What is Parkinson’s disease?

Parkinson’s disease is a progressive neurological condition caused by the breakdown or death of nerve cells (neurons) in a specific part of the brain called the Substantia Nigra. These cells, when healthy, produce an essential hormone called dopamine, so when enough of these cells are gone, there is no longer enough dopamine being produced.

Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease. Despite a great deal of research, scientists still don’t know exactly what causes the death of these nerve cells, but many experts think that a combination of genetic and environmental factors is responsible.

Genetics – although scientists have managed to identify specific genetic mutations that cause Parkinson’s disease, they are not common in every sufferer. In fact, they are relatively uncommon except where certain families have high numbers affected by Parkinson’s disease.

They have also identified other gene variations that do appear to increase the risk of Parkinson’s disease but not with any degree of certainty.

Environmental triggers – exposure to certain toxins, pollution and other environmental factors have been shown to increase the risk of Parkinson’s disease in later life, but again, there is only a small correlation.

Risk factors

There are a number of risk factors that make Parkinson’s disease more likely and these include the following:

  • Age:as people get older their risk of experiencing Parkinson’s disease increases. It is relatively rare for younger adults to be diagnosed. The normal age for developing the condition is around 60 or over.
  • Hereditary:as already stated there is a small risk of inheriting Parkinson’s disease from parents, but unless you have a family with very high degrees of the condition it is unlikely this will happen.
  • Sex:men develop Parkinson’s disease more commonly than women.
  • Exposure to toxins:ongoing exposure to certain pollutions, herbicides and pesticides are believed to slightly increase the risk of Parkinson’s disease.


Like many conditions the specific symptoms individual people experience will vary, some of the early symptoms may be so mild that it is only in hindsight that people realise they had them. However, this is a progressive condition and the symptoms will become more apparent over time.

In some cases symptoms may only begin on one side of the body, that first side will often remain the most serious even when symptoms are prevalent on both sides.

The most common symptoms include:

  • Tremor –a tremor or shake is often the earliest sign of a problem, normally this starts in the arms or legs often in the hands or fingers. Many people start rubbing their thumb and forefinger together, this is known as a “pill-rolling tremor”. When not “pill-rolling” their hand may tremble.
  • Slowed movement (bradykinesia) –as the condition progresses the disease often slows the individual’s movement, making even the simplest of tasks hard and time-consuming.
  • Difficulty walking other than the tremor the most common outward sign of Parkinson’s disease is the change it makes to the way you walk. There is a significant change to the gait, steps become shorter and they often drag their feet. Often the first sign of the condition is the stopping of arm swinging when walking.
  • Stiff muscles –again, this is a progressive symptom and the muscle stiffness people experience will get worse over time.  This may occur in any part of the body causing pain and a reduction in range of movement.
  • Change posture – people’s posture often changes over time with a noticeable stoop often developing.
  • Impaired balance – an apparent clumsiness presents itself especially in the form of poor or reduced balance.
  • Loss of automatic movements – several unconscious movements we all take for granted often become more difficult, and in some cases impossible, without conscious thought. These include blinking, smiling, or swinging arms when walking.
  • Change to speech – speech may become slurred, softer than before or even include an element of hesitation before talking. Other people lose the capacity to use intonations and develop a monotone.
  • Change to handwriting. Handwriting may change and become ineligible, often becoming really small.

Long-term prognosis

Parkinson’s is a progressive disease and as it advances people are going to need ever-increasing assistance. The long-term care needs need to factor in an increasing severity of the above symptoms which will start to severely limit an individual’s capacity to look after themselves.

Eventually they will need support and assistance including personal care, emotional support and help with a complicated medication schedule.

How to care for someone with Parkinson’s disease

Medication for Parkinson’s sufferers does not cure the condition, but it can assist with the management of their symptoms. Medication can also improve their functions, assist with independence, and improve the quality of their lives.

In those that have more advanced Parkinson’s disease, individuals may have real difficulty with sleep and experience night agitations.  In those cases, it is normal to need assistance from a waking night-time carer.

As the condition progresses, initially domiciliary care will probably be required, which will need to be steadily increased before needing to consider residential care, such as a nursing home.

For more information or if you wish to discuss care for your loved one please email care@greensleeves.org.uk