PD patients a challenge for caregivers
Parkinson’s disease is a growing concern with more than 70 lakh cases globally, which is expected to double by 2050.
World Brain Day falls on July 22.
What is Parkinson's disease (PD)?
It is a common degenerative and slowly progressive disorder of the brain caused reduction in the dopamine producing cells. It causes a great deal of disability and suffering to both the individual and the caretaker/family.
Which population is affected?
Most of the people diagnosed with PD are beyond
50 years of age. However a minority (5-10 per cent) may be young (less than
40 years). Men are more likely to develop Parkinson’s disease than are women.
Is there a cause?
The exact cause of PD is still not known, there is ongoing research in this field. People with a family history, head injury, brain stroke, those working with the mining industry, exposure to pesticides are some of the predisposing factors have been associated with the disease.
What are symptoms of Parkinson’s disease?
T (tremors i.e. shaking of one side), R (Rigidity i.e. stiffness in the body), A (akinesia or slowness of all movements) and P (postural instability i.e. difficulty with balancing and walking) are the symptoms affecting movement. Non-motor symptoms like loss of smell, dream enacting, depression, anxiety, constipation, dizziness and fainting may precede the motor symptoms
How is PD diagnosed? A neurologist will diagnose Parkinson’s disease based on the history and neurological exam. A positive response to the drug levodopa confirms the diagnosis. The neurophysician may also ask for an MRI brain and blood tests when indicated. Dopamine transporter scan (DaTscan) is a special nuclear scan used rarely when there is a diagnostic dilemma.
How do you treat PD? Treatment includes drugs, exercise and a healthy lifestyle. Teamwork involving neurology, psychology, physiotherapy, occupational and speech therapy provides holistic care to PD patients. Recently, newer drugs and injections have been made available for PD. In advanced PD, brain surgery (deep brain stimulation) remains an option in selected individuals.
Any concerns for PD patients pertaining to the Covid-19 pandemic? Most of the PD population being aged is at risk. If one is exercising regularly at home and following the neurologist’s prescription, one need not fear. Online consultation with the neurologist is preferred during this pandemic.
Any advice for the caretaker
Caring for our loved ones with PD is an emotionally and physically daunting task. The caregiver may have to face many challenges as the disease progresses as PD patients may become moody, hallucinate, start doubting you (delusion) and may forget you. Mental preparation and counselling for these challenges in advance may help the caretaker cope up better and prevent burnout.
What are the surgical options for Parkinson’s disease?
In selected individuals with advanced PD who have intolerable sideeffects to medicines, a team of doctors will evaluate the suitability for surgery. Deep brain stimulation (DBS) involves implantation of an electrode to stimulate targeted regions of the brain with electrical impulses generated by a batteryoperated neurostimulator. In simpler words, it is a pacemaker for the brain.
DBS is generally safe, but there is a low risk of complications due to anesthesia, infection, stroke, or cranial bleeding. Most of the carefully selected candidates do well after DBS.