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Parkinson's Disease


Written by Verneda Lights and Elizabeth Boskey, PHD on May 9th, 2012. Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP.


Parkinson’s disease (PD) is a progressive neurological disorder. It first presents with problems of movement. Smooth and coordinated muscle movements of the body are made possible by a substance in the brain called dopamine. Dopamine is produced in a part of the brain called the “substantia nigra”. In PD, the cells of the substantia nigra start to die. When this happens, dopamine levels are reduced. When they have dropped to 60 to 80 percent, symptoms of PD start to appear.

There is no cure for PD. This disorder is chronic and worsens over time. More than 50,000 new cases are reported in the US each year. The actual incidence may be even higher, since PD is often misdiagnosed. The Center for Disease Control reports that PD complications are the 14th major cause of death in the United States.


Certain groups of people have an increased risk of PD. Men are on and a half times more likely to get PD than women. Whites are more likely to get PD than African-Americans or Asians. This disease usually appears between the ages of 50 and 60. It only occurs before the age of 40. People with a family history are more likely to develop this disorder.


Some of the earliest symptoms of PD are decreased ability to smell and constipation. These symptoms can precede motor problems by several years. The four major motor problems seen in PD are: tremors (shaking that occurs at rest), slow movements, stiffness of arms, legs, and trunk and problems with balance and a tendency to fall. Secondary symptoms include: blank facial expression, a tendency to get stuck when walking, small or cramped handwriting, muffled or low-volume speech, decreased blinking and swallowing, tendency to fall backwards and reduced arm swinging when walking.


People with PD have problems with activities of daily living. Doctors at the Mayo Clinic have recommended a number of very simple steps to help patients with PD move around and walk more safely. To improve walking: walk carefully, pace yourself, let your heel hit the floor first and check your posture and stand up straight. This will help you shuffle less. To avoid falling: don’t walk backwards, don’t carry things while walking, avoid leaning and reaching and don’t pivot on your feet. When getting dressed: allow yourself plenty of time to get ready, select clothes that are easy to put on and take off, try using items with Velcro instead of buttons and try wearing pants and skirts with elastic waist bands.

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