Parkinson's disease is one of the most common neurological disorders in the elderly, usually affecting those in their sixties.

Causes

It can be divided into idiopathic type and those with secondary causes. Most cases is idiopathic. The definitive cause is unknown, but it is known that progressive destruction of nerve cells in the brain can lead to the depletion of a neurotransmitter called dopamine, which in turn leads to Parkinson's disease. Secondary causes include long-term use of drugs like certain anti-emetics, brain trauma, brain infection and recurrent stroke.

Symptoms

• Tremor, which usually starts in one upper limb, may then involve the other limbs and spread to the whole body eventually.
• Slowness of movement, which is especially obvious on starting movement and turning around.
• Cog-wheel rigidity of limbs and joints.
• Other symptoms include loss of facial expression, speech problems and gait problems.

Management

• Medication: Although there is no effective treatment to cure Parkinson's disease at this stage, drugs can help relieving the symptoms of tremor and stiffness of joints and thereby improve the activities of daily living. Usually, long-term medication is necessary and sudden cessation of medication without medical supervision can make symptoms worse.
• Physiotherapy: Evaluate functional mobility and design individualized rehabilitation program for patients, provide training of muscles and joints, posture and gait; teach proper transfer technique and appropriate use of walking aids, improve patients' mobility and reduce the risk of fall.
• Occupational therapy: It involves the assessment of patients' living environment to identify possible barriers in their daily living, and using appropriate adaptive devices and modifying the home environment to enhance patients' self-care abilities.
• Psychological counseling: As patients are prone to develop depressive symptoms, psychological support and empathy from family members are essential. On the other hand, carers can also be overwhelmed by excess stress. Professional advice should be sought if necessary.