Parkinson’s Disease: 60 and older

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Despite incredible discoveries and advancing technologies, medicine still has its mysteries. Count Parkinson’s disease among them, at least partially. Its cause is unknown, and there’s no cure at present or near at hand.

A neurological disorder of the brain that strikes a person’s muscle control and bodily movements, Parkinson’s disease affects nearly one million people in the United States, with 50,000 to 60,000 new cases being diagnosed each year. It generally occurs in people 60 years and older.

“Parkinson’s disease includes a constellation of symptoms,” says Samuel Frank, M.D. “It usually consists of tremors, slowness of movement, walking problems, or balance issues. We differentiate that from Parkinsonism or Parkinson-like disease, which may be just slowness or stiffness, by the story that people tell us when they come into the office and by the physical exam we do. Right now there is no blood test or X-ray or MRI to diagnose the disease. It is done by history and physical examination.”

Dr. Frank, Associate Professor of Neurology at Boston University School of Medicine, joined Anna Hohler, M.D., Assistant Professor of Neurology at the school, as guests on the August edition of Physician Focus. The two, both board-certified neurologists on the staff at Boston Medical Center who specialize in the treatment of patients with Parkinson’s disease, engaged in a detailed discussion of the condition along with program host and primary care physician Bruce Karlin, M.D.

An accurate diagnosis of the disease -- it is named after James Parkinson, an English doctor who in 1817 published the first detailed description of the condition in An Essay on the Shaking Palsy -- can be difficult because of the lack of known causes and the absence of testing to pinpoint the disorder. Physicians must look beyond the single feature of tremors, the doctors emphasized, and examine how the condition may be affecting aspects of daily life.

One known characteristic of the condition is a dramatic drop in the amount of dopamine in the brain. Dopamine, a neurochemical that sends signals between neurons, helps regulate movement, among other functions. Replacing the dopamine lost over time with medication is part of the treatment for patients with Parkinson’s disease.

The good news is that people are living longer and living better with the condition. “People with Parkinson’s disease can have a very wonderful quality of life,” Dr. Hohler emphasized, “provided they stay in close contact with their physician, stay with proper medications and have those adjusted, and be involved in healthy living with exercise and diet.”

Please join us this month on Physician Focus for an in-depth look at Parkinson’s disease, including suspected causes of the disease, how physicians make a diagnosis, and how the disease is treated.