In the UK, an estimated 166,000 people live with the degenerative neurological condition Parkinson\u2019s \u2013 and someone is diagnosed every 20 minutes. By 2050, the number of people with Parkinson\u2019s worldwide is predicted to double to 25 million, due to ageing populations and the increasing life expectancy of people diagnosed with early-onset Parkinson\u2019s.<\/p>\n
\u201cIt is now regarded as one of the commonest degenerative neurological conditions<\/a> in the world, not just in older adults, but also in younger people,\u201d says Professor K Ray Chaudhuri, a consultant neurologist<\/a> and medical director at private neurology clinic Dementech Neurosciences Clinical Academic Centre and research director at King\u2019s College Hospital. \u201cI see people in their fifties, forties, and even thirties with a diagnosis of Parkinson\u2019s.\u201d<\/p>\n New FeatureIn ShortQuick Stories. Same trusted journalism.<\/p>\n According to Parkinson\u2019s UK<\/a>, around 59 per cent of people living with the condition in the UK today are men. The charity\u2019s data suggests that, on average, people living with Parkinson\u2019s were diagnosed at age 69, and the average age of a person living with Parkinson\u2019s in the UK is 77 years. One in 16 people with Parkinson\u2019s was under 50 when they received a diagnosis.<\/p>\n What are the main symptoms of Parkinson\u2019s?<\/p>\n Symptoms of Parkinson\u2019s are largely related to the loss of the chemical dopamine in the brain due to a decline of the nerve cells that produce it. Dopamine is a neurotransmitter often described as the pleasure or \u201cfeel-good\u201d hormone<\/a> involved in motivation and reward pathways, but its role goes far beyond that: it also regulates movement and motor skills. Having low levels of dopamine in the brain makes movement and day-to-day activities difficult.<\/p>\n There are over 40 movement and non-movement symptoms of Parkinson\u2019s. While symptoms can vary significantly, and everyone\u2019s experience of the disease is different, common symptoms include tremor (or shaking), rigidity (or muscle stiffness), slowness of movement, memory and thinking problems, sleep problems, and mental health problems, including anxiety and depression, pain and balance issues. How Parkinson\u2019s affects someone can change from day to day, hour to hour. <\/p>\n \u201cThe most typical presentation of Parkinson\u2019s is a tremor, difficulty in movement, stiffness of muscles, posture becoming stooped,\u201d says Chaudhuri. Yet while tremor is a widely recognised symptom of Parkinson\u2019s, he notes that around 30 per cent of patients do not experience a resting tremor with the condition.<\/p>\n Lesser-known early signs of Parkinson\u2019s <\/p>\n \u201cBy the time patients come and see me with their symptoms<\/a> and receive a diagnosis, they might have had the condition for many years,\u201d Chaudhuri explains. \u201cThis is what we call prodromal Parkinson\u2019s. These signs can be very subtle. For instance, a sudden or unexpected reduced sense of smell, which we call hyposmia.<\/p>\n \u201cAnother is a sleep disorder called REM behaviour disorder (or RBD), a condition in which you have violent dreams at night, and you act these dreams out without being aware. Often, a bed partner might see this person reaching out, hitting that person in their dream, or even falling out of bed. People who have RBD have a very high chance of going on to develop Parkinson\u2019s in the next 10 or 12 years. Sleep can become very disturbed in Parkinson\u2019s, as dopamine is also involved in the regulation of sleep, and people may wake up frequently at night, which can lead to insomnia.\u201d<\/p>\n Other common early signs, which can present as the so-called prodromal features, include chronic depression and episodes of anxiety. Chronic somnolence as well as severe fatigue are other potential symptoms, as is chronic constipation. \u201cThese symptoms are common in the general population, but when presented together with hyposmia or RBD, may be suggestive of prodromal symptoms of [Parkinson\u2019s],\u201d says Chaudhuri.<\/p>\n Problems with your bladder or bowels are other common symptoms, as dopamine is involved in bladder and bowel function as part of the autonomic nervous system. \u201cSome people may find they are getting up four or five times a night to pass urine, a condition we call nocturia.\u201d Other signs of an overactive bladder can include needing to use the toilet immediately without warning.<\/p>\n A lesser-known symptom of the condition is changes in handwriting, explains Dr Rowan Wathes, associate director of policy and health strategy at Parkinson\u2019s UK. Some people with Parkinson\u2019s find that their movements become smaller and less forceful than before, due to changes in the brain. This can lead to their handwriting becoming smaller than it previously was or gradually getting smaller as they write. For this reason, if you are referred to a specialist by your GP, they may ask you to write or draw something.<\/p>\n A lack of dopamine in the brain can also impact the use of facial muscles, which can limit facial expressions, something that is sometimes referred to as having a Parkinson\u2019s<\/a> \u201cmask\u201d or facial masking, Wathes continues. It can leave people with a blank or serious expression, even if they are actually experiencing strong emotions.<\/p>\n If you are concerned that you are showing signs or symptoms of Parkinson\u2019s, you should make an appointment to see your GP, who may refer you to a specialist.<\/p>\n Management of Parkinson\u2019s<\/p>\n While there is currently no cure for Parkinson\u2019s, treatment can help patients manage the condition and relieve certain symptoms that impact quality of life. Medications include dopamine replacement therapy (DRT), which can be administered orally or via injection. For some people, surgery may be recommended.<\/p>\n \u201cIn addition to the pharmacological treatments that we provide, lifestyle-based wellness measures are equally important,\u201d says Chaudhuri. \u201cIf the two are not combined, treatment becomes suboptimal.\u201d <\/p>\n As Parkinson\u2019s expression can vary so significantly, there is no one-size-fits-all approach to the management of symptoms. However, he outlines a few non-negotiables. \u201cPhysical activity has been shown to be one of the most effective ways that you can combat Parkinson\u2019s progression<\/a>. There is also some evidence to suggest that people who exercise regularly may have lower rates of Parkinson\u2019s. It can provide more dopamine in the brain than some tablets, and it also promotes new cell regeneration. Dancing, specifically ballet, has been shown to be very beneficial in Parkinson\u2019s, while studies suggest practising tai chi may have a positive effect.\u201d<\/p>\n