms and the quality of life for people with this disease.
In addition, numerous medications and devices are currently in development for PD. While the disease process may begin years earlier, the average age of diagnosis for PD is 60 years, but many individuals are diagnosed in their 50s and 40s, or even younger.
It is estimated that nearly 1.5 million Americans are living with PD and approximately 60,000 Americans are newly diagnosed each year.
In view of the COVID-19 pandemic, it should be noted that people with PD who contract this virus are more likely to experience severe respiratory issues and have more difficulty recovering from this infection, particularly in those with advanced disease.
Rigidity of the muscles of the chest wall plus stooped posture can restrict breathing in people with PD. In addition, difficulty in swallowing and clearing secretions from their airway can contribute to complications during a respiratory illness like COVID-19. This infection can also trigger a worsening of both motor and non-motor PD symptoms and may increase the risk of mental health challenges due to social isolation.
Because of all these issues, it is recommended that PD patients receive COVID-19 vaccination unless there is a specific contraindication. The approved vaccines are not known or expected to interact with the disease process or interfere with PD therapies.
There are several national organizations that can provide you with more information, one of which is the Parkinson’s Foundation. For more information, you can go to their website at www.parkinson.org or call their free “Helpline” at 800-4PD-INFO (Monday-Friday from 9 a.m. to 5 p.m.).
Local retired pharmacist/medical writer Richard P. Hoffmann and his wife Margaret, who has young-onset Parkinson’s disease, are patient research advocates for the Parkinson’s Foundation. In addition, during the past eight years, Dr. Hoffmann has served as a consumer and patient representative for U.S. Food and Drug Administration (FDA) Advisory Committees during the new drug approval process.