What is Parkinson's disease?

Parkinson's disease is a condition that mainly affects your movement and mood, and gets worse over time. It happens when the nerve cells in the brain can't make enough dopamine. Dopamine is a chemical in your brain that is vital for the control of your muscles and movement.

Most people with Parkinson's disease are diagnosed around the age of 65 years. However, 1 in 10 people diagnosed are younger than 45 years.

What are the symptoms of Parkinson's disease?

Parkinson's symptoms vary. The range of symptoms usually include:

• tremor or shaking at rest, usually one sided at first
• muscle stiffness (rigidity), which can be painful and affect movement
• slowing of movement, which can make daily activities difficult
• changes to your posture

Early symptoms can be unclear and not specific, making Parkinson's disease hard to diagnose. These may include:

• fatigue
• mild depression
• restlessness
• localised muscle pain

Other movement related symptoms that you may get with Parkinson's disease are:

• balance problems
• slowed and quiet speech
• handwriting becoming very small and hard to read
• swallowing changes
• low blood pressure, especially going from lying to sitting, or sitting to standing

There are also non-movement symptoms, such as:

• sleep problems, including acting out your dreams and sleep talking
• constipation
• slowing of thoughts
• anxiety and depression
• decreased sense of smell
• fatigue not relieved by resting
• increased saliva production

Many of the symptoms of Parkinson's disease can also be caused by other conditions. If you are worried about your symptoms, speak to your doctor.

What causes Parkinson's disease?

Doctors still don't know the exact cause of Parkinson's disease. Some contributing factors include:

• ageing
• genetic changes
• exposure to toxins
• some medicines
• infections

When should I see my doctor?

See your doctor if you notice:

• shaking
• stiff muscles
• lack of balance
• slowed muscle movements

Your doctor may refer you to a specialist, such as a neurologist or geriatrician for more tests.

How is Parkinson's disease diagnosed?

Diagnosing Parkinson's disease is especially difficult in the early stages. No single test can give a diagnosis. To get a diagnosis, your doctor will talk to you about your symptoms and do a physical examination. Your doctor might also see if you respond to a medicine that raises dopamine levels in your brain.

You may need brain scans to rule out other conditions. These could include MRI and CT scans or others. Your doctor may also refer you for blood tests.

How is Parkinson's disease managed?

Your doctor and other health professionals will make you a treatment plan.

Parkinson's disease is best managed with the support of a healthcare team.

• Your local doctor or general practitioner (GP)
• A neurologist
• A physiotherapist
• An occupational therapist
• A psychologist
• A specialist nurse
• A dietitian

While there is no cure for Parkinson's disease, symptoms can be managed through the use of medicines, surgery and lifestyle changes.

Medicines

The medicines used for Parkinson's disease increase the levels of dopamine in your brain. They may be taken as a tablet (pill). If you can't swallow tablets, you can have medicines as an injection or through a tube straight into your small intestine.

The most commonly used medicines are:

• levodopa, a dopamine precursor (building block), used to replace dopamine
• dopamine agonists, which copy the effects of dopamine
• COMT inhibitors, to increase the amount of levodopa that can work in the brain
• MAO-B inhibitors, which help stop the breakdown of dopamine in the brain
• amantadine, used for dyskinesia (uncontrolled abnormal movements)
• anticholinergic medicines to help with the tremor

People respond to medicines in different ways. If your doctor prescribes medicines for Parkinson's disease, it can take time to find the one that works best for you.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Surgery

Deep brain stimulation (DBS) surgery can help to reduce the amount of medicines needed. It can reduce the tremors or lessen wriggling movements in the body.

DBS involves placing electrodes into the part of the brain that controls movement. These are connected to a tiny generator that is implanted in the chest. You can switch this on to send electrical impulses to the brain. The electrodes are then programmed and adjusted for the best effect. In most cases you are awake during the surgery.

DBS is not suitable for everyone, so ask your doctor if it's a good option for you.

Lifestyle changes

If you are living with Parkinson's, making some changes to your lifestyle and physical environment may make it easier.

Healthy diet

Eating a high-fibre diet of fruit, vegetables and grains, and drinking plenty of water, can help prevent constipation.

Most people with Parkinson's disease are able to drink a little alcohol, but it may affect your medicines. You may also be more sensitive to its effects on your balance, speech and thinking.

Exercise

Staying active or exercising may slow the progression of Parkinson's disease and help you maintain:

• your mobility
• posture
• quality of life

Exercise can also reduce depression and anxiety.

Allied health specialists including physiotherapists, occupational therapists, exercise physiologists and speech therapists can recommend exercise programs. As well as strategies to help with freezing of movement and loss of balance.

Living with Parkinson's disease

Can I still work if I have Parkinson's disease?

To help you continue working safely and productively, you may need:

• simple modifications to your workplace
• flexible working hours
• regular review and adjustment to your medicines
• scheduling regular breaks
• work from home options
• changes to work duties with fewer tasks involving fine motor skills or heavy lifting

It's up to you if you tell your employer about your diagnosis. In Australia, it is illegal for employers to discriminate against employees or potential employees on the grounds of disability.

How does Parkinson's disease affect mental health?

Anxiety and depression affect around half of people with Parkinson's disease and can decrease your quality of life.

Apathy is a general lack of interest in certain activities and people, which can occur because of low dopamine levels. Your family, friends and carers should be told that this is a specific symptom of Parkinson's disease.

These mental health aspects of Parkinson's disease need to be treated separately to your movement related symptoms. Ask your doctor for help with any mental health symptoms you notice.

How can Parkinson's disease affect relationships and sex?

Some people with Parkinson's disease have a decrease in sexual desire, performance or satisfaction. In others, medicines that are used as a substitute for dopamine can result in a preoccupation with sexual thoughts and desires.

If you're worried, speak to your doctor, or ask for a referral to a professional counsellor for help.

Young onset Parkinson's disease

Young onset Parkinson's disease (YOPD) refers to a person who is diagnosed under the age of 50 years.

YOPD is diagnosed the same way as Parkinson's disease. There are some differences, such as:

• slower disease progression
• increased rate of abnormal movement (dyskinesia)
• more involuntary muscle contractions causing repeated movements (dystonia)

If you've been diagnosed with YOPD, there are online and in-person support groups that can help.

Resources and support

For more information and tips on living with Parkinson's, visit the Parkinson's Australia website.

Call the Parkinson's Australia info line 1800 644 189 for counselling, information and support.

Download the YOP-X App — an information portal and resource hub supporting people with young onset Parkinson's.

Carers can access a useful information booklet from Parkinson's Australia.

Do you prefer to read languages other than English? Information on Parkinson's disease is available in many different languages on the Fight Parkinson's website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.