Parkinson’s Disease is one of the commonest neurological diseases affecting the elderly. Definition: It is due to damage to the brain cells resulting in the reduction of specific brain chemical (dopamine). Epidemiology: The prevalence of the disease increases with age.

Symptoms

4 key signs and symptoms:

• Tremor (trembling of hands, arms, legs, jaw and/or face)
• Rigidity (stiffness of the limbs and/or trunk)
• Bradykinesia (slowness of body movement)
• Postural instability (impairment of balance and coordination leading to falls)

Early symptoms may be subtle. As the disease progresses, the symptoms begin to affect the activities of daily living. Currently there is no specific lab test for the diagnosis of the disease.

Complications

Physical:

• Falls
• Giddiness / unsteadiness due to sudden change of posture
• Constipation
• Difficulty in swallowing (dysphagia)
• Difficulty in speech (dysarthria)
• Involuntary voiding of urine and faeces (incontinence)
• Pressure sores
• Weight loss

Psychiatric:

• Mood disorders e.g.:
  1. Depression
  2. Anxiety

• Impairment of mental health function e.g.:
  1. Memory
  2. Thought process
  3. Reasoning
  4. Judgment
  5. Perception
  6. Sleeping disorder
  7. Impulse control disorder

Social:

• Loss of independence, isolation, carer’s stress

Treatment

Non Pharmacological

The management is multidisciplinary: Doctors, Nurses, physiotherapist, occupational therapist, speech therapist, psychologist/psychiatrist, pharmacist and medical social worker. It also involve patient and family education, support group services and practicing a healthy lifestyle (exercise and nutrition)

Pharmacological

There is no cure for Parkinson’s disease. Medicines (and surgery in selected cases) can provide relief from symptoms.

Prevention

The exact cause of the disease is unknown.

Rehabilitation

Rehabilitation involving a multidisciplinary team is essential in the management of the disease.

Support Groups

• Malaysian Parkinson’s Disease Association (http://www.mpda.org.my)
• Parkinson’s Disease Society (www.parkinsons.org.uk)
• National Parkinson Foundation (www.parkinson.org)