What is Parkinson’s disease? How exactly does the disease start? Important information given by experts

Pune : Parkinson’s disease is no longer just a disorder of old age. It has now become the fastest growing neurological disorder in the world. At present, about 1 crore patients are affected by it, and it is also found in large numbers among citizens in the age group of 40 to 50 years. The significant rise in younger patients of this disease, previously considered a disease of old age, has been attributed to increased awareness (which causes patients to seek medical advice sooner), increased life expectancy, environmental factors and changing lifestyles. It is very important to recognize the early symptoms. Because timely intervention can improve long-term health, independence and quality of life.

Only tremors are not Parkinson’s, the early symptoms rearing their heads slowly.

In this regard, Dr. Bhushan Mishal says, “The common belief is that tremors are the first symptoms of Parkinson’s. Many times the disease begins with very subtle neurological changes, which are easily overlooked.” Early symptoms include loss of smell (anosmia), sleep disorders such as dream talking, movement, letter shortening (micrographia), and slowness of movement (bradykinesia). Some symptoms may appear years before the onset of tremors, making them difficult to identify. Knowing these ‘non-motor’ symptoms is important to identify the disorder in its early stages. Because many patients don’t realize that Parkinson’s disease starts before tremors appear.

These symptoms are often mistaken for normal aging

Many of the early symptoms of Parkinson’s are ignored as part of aging. Symptoms such as persistent constipation, a slightly bent body, and a masked face are assumed to be changes due to fatigue or age.
But these symptoms can be indicative of neurological problems affecting muscle control and coordination. Such misconceptions can delay treatment.

Delays that take away valuable time

On average, it takes 1 to 3 years for patients to see a neurologist after the initial symptoms appear. Most people go to the doctor only after they have obvious symptoms such as tremors, loss of balance, stiffness, or falls. By that time, the disease has progressed to a great extent. Early consultation allows doctors to start treatment sooner, which can slow the progression of the disease and preserve independent living.

Knowing the risk factors

Advancing age is the biggest risk factor for Parkinson’s, but the disease is not caused by a single factor. About 10–15% of cases have genetic causes, such as LRRK2 or GBA mutations. Also, prolonged exposure to pesticides and heavy metals, especially exposure to chemicals such as paraquat, can also be a contributing factor. Conversely, regular aerobic exercise can be helpful and help delay the onset of symptoms.

Why is early diagnosis important and how is it done?

Early diagnosis of Parkinson’s can improve quality of life. Early exercise and treatment can help maintain long-term mobility and independence. Intense aerobic exercise is considered an important measure to help slow the progression of the disease. There is no blood test that can accurately diagnose Parkinson’s disease. Diagnosis is primarily based on clinical examination, including neurological examination, DaTscan imaging, and levodopa challenge test.

A better future through early action

Parkinson’s is not just a movement disorder. Mood changes, fatigue, constipation, and sleep disturbances precede the onset of tremors in about 90% of patients, and some patients never experience tremors. Today, Parkinson’s is a well-manageable disease. Treatments such as levodopa control these symptoms and help lead an active, independent life. Advanced treatment options such as Deep Brain Stimulation (DBS), MRgFUS and Apomorphine Infusion Pump are now available in India and are very helpful in some carefully selected patients.