Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a slowly progressive disorder that diminishes the ability to move, control muscles, and balance. PD is also known as the most common movement disorder that affects an estimated 2% of the United States population age 65 years and older. The disease has an annual prevalence of 500,000, with 50,000 people newly diagnosed each year. In regards to gender, males are more prone to having the disease than females. In regards to race, Caucasians are the most at risk of developing Parkinson’s disease.
The destruction of cells in certain areas of the brain stem, particularly the crescent-shaped structure called the substantia nigra, is part of the characteristic of Parkinson’s disease. The nerve cells of the substantia nigra release fibers to tissue embedded in both sides of the brain. Essential neurotransmitters are released by these cells, which contribute to movement control and coordination. These neurotransmitters associated with Parkinson’s disease include dopamine, GABA, glutamate, substance P, endorphins, and acetylcholine. Each of these neurotransmitters function specifically to facilitate in movement, pain impulses, mood modulation, memory and learning. When the cells of the substantia nigra die, the fibers are unable to release enough neurotransmitters for the body to function normally.
Age is a huge risk factor for Parkinson’s disease. 75% of cases occur in older adults above 60 years of age. The average age onset of the disease is 55 years. As mentioned above, being a male, as well as being Caucasian, are also risk factors of PD. In women, declining estrogen levels after menopause increase risk of PD. Other risk factors include environmental exposure to herbicides and pesticides, well water, and long-term exposure to metal, as well as experience with head trauma.
Studies have shown that the interaction of hereditary and environmental factors, such as a diet low in vitamin B6 and metabolism, significantly affect both disease risk and response to treatment.
Primary signs of Parkinson’s disease are tremors, rigidity (stiffness), akinesia (the loss or decreased ability to control voluntary movement), and postural instability. Non-movement problems associated with PD include sleep disturbances such as Excessive Daytime Somnolence and Restless Leg Syndrome, fatigue, skin problems such as seborrhea, increased depressive mood, and autonomic dysfunction such as low blood pressure (hypotension), drooling, constipation, incontinence, and sexual dysfunction.
There are various treatment options for Parkinson’s disease. Pharmacologic treatments such as Levodopa, as well as non-pharmacologic treatments such as physical therapy and occupational therapy can be used. Surgical treatment includes deep brain stimulation. Studies have shown that gene therapy yields promising results for PD patients, but is still in need of more research.
There are a substantial number of seniors with Parkinson’s disease residing in nursing home facilities that continuously need well-trained care staff to provide the best quality of care to retain quality of life for these vulnerable patients. Physicians must carefully prescribe the best treatment options for each individual in this patient population. If you or a loved one has suffered due to experiencing inadequate care in a nursing home, contact us today.