Parkinson’s remains such an enigmatic and idiosyncratic condition. It is a degenerative disease of the brain which results in the progressive death of specific brain cells leading to a range of neurological symptoms manifest in problems with movement, speech, cognition, mood and a variety of other complications. There are no definitive tests for Parkinson’s; it is diagnosed clinically by specialists based a patient’s history, symptoms and the exclusion of other potential diagnoses. While there are good symptomatic treatments, there is no cure or definitive way to identify those at risk.
Considered the fastest growing neurological disorder in the world, Parkinson’s currently affects over 8.5 million people, a number that has doubled in the past 25 years and will continue on its devastating path unless we increase our understanding of the disease and how we can best combat it. This will require a multi-pronged and multi-disciplined approach.
There is still great mystery surrounding Parkinson’s: Why do people develop it? How can we improve treatments? Why can’t we stop, slow or reverse the progression of the degenerative process? Why is it so difficult to diagnose? How can we predict the trajectory of disease? To answer these and the many other questions posed by people living with Parkinson’s, their families, carers and friends, we need to start with a better recognition and appreciation of the condition.
Named after the surgeon and apothecary Dr James Parkinson, who in 1817 described the first cases in the Western medical literature, Parkinson’s has historically and mistakenly been passed off as an old person’s condition, characterised solely by movement symptoms of tremor, slowness and stiffness together with postural instability. But it can impact anyone at any age. And there is so much more to this insidious and devastating malady than movement symptoms. As described in Elizabeth’s story above, the most debilitating symptoms are often the less-recognised, non-motor symptoms, particularly those including anxiety, depression and cognitive dysfunction that are very prominent in many people living with Parkinson’s. Each person’s Parkinson’s is different. It impacts the individual and those around them in unique ways. Treatment strategies and symptom management need to be individually tailored for the best results – something that is often almost impossible for people without access to the full suite of medical and allied health professionals with expertise in the area. Indeed, even receiving a timely and accurate diagnosis remains challenging for many in Australia, let alone those living in countries with less advanced and equitable health systems.