A progressive movement disorder causing tremor, stiffness and slowness of movement.
Overview of Parkinson's disease
Parkinson’s disease is a long-term movement disorder that gradually worsens over time. It occurs when the brain cells responsible for producing dopamine slowly become damaged or stop functioning. Dopamine is a chemical that helps the body control smooth and coordinated movements. Common symptoms include shaking (tremors), muscle stiffness, slowed movements and problems with balance and walking. Approximately 8.5 million people worldwide are living with Parkinson’s disease.
Causes of Parkinson's disease
In many people, the exact cause of Parkinson’s disease is still not fully known, which means there is currently no proven way to prevent it.
Certain factors may increase the risk of developing Parkinson’s disease, including:
- Age above 60 years: Symptoms usually begin after the age of 60, although a less common early-onset form can occur before age 50.
- Male gender: Parkinson’s disease can affect anyone, but it is more commonly seen in men.
- Family history: Having a close family member with Parkinson’s disease may slightly increase the risk.
- Environmental exposure: Long-term exposure to pesticides or certain metals, such as manganese used in welding, may also raise the risk.
Signs and symptoms of Parkinson's disease
Parkinson’s disease can cause both movement-related and non-movement symptoms. These symptoms may gradually affect daily activities and quality of life.
Movement-related symptoms are as follows:
- Slow body movements
- Shaking or tremors
- Muscle stiffness
- Difficulty walking
- Poor balance or frequent falls
- Uncontrolled or involuntary movements
Some people may also develop painful muscle tightening or twisting (called dystonia), which can make speaking and movement difficult.
Non-movement symptoms are as follows:
- Memory and thinking problems
- Depression, anxiety or other mental health concerns
- Sleep disturbances
- Pain or discomfort
- Changes in sensation, such as numbness or unusual feelings
As the disease progresses, some individuals may develop dementia (A decrease in memory and thinking ability), which can affect memory, decision-making, and daily functioning. These symptoms can increase the need for support and long-term care.
Complications due to Parkinson's disease
Over time, Parkinson’s disease can lead to other health problems, including:
- Problems with blood pressure, digestion, bladder control or sweating
- Difficulties with memory, concentration and decision-making
- Increased risk of falls and injuries
- Reduced ability to perform daily activities independently
- Mood and emotional changes, such as depression or anxiety
- Difficulty swallowing, which may increase the risk of choking
These complications vary from person to person and regular medical follow-up can help manage changing needs.
Diagnosis
There is currently no single test that can confirm Parkinson’s disease. Diagnosis is usually made by a neurologist, a doctor who specializes in brain and nervous system disorders. The doctor diagnoses Parkinson’s disease based on your medical history, symptoms and a physical and neurological examination.
Tests and evaluations that may be recommended include:
- Physical and neurological examination: Checks movement, balance, coordination, reflexes, memory and thinking ability
- Blood tests: Help rule out other conditions that may cause similar symptoms
- Imaging tests: Magnetic resonance imaging (MRI), brain ultrasound, or positron emission tomography (PET) scans may be used to exclude other brain disorders, although they do not directly diagnose Parkinson’s disease
- Dopamine transporter (DAT) scan: A specialised scan that may help support the diagnosis and distinguish Parkinson’s disease from other causes of tremor.
- Genetic testing: May be advised in people with a strong family history or early-onset Parkinson’s disease
- Medication trial: Doctors may prescribe Parkinson’s medicines for a short period to see whether symptoms improve
- Alpha-synuclein test: Newer tests using skin or spinal fluid samples may help detect abnormal protein buildup linked to Parkinson’s disease.
Regular follow-up with a neurologist is important to confirm the diagnosis and guide treatment over time.
Treatment
There is currently no cure for Parkinson’s disease, but treatments such as medications, surgery and rehabilitation therapies can help manage symptoms and improve quality of life.
Treatment for Parkinson’s disease usually includes a combination of medications, therapy, rehabilitation and supportive care. Treatment plans are personalised and may change over time based on symptoms and patient needs.
Medications: Medicines are the main treatment and help improve movement symptoms by increasing or supporting dopamine activity in the brain. Commonly used medicines include:
- Carbidopa-Levodopa: Helps improve slowness, stiffness and tremors
- Dopamine agonists: Act like dopamine to help control movement symptoms
- Monoamine Oxidase-B (MAO-B) inhibitors: Help dopamine remain active in the brain for longer
- Catechol-O-Methyltransferase (COMT) inhibitors: Help Levodopa work longer between doses
- Amantadine: May reduce uncontrolled movements that develop after long-term treatment
- Anticholinergic medicines: May help reduce tremors
Additional medicines may also be used to manage symptoms such as memory problems, depression, anxiety, sleep disturbances or sexual difficulties.
Infusion therapies: These are advanced treatments that deliver medication continuously through a small pump under the skin. These may help patients who continue to experience symptom fluctuations despite oral medicines.
Therapy and rehabilitation: Rehabilitation therapies can help patients stay active and independent:
- Physical therapy: Improves balance, strength and walking
- Occupational therapy: Helps with daily activities
- Speech therapy: Supports speaking and swallowing
Surgery: Surgery may be considered when medications no longer control symptoms effectively. The most common procedure is deep brain stimulation (DBS), which uses electrical signals to help control movement symptoms. It can improve the quality of life but does not cure Parkinson’s disease.
Lifestyle and supportive care: Healthy lifestyle habits are an important part of treatment and may include:
- Eating a balanced diet
- Staying physically active
- Maintaining good sleep habits
- Receiving emotional and social support
- Regular follow-up with healthcare providers
Ongoing care helps ensure treatment is adjusted as symptoms change over time.
What to expect
Parkinson’s disease is a long-term condition that gradually worsens over time, although the rate of progression differs from person to person. Some individuals experience slow changes over many years, while others may notice symptoms progressing more quickly. Treatment can help manage symptoms and improve quality of life, but ongoing medical care and adjustments in treatment may be needed over time. Living with Parkinson’s disease often involves adapting daily routines and accepting support as needs change.
Frequently Asked Questions
Why is exercise important for Parkinson's?
Regular exercise is very important for people with Parkinson’s disease. It can improve movement, strength, balance, mood, sleep and constipation, while also helping manage stress and supporting overall well-being. Studies suggest that exercise may even help slow the progression of symptoms. Activities such as walking, yoga, cycling, dancing and boxing can be beneficial.
What happens if Parkinson's is left untreated?
Although there is currently no cure for Parkinson’s disease, treatments and medications can help manage symptoms and improve daily life. Without treatment, symptoms may worsen faster and significantly affect everyday activities.
Can Parkinson’s disease result in death?
. Contrary to common belief, Parkinson’s disease itself does not usually reduce life expectancy. However, in later stages, problems such as reduced mobility, poor balance and difficulty swallowing can increase the risk of serious complications like falls with fractures, pneumonia and choking.
Myths & Facts
Parkinson’s disease only affects movement.
Although Parkinson’s disease is commonly known for movement-related symptoms such as tremors, muscle stiffness, slowed movements and reduced facial expression, it can also affect many other aspects of health. Non-movement symptoms may include memory and thinking problems, anxiety, depression, fatigue and sleep disturbances. In some people, these symptoms can be more troublesome than movement problems
Everyone with Parkinson’s disease has tremors.
Tremors are a well-known symptom of Parkinson’s disease, but not everyone with Parkinson’s experiences them. In some people, tremors may not appear in the early stages of the condition.
Aside from medication, there isn’t much you can do to treat Parkinson’s disease.
The belief that “nothing can be done” for Parkinson’s disease is not true. Staying physically active can make a big difference in managing symptoms and maintaining independence. Studies have shown that people with Parkinson’s who exercise regularly are often able to perform daily activities better than those who are inactive.
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