According to the Parkinson’s Foundation, more than one million Americans are currently living with Parkinson’s disease, and nearly 90,000 new cases are diagnosed each year. The condition is significantly more prevalent in adults over 60, making it an important issue for older adults to be aware of.
In recognition of Parkinson’s Awareness Month, this guide will help you understand what Parkinson’s disease is, how to distinguish its early warning signs from normal aging, and what can be done to manage symptoms and maintain quality of life.
What Is Parkinson’s Disease?
Parkinson’s disease is caused by the gradual loss of dopamine-producing cells in the brain. Dopamine is a chemical messenger that enables smooth, coordinated movement. When dopamine levels decrease, it becomes harder for the body to move the way it should. This causes the stiffness, slowness, and tremors commonly associated with Parkinson’s disease.
Alongside motor symptoms (those affecting movement), Parkinson’s disease also produces a range of non-motor symptoms, including disrupted sleep, changes in mood, cognitive shifts, and digestive issues. However, the condition progresses differently in every individual. Some people experience mild symptoms for many years, while others face more rapid functional changes. No two cases look exactly alike, which is part of why the condition can be easy to miss in its early stages. While the exact cause of the dopamine-cell loss is not yet fully understood, age is the greatest known risk factor.
Parkinson’s Disease Symptoms vs. Normal Aging: How to Tell the Difference
Some early symptoms of Parkinson’s disease can come on gradually and be easy to overlook. Learning the differences between age-related changes and the warning signs of Parkinson’s disease can help you take action sooner.
Common early symptoms of Parkinson’s disease include:
- Resting tremor: A rhythmic shaking that occurs when the hand is relaxed and still.
- Micrographia: Handwriting that becomes progressively smaller and more cramped.
- Bradykinesia: An unexplained slowness of movement that makes daily tasks feel like they are being performed underwater.
- Changes in posture or gait: A slightly stooped posture, reduced arm swing while walking, or a shuffling stride where the feet do not lift fully off the floor.
- Reduced facial expression: A “masked” face that may appear flat or expressionless, even when the person is emotionally engaged.
- Loss of sense of smell: In some people, this symptom can show up years before motor symptoms.
- Voice or speech changes: A voice that becomes softer, more monotone, or harder to hear in conversation.
- REM sleep behavior disorder: Physically acting out vivid dreams (talking, shouting, or moving during sleep).
To distinguish these from normal aging, look at the nature of the change. For example, it is normal for joints to get stiff with age, making it a bit harder to get out of a low sofa. However, in Parkinson’s disease, the slowness is more profound. Simple tasks like buttoning a shirt or cutting food become unexpectedly difficult and time-consuming, regardless of joint pain.
Similarly, many people develop a slight “essential tremor” as they age. Their hands might shake slightly when reaching for a cup of tea or threading a needle. A Parkinson’s tremor is usually a “resting tremor,” meaning the hand shakes when idle, but stops during purposeful movement.
Guideline: When symptoms appear primarily on one side of the body (asymmetry), worsen over time and begin to interfere with your ability to perform daily chores or enjoy hobbies, it is time to speak with a doctor. Asymmetric onset is a hallmark feature of early Parkinson’s disease.
Management Strategies for Parkinson’s Disease
With the right care planning, many people with Parkinson’s disease live full, enriching lives for years after diagnosis. There are several key pillars for managing the condition.
- Medication: The most common medications work by increasing dopamine availability in the brain or by mimicking its effects. Taking medication on schedule is important, as fluctuations in dopamine levels will affect symptom control. Side effects should be monitored closely and discussed with your neurologist, as adjustments are common over time.
- Exercise: Research has consistently shown that regular physical activity can slow functional decline in Parkinson’s disease. Types that are particularly well-supported include: aerobics, treadmill training, progressive resistance training, dance, tai chi and yoga.
- Speech therapy: Many seniors with Parkinson’s disease notice their voice “fading.” Two widely validated speech treatment programs are SPEAK OUT!® (one-on-one therapy) and LOUD Crowd® (group therapy). Both focus on increasing vocal loudness and clarity in Parkinson’s disease patients, and both are used at our Joseph Gringlas Center for Integrated Rehabilitative Medicine.
- Occupational therapy: Experienced therapists can recommend adaptive utensils that reduce the impact of tremors at mealtimes, suggest techniques for dressing and grooming that work around slowness, and help modify the home environment to improve mobility.
- Diet: A diet rich in fiber, antioxidants, and omega-3 fatty acids is generally recommended to support overall brain and gut health (dopamine plays a role in gut motility). It is also important to talk with your doctor about how food interacts with your specific medications. Some medications are better absorbed with an empty stomach, while others may cause nausea and work better when taken with food.
- Sleep: Prioritizing sleep hygiene is essential because Parkinson’s disease can disrupt sleep cycles. Keeping regular sleep and wake schedules, avoiding caffeine after midday, reducing evening light and screen exposure, and ensuring a cool, comfortable bedroom can promote better sleep and help manage daytime symptoms.
- Mental health support: Depression and anxiety are common in Parkinson’s disease and are partly neurological in origin. Therapy, peer support groups (such as those offered through the Parkinson’s Foundation’s PD Conversations community), and open conversations with your care team about emotional wellbeing are all important components of comprehensive care.
How Caregivers Can Support a Loved One with Parkinson’s Disease
Caring for someone with Parkinson’s disease requires both practical knowledge and patience. Your loved one’s healthcare team will be able to provide advice specific to their symptoms and circumstances. However, there are a few general tips that will help you provide better support.
For example, people with Parkinson’s disease may experience a symptom known as Freezing of Gait (FoG). This is a sudden, temporary inability to move the feet, often described as feeling like they are “glued to the floor.”
FoG is often triggered by doorways, turning around in tight spaces, or feeling rushed/stressed. To help, try these strategies:
- Rhythmic cues: Use a steady beat. Say “left, right, left” or hum a marching tune.
- Visual cues: Use grout lines, floor tape, or a laser pointer cane to project a line on the floor for them to step over.
- Do not rush: Never pull or push a person who is frozen. This can cause a fall. Instead, encourage them to shift their weight from side to side before trying to step.
In the home, look for opportunities to improve safety and mobility. Remove loose rugs, clear clutter from walkways, install grab bars in the bathroom, and ensure the home is brightly lit. Consider requesting a professional home safety assessment through an occupational therapist, who can identify hazards you may not notice.
Parkinson’s disease affects the muscles of the face and throat, which can slow down speech. Be patient. Give your loved one extra time to process and respond. Resist the urge to finish their sentences – it can feel dismissive, even when well-intentioned. If communication becomes significantly impaired, a speech therapist can provide strategies for both the patient and their family.
