How Parkinson’s Disease Progresses

Dr Jane Gilbert Aug 9, 2017 4 min

Knowing how Parkinson’s progresses can help you to prepare for the future and live a happier, more independent life, for longer.

Coping with Parkinson’s

A diagnosis of Parkinson’s Disease can be overwhelming for the individual and for those who love and care for them. However, by identifying ways to control and cope with symptoms, it is more than possible to live a fulfilling life.

Parkinson’s disease is a condition that affects around one in five hundred people in the United Kingdom. Parts of the brain become progressively damaged, so that the body’s ability to move deteriorates over time. It can be a frustrating and difficult condition to live with, but there are effective treatments that can maintain mobility, improve function and restore quality of life.

How Parkinson’s progresses

Parkinson’s disease gradually affects an area in the brain called the basal ganglia. It contains nerve cells that produce an important chemical messenger called dopamine. Dopamine works to send messages to the parts of the brain that coordinate movement.

In Parkinson’s the dopamine-producing cells gradually die off, so that the body’s ability to move is progressively impaired, leading to symptoms of tremor, stiffness and slowing down.

Initially the symptoms may be mild and barely noticeable; a slight shake, some joint stiffness, smaller handwriting, and other easy to ignore symptoms. However, as increasing numbers of nerve cells die, the symptoms can become more extensive and severe. With time, the individual’s ability to move normally can be significantly impaired, they may also suffer distressing drooling, digestive problems, depression and dementia.

What causes Parkinson’s disease?

The frustrating fact is that despite significant research, medical science still doesn’t fully understand the reasons why people develop Parkinson’s. But there are a number of potential links with the environment, toxins and an underlying genetic tendency.

The gene factor

It is rare for Parkinson’s to be inherited directly from parent to child. However, it’s estimated that there may be a genetic component in around one in twenty cases. Even if a family member does have the disease, the risks of developing the condition are low. As with heart disease and hypertension, genes provide a tendency not an inevitable destiny.

Environmental factors

Studies are currently investigating whether toxins in the environment could be killing the dopamine-producing cells. Bacteria, viruses, chemicals and metals have all been postulated as acting as triggers and there has been speculation about the role of herbicides and pesticides as causes of the disease. Hopefully, more research will help us understand more fully the factors behind this devastating disease.

When does Parkinson’s disease develop?

The risk of Parkinson’s goes up with increasing age, with people first noticing symptoms when they are over 50. However, sometimes younger people can be affected, a famous example being the actor Michael J. Fox, who received his diagnosis at just 29 years of age, having noticed a stiff shoulder and a twitchy little finger. He said:

“It was scary, I was 29 years old and so it was the last thing I expected to hear… The doctor said ‘You have Parkinson’s disease.’ The good news is that you have 10 years of work left.'”

But the doctor was overly pessimistic. Although symptoms do get worse over time, treatment and support can help control the impact of the disease. With effective drug treatment, Michael J. Fox managed to continue to work at the very top level for over twenty years.

Living with Parkinson’s can be a challenge, but Fox is a great example of someone who lived well, worked consistently and continued to enjoy life with Parkinson’s disease.

What can be done?

There is currently no cure for Parkinson’s, but the shaking, slowness and stiffness can often be eased. With treatment, movement can be loosened up, tremor can be tamed and wellbeing can be increased.

Medical treatment

Drugs still offer the most effective way of treating Parkinson’s disease. The medicines all work in different ways to increase the action of dopamine in the brain, either by increasing levels or boosting the effect.

L-dopa

Also known as Madopar or Sinemet, this is a medication that most people with Parkinson’s will take at some stage. The chemical is broken down within the body to become dopamine, which can rapidly soothe symptoms. It can be incredibly effective, especially when first taken. Unfortunately, with time it has less of a therapeutic effect and the side effects of uncontrolled jerky movements can become more of a problem.

Dopamine agonists

These drugs mimic the action of dopamine. They can be used together with L-dopa, to minimise side effects, or they can be taken on their own. They can provide symptomatic relief, but as with all drugs there are potential side effects. Dopamine agonists can cause hallucinations and confusion especially in the elderly.

Monoamine Oxidase-B inhibitors

These include the drug Selegiline which blocks the breakdown of dopamine in the body, giving levels a boost and easing symptoms.

Therapeutic support

There are a whole team of experts that can offer support in managing Parkinson’s. Physiotherapists can help improve mobility, coordination and balance. Speech therapists can assist with problems with swallowing, dribbling and speech and occupational therapists can advise on household aids to make it easier to eat, bathe and get on with jobs around the house. Ask your GP, specialist or contact Parkinson’s UK for information, advice and referral.

For more information about Parkinson’s disease; the history, causes, treatments and more, see Parkinson’s: A Deeper Dive

Help at home

In the later stages, living with Parkinson’s can be a physical and mental challenge. The restrictions on movement can make it difficult to manage alone. Everything takes longer and running a home, together with coping with cooking and self-care can be exhausting. A helping hand can make an enormous difference. A dedicated carer can be employed to come into the home and help out with challenging chores, taking medications, preparing snacks and just having company for a chat over a cup of tea.

The right treatment and support can improve function, wellbeing and quality of life, so that each individual can continue to live well and with dignity, despite Parkinson’s disease.

Find out more about Parkinson’s:

Dr Jane Gilbert

Jane has over 20 years’ experience as a health writer and TV presenter. Jane writes on a wide variety of clinical and care topics – from explaining the latest studies and research to unpacking conditions and discussing treatment options. Jane holds a MBBS degree from Imperial College, London and spent seven years working in the NHS.