What do you think of when you hear the term “Parkinson’s Disease”? Do you think of hand tremors? Do you picture an elderly person, perhaps a grandfather? Although hand tremors are a common symptom of Parkinson’s, and the disease is more likely to affect people 60 and older, there is much more to PD than you may realize.
Parkinson’s disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Symptoms generally develop slowly over years. The progression of symptoms is different from one person to another. People with PD may experience tremors, mainly at rest. Slowness of movements (bradykinesia). limb rigidity, gait and balance problems are also symptoms of PD. Non-motor symptoms can include apathy, depression, constipation, sleep behavior disorders, loss of sense of smell, and cognitive impairment.
According to the Michael J Fox Foundation for Parkinson’s Research, while the average age at onset is 60, people have been diagnosed as young as 18. There is no objective test, or biomarker, for Parkinson’s disease, so the rate of misdiagnosis can be relatively high. Estimates of the number of people living with the disease therefore vary, but research indicates that at least one million people in the United States, and more than five million worldwide, have Parkinson’s disease. That is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease (or Amyotrophic Lateral Sclerosis).
Although there is no cure for the disease and the exact cause is unknown, we do know both environmental and genetic factors play a role. Research is ongoing to learn more about the disease, treatments, and someday a cure. Current medications help to manage symptoms. Surgery, known as Deep Brain Stimulation, can help to reduce tremors. Another way to manage symptoms is through exercise. Although more research is needed on how exercise reduces symptoms, or if it actually slows the progression of the disease, we do know that exercise is good for everyone for a variety of reasons.
Exercise can improve daily function such as getting out of bed, standing up from a chair, or dressing oneself. Exercise also improves balance. As a matter of fact, it is the only thing that can improve balance. Medications do not help, and often can increase balance problems. Exercise improves strength which we need for daily activities such as carrying groceries or picking up children or grandchildren. Exercise improves endurance. Exercise improves flexibility. It is difficult to bend down to tie your shoes or reach around for the seat belt in your car without it. We also know that regular exercise helps to lower blood pressure, reduce blood glucose levels in those with diabetes, improve mood to reduce depression and anxiety, and improve sleep.
These improvements will not just help those with Parkinson’s, but almost all of us. So why wouldn’t we prescribe exercise? Prescription medications are necessary, but exercise is medicine as well…without side effects. This time of year, exercise becomes a priority for many Americans as they make New Year’s Resolutions. For people with PD, exercise isn’t just a resolution. It is a necessity. I once heard a Neurologist say, “If I had PD and had to leave my career, my job would be to exercise every day.” That is how important exercise is to those with Parkinson’s Disease, and why we say Exercise IS Medicine.