Parkinson's disease takes its name from the physician who identified and described it as a distinct condition in 1817. It is now widely known to the general public, not least because Pope John Paul II suffered from it in his final years, yet many of its aspects remain misunderstood and fuel persistent myths.
People often think it is a disease of the elderly. In fact, it appears most frequently between ages 55 and 70. It is not uncommon—roughly 20 percent of cases—in people under 50, and occasionally strikes younger people still. In those over 75 (about 20 percent of patients), the disease typically progresses slowly and mildly.
The main symptoms are a general slowing of all movement (bradykinesia) and loss of the ability to perform everyday activities that require motor coordination, balance, and posture. Watch a child from six months to two or three years old, and every parent sees something revealing: the movements an adult performs "automatically" are learned gradually. They require constant practice before becoming truly automatic. Parkinson's strikes exactly these capacities that a child learns unconsciously.
Tremor—the most visible symptom, and deeply troublesome both for the patient and those nearby—actually occurs in only about half of those affected.
As the disease progresses, its cause still unknown, other non-motor symptoms may appear: urinary and intestinal problems, low blood pressure, difficulty coordinating various daily activities, diminished voice, slowed speech.
The biological mechanism producing such varied symptoms—different from person to person—stems from the degeneration and eventual death of certain nerve cells that produce a chemical messenger called dopamine. The brain contains a small region where these cells are particularly abundant. The disease manifests clinically only when less than 20 percent of a person's dopamine-producing cells remain.
Fortunately, scientists discovered the missing substance in the 1960s. Soon after, medications were developed to supply the body with this precious dopamine. Drug therapy transformed the quality of life for patients, who today can live nearly normal lives for many years after their diagnosis.
But "Mister Parki," as many patients affectionately call it, is an unwelcome lifetime companion who never leaves. What strikes me most when speaking with someone who has Parkinson's is the sense of constantly moving between death and life—or the simple difficulty, when medication wears off, of performing ordinary acts: rising from a couch, turning in bed, eating properly.
Alongside medication, rehabilitation therapies are essential: physical therapy, speech therapy, occupational therapy. These help the person with Parkinson's—not just the "patient," but the whole person—overcome difficulties and feel autonomous as long as possible.
Equally important is involving family members, especially spouses. They provide practical help during difficult moments and help the person resist isolation stemming not only from motor problems but also from loneliness, frustration, anger, and feelings of inadequacy. Together, patients and families can continue to feel active and useful in society and in life.
Dr. Valeria Levi della Vida, 2006
Vice President, Azione Parkinson Association