Parkinson’s Disease: Causes, Symptoms, Stages, Treatment and Prevention

Parkinson’s disease is a neurological disorder that affects the small cells in the brain area called Substantia Nigra. It leads to shaking, stiffness, and difficulty walking, balance, and coordination.

Parkinson’s symptoms usually begin slowly and get worse over time. As the condition progresses, people may have difficulty walking and talking. They may also have mental and behavioural changes, sleep problems, depression, memory difficulties, and fatigue. Both men and women can develop Parkinson’s disease. However, men are affected by the condition around 50% more than women.

One apparent risk factor for Parkinson’s is age. Although most people with Parkinson’s first develop the disease at about age 60, about 5 to 10 per cent of people with Parkinson’s have an early-onset disease, which begins before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some states have been linked to specific gene mutations.

The term “parkinsonism” refers to a group of brain disorders that result in rigidity, delayed movement, and tremors. Numerous factors, such as genetic mutations, reactions to medication, and infections, can cause these disorders.

Symptoms of Parkinson’s Disease

Parkinson’s disease has four primary symptoms:

• Tremor (trembling) in hands, arms, legs, jaw, or head
• Stiffness of the limbs and trunk
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls.

Other symptoms may include

• Depression and other emotional changes;
• Urinary problems or constipation
• Skin problems
• Sleep disruptions.

Symptoms of Parkinson’s and the rate of progression differ among individuals.

Sometimes, people dismiss early symptoms of Parkinson’s as the effects of normal ageing. However, in most cases, there are no medical tests to detect the disease, so it can be challenging to diagnose accurately.

The early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of chairs. In addition, they may notice that they speak too softly or that their handwriting is slow and looks cramped or small.

What is the Cause of the Condition?

Although there are several recognised risk factors for Parkinson’s disease, such as pesticide exposure, the only proven causes of Parkinson’s disease are genetic. When a genetic disorder does not cause Parkinson’s disease, it is classified as “idiopathic”. That means they don’t know exactly why it happened. Many conditions look like Parkinson’s disease, but they are Parkinsonism’s, which refers to conditions similar to Parkinson’s disease. In addition, some psychiatric medications can cause this condition.

Who could be the first person to detect the change in Parkinson’s patients?

Friends or family members might be the first to detect changes in someone with early Parkinson’s. For example, they may see that the person’s face lacks expression or that the person does not usually move an arm or leg.

People with Parkinson’s often develop a parkinsonian gait which is they create a way of walking that tends to lean forward, small quick steps as if hurrying along, and reduced swinging of the arms. However, they also may have trouble with continuous movement.

Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other.

Is this condition common?

Parkinson’s disease is a common condition that affects the brain, ranking second among age-related degenerative brain diseases. It is also the most common brain disease caused by a movement problem. It affects at least 1% of people over 60 worldwide.

Stages of Parkinson’s Disease

Parkinson’s disease progresses in five stages, each with increasing severity of symptoms that affect movement, balance, and daily activities. Below is an overview of these stages:

Stage 1

Individuals usually experience mild symptoms that do not interfere with their daily activities. Tremors and other movement symptoms occur only on one side of the body. They may experience changes in posture, walking, and facial expressions.

Stage 2

Stage 2 of Parkinson’s disease can be characterised by worsening symptoms, including tremors, rigidity, and other movement problems on both sides of the body. The person can still live alone, but they find daily tasks more complex and more prolonged.

Stage 3

This is the third stage of the treatment. Again, individuals experience a loss of balance and slowness of movements. While remaining fully self-sufficient, these symptoms impair activities such as dressing and eating. Falls are more common as people get older.

Stage 4

Stage four is when the symptoms are very severe and limit your ability to function. For example, a walker may be necessary to help an individual move. People in stage four require assistance with daily activities and cannot live independently.

Stage 5

The stiffness in your legs may make it difficult to stand or walk. The person needs a wheelchair or is bedridden. It is necessary to provide around-the-clock nursing care for all activities. In addition, the person may experience hallucinations and delusions, which may disturb their everyday life.

What Tests Will Be Done to Diagnose this Condition?

When healthcare providers suspect Parkinson’s disease or need to rule out other conditions, various imaging and diagnostic tests may be done. Among these elements are the following:

• A blood test
• (CT) computerised scan
• genetic testing
• MRI
• Assay of the emission from the position
• New laboratory tests are possible

The following methods shall be used in these two tests.

• Spinal Tap – One of these tests looks for Alpha-synuclein protein in the cerebrospinal fluid surrounding your brain and spinal cord. This test includes a spinal cord (lumbar puncture) test, where a medical officer inserts a needle into your spinal canal to collect some cerebrospinal fluid for testing.
• A skin biopsy is a procedure used to collect cells from the skin. Another possible test is a biopsy of surface nerve tissue. This could be done to see if there is a problem with the nerve. A biopsy involves taking a small sample of your skin, including the nerves in the skin. The samples come from different parts of your back and one part of your leg. Analysing the samples can help determine if your alpha-synuclein has a malfunction that could make you more likely to develop Parkinson’s disease.

Treatment of Parkinson’s Disease

There is no cure for Parkinson’s disease, but treatments can help manage symptoms and improve quality of life. Treatment varies based on symptom severity and individual response.

Medications

• Levodopa/Carbidopa: Converts into dopamine in the brain and helps control symptoms. Long-term use may lead to motor fluctuations and dyskinesia.
• Dopamine Agonists: Mimic dopamine and stimulate receptors, often used in early stages or alongside levodopa (e.g., pramipexole, ropinirole).
• MAO-B Inhibitors: Slow dopamine breakdown to prolong its effects (e.g., selegiline, rasagiline).
• COMT Inhibitors: Extend levodopa’s effectiveness by preventing its breakdown (e.g., entacapone, tolcapone).
• Anticholinergics: Help control tremors but can cause memory and cognitive issues.
• Amantadine reduces dyskinesia and mild symptoms by promoting dopamine release.

Surgical Treatments

• Deep Brain Stimulation (DBS): Electrodes implanted in the brain deliver electrical impulses to regulate abnormal activity, reducing tremors and motor fluctuations.

Supportive Therapies

• Physical Therapy improves mobility, balance, and strength.
• Occupational Therapy: Helps with daily tasks and assistive device use.
• Speech Therapy addresses speech and swallowing difficulties.
• Hydrotherapy: Water-based exercises enhance movement and reduce stiffness.

Lifestyle and Support

• Exercise: Walking, yoga, and swimming improve mobility and balance.
• Diet: Fiber-rich foods aid digestion, and protein intake should be managed for optimal medication absorption.
• Mental Health Support: Counseling and support groups help individuals and caregivers cope.

While Parkinson’s remains progressive, ongoing research and new treatments offer hope for better symptom management and quality of life.

Prevention

Since the exact cause of Parkinson’s disease remains unknown, there are no definitive ways to prevent it. However, research suggests that certain lifestyle factors may be associated with a lower risk.

• Regular Exercise: Engaging in aerobic activities may contribute to brain health and reduce the likelihood of developing Parkinson’s.
• Caffeine Intake: Some studies indicate a potential link between caffeine consumption—such as coffee and green tea—and a reduced risk of the disease.
• Medications: Certain drugs, including anti-inflammatory medications and cholesterol-lowering statins, have been explored for their possible protective effects.

While these factors may play a role, Parkinson’s disease can still develop unpredictably, and no guaranteed prevention strategies exist. Ongoing research continues to explore ways to mitigate risk and better understand the condition.

Conclusion

Parkinson’s disease remains a progressive condition with no known cure, but medical advancements and therapeutic approaches have significantly improved symptom management. Research continues to uncover new insights into its causes, potential treatments, and preventive measures. While the disease presents challenges, early intervention, innovative therapies, and strong support systems empower individuals to maintain their quality of life. The ongoing pursuit of better treatments and a deeper understanding of Parkinson’s offers hope for a future with more effective solutions and, ultimately, a potential cure.