Michael J. Fox and Muhammad Ali are two most wellknown celebrities who were diagnosed with Parkinson’ s.

Early diagnosis vital as the disease is not part of ageing

BY NURUL AIN HUDA ABDULLAH

N estimated seven to 10 million people live with Parkinson’ s disease worldwide. These includes famous actors such as Neil Diamond who announced in January 2018 that he was ending his 50th anniversary world tour due to being diagnosed with the disease. Other famous people include actor Michael J. Fox and heavyweight boxing champion Muhammad Ali.

Pantai Hospital Kuala Lumpur consultant physician and geriatrician Dato Dr Rajbans Singh explained that Parkinson’ s is a disease frequently affecting older people, however there are young people who can be diagnosed with it in their 40’ s.

Although most of the time the cause is unknown, he said that the deficiency of dopamine in the substantia nigra associated with cellular death results in Parkinson’ s disease.

“ It can be environmental and it can also be caused due to repeated trauma to the brain as in the case of Muhammad Ali.”

Parkinson’ s signs and symptoms

• The symptoms are very characteristic which include a tremor, or shaking which usually begins in a limb, often the hand or fingers. You may notice a back-and-forth rubbing of the thumb and forefinger, known as a pill-rolling tremor.

• While a tremor may be most wellknown sign of the disease, the disorder also commonly causes slowed movement known as bradykinesia where your steps may become shorter when you walk, or you may find difficulty getting out of the chair.

• Muscle stiffness may occur in any part of the body which can limit your range of motion and cause pain.

• Loss of automatic movements such as a decreased ability to perform unconscious movements including smiling or even swinging your arms when you walk.

• Impaired posture and balance due to the shuffling of the gait. The disorder is often accompanied with increased sweating, constipation and depression. There are typical patterns of progression which is defined by stages. These include:

Stage 1 Where a person has mild symptoms that generally do not interfere with daily activities.

Stage 2 Symptoms at this stage get worse where tremor, rigidity and movement is affected on both sides of the body.

Stage 3 During this stage, a person may suffer loss of balance and slowness of movements which basically impairs activities such as dressing and eating.

Stage 4 At this point, symptoms are severe that a person may get wheelchair bound. They would also need assistance with

activities of daily living and is unable to live alone.

Stage 5 The most advanced stage, the person would be bed bound and need complete care from feeding to toileting.

Treatment

Rajban explained that the aim of treatment is to delay the progression of the disease by keeping them involved in activities of daily living to make sure that they can manage their normal functioning as long as possible.

“ However, the treatment for younger and older patients can be different. Usually, a younger patient will be cared for by a neurologist. If we treat them with drugs too early, after 10 – 15 years they might have a losing effect which is known as an on-off phenomena. So we tend to delay that.”

“ But older patience, it would be more of a symptom relieve and they would be put on dopamine drugs to regulate the chemicals in the brain that controls the movements. The other treatment would be physiotherapy and exercise to get them to mobilise and balance themselves and prevent falls,” he explained.

Meanwhile, he stressed on the importance of an early diagnosis as Parkinson’ s is not a part of ageing.