Parkinson's Disease

Parkinson’s disease affects nerve cells in the parts of the brain called the basal ganglia. This part of the brain controls movement and balance in the body. These nerve cells produce and store a chemical messenger called dopamine which carries signals about movement from cell to cell in the brain. The brain then sends instructions to the body. In Parkinson’s disease, the cells that produce dopamine are damaged. The instructions from the brain to the body about movement are disrupted as dopamine decreases. In Parkinson’s disease, many nerve cells are damaged. They do not produce enough dopamine to carry signals properly.

A person with Parkinson’s disease may have one or more symptoms. The most common symptoms are:

Tremor – shaking in one or both hands, arms, or legs, or the jaw, usually when the person is not moving. Seven out of 10 people with Parkinson’s disease have tremor.

Bradykinesia – slower than normal movement.

Rigidity – stiffness in the arms, legs, face, or body. It limits how far a person can move that part of his or her body.

Postural instability – Parkinson’s disease can affect balance, most often after a person has had it for several years. The person may tend to lean too far forward or too far backward when standing and walking, causing instability.

These symptoms affect people with Parkinson’s disease in important daily activities. Rigidity in the face and/or neck can cause problems with speech or swallowing food or liquids. Tremor or rigidity in the hands can make dressing, washing, cooking, and writing difficult. Bradykinesia and postural instability can make getting from place to place difficult. People with Parkinson’s disease also may feel weak or depressed, have trouble sleeping, or have mood changes. All of these symptoms can made people uncomfortable around family, friends, or out in public.

Parkinson’s disease generally commences in middle or late life and leads to progressive disability. The disease occurs in all ethnic groups, has an equal sex distribution, with a prevalence of one or two per 1000 of the general population and one per 100 among people older than 65 years. Signs of parkinsonism are extremely common in the elderly. About 15% of individuals between 65 and 74 years of age and more than half of all individuals after age 85 have abnormalities on examination consistent with the presence of Parkinson's disease type disorder.

The incidence of Parkinson’s disease is about 18 cases per 100,000 persons per year, with a prevalence of about 160 per 100,000. In a population of 100,000 there will be about 60 patients with little or no disability, about 50 who are moderately disabled, and a further 50 severely disabled. A substantial number will have major cognitive problems and about 12 of whom will require institutional care. Each general practitioner will have about 3 patients with Parkinson’s Disease.

Parkinson's Disease Service

Greater Glasgow Movement Disorder Clinics; Primary Care Awareness Newsletter

The key factors which enable people with Parkinson’s to remain in or re-enter employment

Pilot research project – Towards a social model of service provision for people living with Parkinson disease

Parkinson's Disease Society, Scotland

The journey; Parkinson's Disease (BMJ article)