Objective 10 - Epidemiology of Parkinsons Disease

Definition

Parkinsons disease s a degenerative disorder of central nervous system


Epidemiology

Second commonest cause of neurological disability in UK
Affect 100-180 people per 100 000 of population
The incidence increase with age.
It affects about 0.4% of people over 40 years, about 1% of people over 60 years, about
2-3% of those older than 65 and 3-4% of those older than 85.

Type of Parkinson Disease

1. Idiopathic PD - The most common type which is due to degenerative brain disorder.
2. Vascular PD - Produce by one or more small strokes
3. Drug-induced PD - Occur from the use of certain drugs
4. Inherited PD People inherited the PD genes
5. Juvenile PD Terms used when PD affects people under the age of 20


Symptoms

Primary Symptoms

1. Bradykinesia - Slowness of voluntary movement. Difficult to initiate movement. This
also can affect the facial muscles and result in expressionless.
2. Rigidity Stiffness of the limbs and trunk. Loss fine of hand movement can lead to
cramped handwriting (micrographia)
3. Postural gait Impaired or lost reflexes. Make it difficult to adjust posture and to
maintain balance. Lead to falls.
4. Tremors Trembling in finger, hands, feet, legs, jaw or head. Most often occur during
resting. Tremors may worsen when individual is excited, tired or stressed
5. Parkinsonian gait Shuffling walk with a stooped position and diminished or absent
arm swing. The person may be difficult to start walking and to make turns

Secondary Symptoms

1. Anxiety, insecurity and stress
2. Confusion, memory loss and dementia
3. Handwriting very small and cramped (micrographia)
4. Involuntary movement and prolonged muscle contraction (dystonia)
5. Swallowing difficulties (dysphagia)
6. Lost facial expression
7. Sexual dysfunction
8. Urinary incontinence (Bladder weakness) and retention (difficulty getting rid of urine)






Causes

1. Lack of dopamine
Many symptoms result from the lack of a chemical messenger (dopamine). Dopamine acts as a
messenger between two brain areas substantia nigra and corpus striatum- which produce
smooth and control movement. Thus, if the amount of dopamine is too low, communication
between the two areas becomes ineffective

2. Presence of Lewy Bodies
Abnormal protein clumps. Contain the protein alpha-synuclein and found in many brain cells
of individuals with PD

3. Environmental trigger
Exposure to toxins or viruses which can trigger the Parkinsons signs and symptoms

4. Stress


Risk Factors

1. Age - Young adult rarely experience Parkinsons disease. It ordinarily begins in middle
or late life.
2. Gender - More common in men than women. The female hormone estrogen protects
dopamine neurons.
3. Family history - A person who has a close relative (brother, sister, mother, father) with
Parkinsons disease has a slightly higher risk of developing it himself/herself, compared
to others.
4. Race and Ethnicity - African-Americans and Asian-Americans appear to have lower
risk than Caucasians
5. Exposure to toxin - Excessive exposure to industrial toxic chemicals such as pesticides
and herbicides can increase the risk of developing PD.
6. Trauma - Head trauma may increase the risk for PD due to damages of dopamine
producing neurons.