Parkinson’s Disease 1 Parkinson’s Disease: The Stages and What Can Be Done from Progressing Emily Kalarovich Basic Adult Health Keiser University Professor Gordon 08/07/2022 2 Abstract Parkinson’s Disease is an uncurable condition that while happens in predominantly males, it can happen to anyone, it has no specific “type”. Parkinson’s causes both motor and nonmotor disturbances in the sufferers ability to function normally. It starts minimal in stage one and progresses to stage five with being completely debilitated, bedbound and possibly suffering with dementia as well. While many advancements since the 1960’s have been made to slow the disease process, there has been few major advancements on finding a cure for this horrible disease. This disease finds many people feeling confused and lonely, it is imperative as a nurse, loved one and family member to understand the different stages and what can be done to help slow progression of Parkinson’s disease. 3 Parkinson’s Disease: The Stages, and What Can Be Done from Progressing In the United States there are nearly one million people living with Parkinson’s disease and each year sixty thousand people are diagnosed (Parkinson.org, 2022). Parkinson’s disease is a neurological condition that affects a person’s speech and mobility, ultimately leading to the sufferer’s complete loss of control of muscles throughout their body. Symptoms of Parkinson’s include drooling, low blood pressure when standing, voice issues, depression, anxiety, constipation, sleep problems, dementia, and hallucinations. There is no proven way to prevent Parkinson’s, but some researchers believe exercise reduces the chance of developing Parkinson’s. This condition is caused by decreased formation and action of dopamine, produced by dopaminergic neurons in the brain, meaning there is a breaking down or degeneration of cells in the nervous system. Parkinson’s disease has been categorized into five stages. Specialists highly encourage and recommend diet and exercise to keep the muscles strong in the early stages to help as it progresses severely in the later stages. Treatment for Parkinson’s does not mean to cure but helps to control the manifestations of symptoms by increasing or mimicking the actions of dopamine in the brain. Regular visits with a neurologist are vital to ensure the diagnosis is on point and the symptoms are being properly managed and addressed. In 1817, Dr. James Parkinson published “An Essay on The Shaking Palsy” which described both non-motor and motor symptoms of the disease that bore his name. “Parkinson’s is not just a movement disorder,” explained Dr. Shprecher (Boland, 2020). Living with Parkinson’s can also include an impaired sense of smell, constipation, and dream enactment before the motor symptoms of Parkinson’s set in. Parkinson’s disease worsens over time, which is why it is pinned as a “progressive” disease. Stage one of Parkinson’s disease, individuals 4 experience very mild symptoms, and they not typically interfere with their daily activities or lives. Patient may notice changes in body posture, facial expressions, walking and a tremor in only one side of the body. Stage two the disease progresses to include tremors, rigidity, and movements on both sides of the body. The individual can still live alone however, daily tasks are more challenging and take longer to finish. Stage three is known as mid-stage; these individuals begin to experience loss of balance and slow movements; it is more common in this for patients to become fall risks. They are still independent, but these symptoms significantly impair their ability to eat and dress themselves. Symptoms in stage four have progressed to severe and limiting. The patient may stand without help but likely requires a walker for movement. In stage four, individuals are not able to live alone and require help with daily activities. It is impossible to stand or walk in stage five, they require a wheelchair or are bedridden. Patients in stage need around the twenty-four-nursing care due to the complexity of the stage. Delusions or hallucinations are also experienced in stage five. Depending on the severity of the disease, life looks different for an individual with Parkinson’s disease, the top priority for a loved one suffering with this disease regardless of the stage should be comfort, peace of mind, and safety. Many studies have shown over recent years that a balanced nutrition plan may help slow the advancement of Parkinson’s disease. Eating a plant based, whole food, Mediterranean-style diet such as fresh vegetables, berries, nuts, seeds, fish, coconut, and olive oils can slow the progression of the condition. Exercise is crucial to maintain health when you live with Parkinson’s disease, according to the Parkinson’s Outcome Project at least two and a half hours of physical activity per week can slow the progression of symptoms of Parkinson’s (Parkinsons.org, 2022). Exercise helps minimize the risk of falls in those suffering from this 5 condition along with improved memory, thinking, minimized depression and anxiety. Speech and Physical therapy have also been used to improve symptoms of Parkinson’s. It is recommended to exercise at least hundred and fifty minutes per week, plan a weekly routine which includes aerobic activity, strength training, balance and stretching exercises such as yoga. Visit a physical therapist that specializes in Parkinson’s for optimal exercise recommendations. Experts have spent decades working on therapies strong enough to slow Parkinson’s because unfortunately diet and exercise is not enough for this disease. In 1967, Levodopa was introduced, is still the used as the first line of defense to this day. Levodopa is often referred to as the gold standard of medication for those suffering with Parkinson’s. “Expert practitioners in the Parkinson’s Foundation Parkinson’s Outcomes Project report utilizing levodopa more than any other drug for Parkinson’s therapy and used levodopa more as the disease progressed.” (Parkinson.org, 2022) Levodopa helps to restore control over the muscles by converting to dopamine once it crosses the blood-brain barrier, therefore it increases the level of dopamine and counters the effects of the disease. Levodopa can cause involuntary movements called dyskinesias as a side effect, which is why the combination of Levodopa-Carbidopa helps reduce the side effects of the medication. The other issue with this drug is that the effects wear off over time which causes the dosage to need to be increased and eventually the drug seemingly does not work at all. MAO-B inhibitors such as Rasagiline, prevent breakdown of dopamine by inhibiting the enzyme MAO-B. These medications are sometimes given with levodopa to prevent wearing off. Anticholinergics have been used for years to help control the tremors in Parkinson’s disease such as benztropine. Nuplazid has been used to treat the hallucinations and delusions that occur with Parkinson’s disease. Many people 6 also use medical marijuana to help reduce the hand tremors associated with Parkinson’s, researchers also believe that cannabis can help with the side effects of Levodopa such as dyskinesias and. Deep brain stimulation is a surgical procedure in which surgeons implant electrodes in part of the brain, the electrodes are connected to a generator implanted near the collarbone that sends electrical pulses to the brain to relieve symptoms of Parkinson’s. , The number of those suffering with Parkinson’s disease is more than multiple sclerosis, Lou Gehrig’s disease and muscular dystrophy combined in the United States combined. Nearly ten million people worldwide are living with the disease and about 40% of people are diagnosed before the age of fifty (Parkinsons.org, 2022). Males are more likely than females to be diagnosed with Parkinson’s disease. Not everyone will experience the same signs and symptoms of Parkinson’s or in the same order. This disease is slow progressing, taking years to reach a diagnosis at times and even longer to reach end stage Parkinson’s which usually includes dementia. Exercise, diet, physical therapy can dramatically help those with Parkinson’s because it helps increase muscle tone and improve balance. Speech therapy can help improve speech problems and brain stimulation. Through the years, advancements in medications such as Levodopa-carbidopa, Rasagliline, anticholinergics and Nuplazid has significantly helped those suffering with this disease relieve symptoms and slow progression but there are still no major moves in a cure for Parkinson’s. There have even been surgeries such as deep brain stimulation to help sufferers when medication starts to fail, and stages start to progress even further. It is important to remind those suffering with this disease that they are not alone, coping can be isolating, confusing and scary. The top priority should be always to provide comfort, mental health, peace of mind and safety. 7 References Parkinson’s disease - Symptoms and causes. (2022, July 8). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptomscauses/syc-20376055 Statistics. (2022). Parkinson’s Foundation. https://www.parkinson.org/UnderstandingParkinsons/Statistics The 5 Stages of Parkinson’s Disease. (2020). Banner Health. https://www.bannerhealth.com/healthcareblog/teach-me/the-5-stages-of-parkinsonsdisease
