Parkinson’s Disease: Finding Your Balance in a Shaky Reality

Parkinson's disease is a long-term degenerative neurological condition that worsens over time. It is caused by the progressive loss of dopamine-producing nerve cells in the substantia nigra, a part of the brain responsible for coordinating movement. This loss impairs the brain's ability to send smooth, controlled signals to the muscles, resulting in symptoms like tremors, rigidity, and slow movements. The disease typically starts after age 60 but can also occur earlier in some cases. The World Neurology Foundation recently reported that the average age of onset for Parkinson's disease (PD) in India is nearly ten years younger compared to other countries. This is alarming, particularly given India's large youth population, as early-onset PD necessitates a specialised approach to various aspects of management.

Early on, Parkinson’s disease can be as subtle as a whisper in a loud room. The signs of Parkinson's disease are often sneaky and can easily be mistaken for just “getting older” or “having a bad day.” 

Here’s what to watch for:

• Tremors

Picture your hand experiencing some involuntary shaking, as if it were having a moment of excitement. This tremor often begins in one hand.

• Bradykinesia

This term describes the slowness of movement. Imagine trying to pick up a spoon, but everything feels like it’s happening in slow motion. It’s as if your body is in a constant state of delay, making even simple tasks more challenging.

• Rigidity

Your muscles might feel like they are on a permanent vacation —  stiff and not cooperating.

• Postural Instability

Balancing can become as tricky as walking on a tightrope. You might notice that you are more prone to losing your balance, even on solid ground.

As Parkinson’s disease progresses, the symptoms can sometimes make everyday life overwhelming.

Dr Anshu Rohatgi, MD, a neurologist in Delhi, advises, “If you experience persistent symptoms like tremors or stiffness, seek a specialist early to manage Parkinson's effectively. Regular physical exercise, including stretching and balance training, alongside occupational therapy, can significantly improve quality of life and mobility.” 

Parkinson's disease is primarily known for its motor symptoms (which refer to the physical movements and coordination issues, such as tremors, rigidity, and slowness of movement). However, it is crucial to recognise that Parkinson's also encompasses a range of non-motor symptoms (which include a variety of psychological and physiological changes that can impact daily functioning, such as sleep disturbances). These non-neurological manifestations often emerge alongside or even prior to the motor symptoms. Understanding both the motor and non-motor aspects of Parkinson's disease is vital for comprehensive care and effective management:

• Shuffling walks

You may notice that your gait becomes more shuffling, with steps that feel less smooth and more cautious. Concentrate on exercises that enhance your stride and boost overall mobility to tackle this issue.

• Masked face

Your face might take on a more serious expression, even if you are not feeling particularly grumpy. Your face may seem in a fixed “thinking hard” guise, even when watching TV.

• Reduced arm swing

Your arms might decide to take a break from swinging while you walk.

• Difficulty with fine motor skills

Tasks like buttoning a shirt or writing neatly might become more challenging. 

• Voice changes

Your voice might become softer or take on a monotone quality, as though someone has turned down the volume on your vocal cords. People might ask you to repeat yourself more often.

• Sleep Problems:

Individuals with Parkinson's disease often face sleep disturbances, such as acting out dreams during deep sleep. This can result in sudden movements or vocalisations, causing distress for both the individual and their partner.

• Cognitive Dysfunction:  

Cognitive dysfunction may present as slowed thinking, making it difficult for individuals to process information quickly. Additionally, issues with executive function can impair decision-making, while memory retrieval problems hinder recalling important information.

• Emotional Disorders:  

Emotional disorders like anxiety and depression frequently affect those with Parkinson's, often emerging without clear cause. Many may also lose interest in activities they once enjoyed, leading to feelings of isolation.

• Hallucinations or Delusions:  

Hallucinations can occur in some individuals, involving the perception of things that aren't there. This may be accompanied by delusions, which complicate the emotional and psychological challenges of living with Parkinson's disease.

Parkinson's disease doesn’t follow a uniform path; it progresses through various stages, each presenting its own unique challenges. Here’s a brief overview:

Stage 1: Symptoms are mild and usually affect just one side of the body. Slight tremors or stiffness may be noticeable, but they are manageable and do not significantly interfere with daily activities.

Stage 2: Symptoms begin to impact both sides of the body. Walking and balancing might become more challenging, and daily tasks may require more effort. 

Stage 3: This is where things get trickier. Balance issues become more pronounced, and falls might become more frequent. Daily tasks may take longer, and some additional support might be needed.

Stage 4: Symptoms are severe, and assistance with daily activities may be required. Walking without help can be quite difficult.

Stage 5: This stage involves advanced symptoms and significant mobility issues. A wheelchair or assistance with most daily activities may be necessary. 

Living with Parkinson’s disease does not have to be all doom and gloom. Here are some tips to help improve overall well-being and quality of life:

• Stay active

Incorporate exercises such as stretching, strength training, and balance exercises like tai chi, which are doctor-approved and supported by research to maintain strength, flexibility, and balance.

• Healthy eating

A diet abundant in fruits, vegetables, whole grains, lean proteins, and healthy fats should be followed. Berries and fish, which contain high quantities of antioxidants and omega-3 fatty acids, are particularly beneficial.

• Support network

Build a robust support system with friends, family, and support groups. Their encouragement and assistance are crucial for navigating challenges and maintaining mental well-being.

• Professional help

Consult with doctors and physical therapists for tailored strategies and treatments. They can provide evidence-based therapies and exercise regimens to minimise symptoms and improve overall well-being effectively.

Parkinson’s disease might bring unexpected challenges, but with the right knowledge and support, you can manage and navigate its twists and turns with confidence. By recognising the early signs, understanding the symptoms, and being aware of the stages, you can keep a step ahead of this unwelcome obstacle. Remember, while Parkinson’s disease might add surprising moves to your routine, you’ve got the rhythm to keep moving forward.

Parkinson's disease develops when nerve cells in the brain that produce dopamine, a neurotransmitter crucial for movement, begin to break down. While the exact cause is unknown, environmental exposures, genetics, and ageing may contribute to its occurrence.

Early signs of Parkinson’s disease often include a noticeable tremor or shaking in one hand, muscle stiffness, or slow movements. People might also experience a change in their walking pattern or have trouble with balance.

Parkinson’s disease itself is not usually fatal, but it can lead to complicated issues that can profoundly impact life expectancy if not managed properly. With proper management and care, many people with Parkinson’s disease live long, fulfilling lives.

At present, there is no cure for Parkinson’s disease, but treatments can effectively manage symptoms and enhance quality of life. 

Parkinson’s disease can impact daily life by causing tremors, stiffness, and difficulty with movement. This can make routine tasks like walking, dressing, and eating challenging. It may also affect balance and coordination, making it more difficult to write or button a shirt. Additionally, emotional disorders, such as anxiety and depression, can further hinder daily functioning by reducing motivation and interest in activities, making it even more difficult to engage in social interactions or maintain routines. Effective management of Parkinson’s disease should address both motor and non-motor symptoms, including mental health.