Health now- what is Parkinson’s disease? causes-treatment

General view

Parkinson’s disease is a degenerative brain condition associated with motor symptoms (slowness of movement, tremors, stiffness, gait disturbances, and imbalance) and a wide variety of non-motor complications (cognitive decline, mental disorders, sleep disorders, and pain and other sensory disturbances). Motor impairments such as dyskinesias (involuntary movements) and dystonias (involuntary and painful muscle contractions) lead to limited speech, mobility, and other restrictions in many areas of life. The progression of these symptoms leads to high rates of disability and care needs. Many people with Parkinson’s disease also develop dementia during the course of the disease.

Although Parkinson’s disease is the most common movement disorder, there are other movement disorders such as multiple system atrophy, progressive supranuclear palsy, chorea, ataxia, and dystonia. Some movement disorders have symptoms similar to those of Parkinson’s disease, such as tremor, slowness of movement, and stiffness. All movement disorders carry the same challenges as Parkinson’s disease in terms of diagnostic and therapeutic gaps and access to medicines, especially in low- and middle-income countries. 

Risk factors for Parkinson’s disease include increasing age, although younger people may also be affected. This disease affects more men than women. Several studies have shown that environmental factors such as pesticides, air pollution, and industrial solvents may increase the risk of Parkinson’s disease. 

The causes of the disease are unknown, but it is believed that it may be due to a complex interplay between genetic factors and lifetime exposure to environmental factors such as pesticides, solvents and air pollution. 

epidemiological situation

Worldwide, disability and deaths due to Parkinson’s disease are increasing faster than those of any other neurological disorder. The prevalence of Parkinson’s disease has doubled in the last 25 years. Global estimates in 2019 showed a figure of more than 8.5 million people with this disease. Current estimates suggest that Parkinson’s disease caused 5.8 million disability-adjusted life years in 2019, an 81% increase since 2000, and caused 329,000 deaths, representing an increase of 81% since 2000. which is equivalent to an increase of more than 100% since the year 2000.

Assessment and care

Parkinson’s disease is a clinical diagnosis that can be established not only by neurologists, but also by lay health workers. Primary care assessment and treatment of Parkinson’s disease by lay health workers is especially important in areas where specialized neurological services are not available, such as some low- and middle-income countries.

Although there is no cure, medications, surgical treatment, and other therapies can treat the symptoms of Parkinson’s disease. Levodopa/carbidopa remains the most common and effective medicine, and is on the WHO Model List of Essential Medicines . Other medications, such as anticholinergics, or therapies such as deep brain stimulation, can also treat the symptoms of Parkinson’s disease, especially tremors, as well as reduce the intake of other medications. However, many drugs and surgical resources are not accessible or affordable, or are not available everywhere.

As with many degenerative neurological disorders, non-pharmacological treatment, such as rehabilitation, can offer relief. Specific types of physical therapy, such as strength training, mobility and balance exercises, and hydrotherapy, can help improve function and quality of life for people with Parkinson’s disease and other movement disorders. They can also reduce the pressure on those caring for people with this disease.

Telemedicine can also be used to improve access to care services for people with Parkinson’s disease.

Impact on families and caregivers of people with Parkinson’s disease

Those who informally care for people with Parkinson’s disease (usually family and friends) spend many hours a day providing such care. This can be overwhelming. Physical, emotional and financial pressure can cause great stress to families and those who care for these people, and support is needed from health, social and financial systems and legal systems. Useful support resources from other conditions can be tapped, such as the WHO iSupport program for dementia .

Human rights

People with Parkinson’s disease are often subject to stigma and discrimination, including unfair discrimination in the workplace and lack of opportunities to be involved and participate in their communities.

Like the rest of the population, people with Parkinson’s disease need accessible health services to meet their general health care needs, including access to medications, promotional and preventive services, and diagnosis, prompt treatment and care. A common obstacle is insufficient knowledge and misconceptions among health care providers about Parkinson’s disease and myths that Parkinson’s disease is contagious or a normal consequence of aging.

WHO response

In May 2022, the World Health Assembly approved the Global Action Plan on Epilepsy and other Neurological Disorders. This Action Plan will try to solve the challenges and deficiencies that exist worldwide in the provision of care and services to people with epilepsy and other neurological disorders, such as Parkinson’s disease, and will ensure a comprehensive and coordinated response in all the sectors. This includes prioritizing policies and strengthening governance, providing effective, timely and responsive diagnosis, treatment and care, implementing promotion and prevention strategies, fostering research and innovation and strengthening information systems. 

The WHO technical report Parkinson disease: a public health approach may be consulted by policymakers , health program managers and planners, health care providers, researchers, people with Parkinson’s disease and those who care for them, and other stakeholders. The report outlines important Parkinson’s disease action areas that require action, including global health policies focused on prevention and risk reduction, education and awareness, and access treatment and health care at different levels of health systems.

WHO iSupport, which is a skills and knowledge training program for caregivers of people with dementia, is available in both online course and printed manual formats . iSupport Lite comprises easy-to-read posters and a short video that can serve as a quick reference or refresher, reinforcing previously acquired knowledge and skills in caring for people with dementia.

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