Parkinson’s Disease

Parkinson’s disease is a progressive movement disorder that worsens over time. It happens when brain cells that make dopamine slowly stop working. Dopamine is a chemical that helps control movement.

Common symptoms include tremors, muscle stiffness, slow movement and balance problems. You might also have symptoms that don’t affect movement, like sleep problems, mood changes or depression.

The disease is common. About 90,000 people in the U.S. are diagnosed with it each year. And an estimated 1 to 1.5 million people live with the condition.

There’s no cure for Parkinson’s disease. But treatment may help manage symptoms.

Types of Parkinson’s

There are two types:

• Idiopathic Parkinson’s disease: This is the most common type. “Idiopathic” means the exact cause isn’t known. Experts believe a protein (alpha-synuclein) in your brain doesn’t fold the right way. This causes clumps, called Lewy bodies, to build up and damage brain cells.
• Familial (genetic) Parkinson’s disease: This type runs in families. It’s much rarer than idiopathic Parkinson’s. It happens because of inherited gene changes. Often, genetic forms start at a younger age.

Parkinson’s disease symptoms

Symptoms of Parkinson’s often start mild, slow and usually affect one side of your body first. Early symptoms may include tremors, stiffness or slower movement. Over time, these symptoms may affect both sides of your body and can make daily tasks harder.

Movement-related symptoms may include:

• Slowed movement
• Tremors at rest, often in your hands, arms or legs
• Muscle stiffness or rigidity
• Changes in posture and walking, like a stooped stance, shuffling steps or trouble turning
• Less facial movement
• Softer or quieter voice
• Small or cramped handwriting

Non-movement symptoms may include:

• Loss of sense of smell
• Sleep problems like acting out dreams or restless sleep
• Mood changes, like depression or anxiety
• Constipation, urinary urgency or digestion problems
• Sexual dysfunction
• Drooling

Not everyone has the same symptoms. A healthcare provider can explain which symptoms are most likely and how they may change over time.

Causes of Parkinson’s disease

Parkinson’s disease happens when certain brain cells slowly stop working or die. These cells normally make dopamine. This is a chemical that helps with movement.

When dopamine levels drop, your brain has trouble sending signals to your muscles. This leads to symptoms like tremors, stiffness and slow movements. As the condition progresses, it can also affect thinking, mood and memory.

In many cases, the exact reason Parkinson’s disease develops still isn’t fully understood. For these reasons, there’s no way to prevent it.

Risk factors

You may be more likely to develop this condition if you:

• Are over age 60: Symptoms most often begin around age 60, though a less common early-onset form can start before age 50.
• Are male: Parkinson’s disease can affect anyone, but it occurs more often in males.
• Have a close biological relative with the condition: It can occasionally run in families.
• Have certain environmental exposures: Contact with pesticides or long-term exposure to metals like manganese (often seen in welding) may raise risk.

Complications

The disease can lead to other health challenges over time. Common complications include:

• Autonomic nervous system problems: These can affect things you don’t control on purpose, like blood pressure, digestion, bladder control and sweating.
• Cognitive issues: You may develop trouble with focus, decision-making or memory over time.
• Injury: Mobility issues may put you at risk of falls.
• Loss of independence: As movement and balance problems worsen, daily activities may become harder without help.
• Mental health challenges: Ongoing changes in your brain may affect your mood and emotional health.
• Trouble swallowing: Weak throat muscles can make swallowing harder and raise the risk of choking or food falling into your lungs.

These vary from person to person. A healthcare provider can watch for changes and offer support as your needs evolve.

How doctors diagnose Parkinson’s disease

Parkinson’s disease is mainly diagnosed through a medical exam and a discussion of symptoms. There isn’t one single test that can confirm it. Instead, healthcare providers look at how symptoms affect movement and how they change over time.

Your provider will start by reviewing your medical history and doing a neurological exam. They’ll watch how you move, walk and use your hands.

What tests diagnose Parkinson’s disease?

Tests help rule out other conditions. Your provider may recommend:

• Blood tests
• Brain imaging tests, like MRIs
• DaTscan (dopamine transporter scan)

In some cases, genetic testing may help if Parkinson’s disease runs in your family. This isn’t common and is usually done only when there’s a strong family history.

Researchers are also studying newer lab tests that look for abnormal proteins linked to Parkinson’s disease. These tests aren’t widely used yet. But they may help with an earlier diagnosis in the future.

Parkinson’s disease treatments

Treatment helps manage symptoms to improve daily life. Care usually involves a mix of medications, therapy and supportive care. Treatment plans are personalized and may change over time.

You can also ask your provider about clinical trials. These studies look at new ways to treat the condition.

Medications

Medications are the main treatment. They may replace or support dopamine, a brain chemical that controls movement. Providers may offer:

• Carbidopa–levodopa: Levodopa turns into dopamine in your brain. This may improve slowness, stiffness and tremor. Carbidopa helps levodopa work better and may reduce side effects like nausea.
• Dopamine agonists: These act like dopamine in your brain. They help with movement symptoms. Providers monitor them closely because they can cause side effects like sleepiness or impulse-control problems.
• MAO-B inhibitors: These slow the breakdown of dopamine in your brain. This allows dopamine to last longer. It may help with mild symptoms or support other medications.
• COMT inhibitors: These may help levodopa last longer in your body. They’re added when symptoms return before the next dose of levodopa is due.
• Amantadine: This may reduce involuntary movements that can happen after long-term levodopa use (called “levodopa-induced dyskinesia”).
• Anticholinergic medications: These may reduce tremors.
• Infusion therapies: These treatments deliver medication continuously through a pump. They’re used in later stages when pills no longer manage symptoms well.

Several other medications treat specific symptoms, including:

• Dementia
• Depression and anxiety
• Sexual dysfunction
• Sleep problem

Therapy and rehabilitation

Therapies help you stay active and independent for as long as possible. These may include:

• Physical therapy to improve balance, strength and walking
• Occupational therapy to help with daily tasks
• Speech therapy to support speaking and swallowing

Surgery

Surgery may be an option when medications no longer manage symptoms well. The most common type is deep brain stimulation (DBS). This implanted device helps reduce movement symptoms. But it’s not a cure, and it doesn’t stop the disease from progressing.

Lifestyle changes and supportive care

Healthy habits play an important role in managing this disease. Supportive care may include:

• Eating balanced meals
• Getting regular physical activity
• Having emotional and social support
• Keeping good sleep habits

Working closely with a healthcare provider helps ensure your treatment matches changing needs over time.

When should I see my healthcare provider?

You should consider seeing a healthcare provider if you notice:

• New or ongoing movement changes, especially on one side of your body, like tremors at rest, stiffness or slower movements
• Trouble with everyday tasks, like getting dressed, writing or standing up from a chair
• Changes in balance or walking, like shuffling steps, freezing or frequent falls
• Ongoing non-movement symptoms, like constipation, sleep problems, depression or loss of smell
• Symptoms that affect safety, like trouble swallowing, dizziness when standing or falling
• A mix of symptoms that don’t go away or slowly get worse over time

If something feels off or starts getting in the way of your daily life, it’s OK to bring it up. Your provider can decide whether further testing or a referral to a specialist is needed.

What can I expect if I have Parkinson’s disease?

Parkinson’s disease is a long-term condition that slowly gets worse over time. How fast it changes varies from person to person. Some people notice changes slowly over many years, while others may progress more quickly.

Treatment can help manage symptoms. You may need ongoing care and regular changes to your treatment plan. Living with Parkinson’s often means adjusting your routine and accepting support as needs change.

Parkinson’s disease life expectancy

Parkinson’s disease isn’t usually fatal on its own. It’s a long-term condition that slowly gets worse.

Many people live with Parkinson’s disease for many years, especially with regular medical care and support. As symptoms progress, complications can develop. These may include problems with balance, swallowing and thinking. It can also affect automatic body functions, like blood pressure.

Because of these, you may have a shorter life expectancy than someone without the condition. How the disease affects lifespan varies widely and depends on factors like age at diagnosis, overall health and symptom management.