¶ … PARKINSON'S DISEASE UNDERSTANDING THE PARKINSON'S DISEASE

Understanding Parkinson's disease

Description

Parkinson disease is a progressive neurological problem that affects people of all ages and races. It is a very common condition. It is estimated that about 70, 000 Australians live with this disease. The average diagnostic age is 65 years, however, that does not rule out the possibility of young people developing Parkinson. In young people, the condition is known as Young Onset Parkinson Disease. Diagnosing Parkinson disease is not an easy task. There are no known laboratory tests like brain scan or blood test, so it is important to ensure a specialist such as a neurologist carries out the diagnosis. The specialist is expected to look for any known physical signs of the condition and take the detailed history of the symptoms of Parkinson's disease. There is still no known cause of Parkinson's disease in people. Many theories exist as to why people develop this condition, most of which amount to the belief that several factors could be responsible. One underlying cause of the symptoms of this condition is related to a reduction in the production of the important brain chemical known as dopamine. Most of the brain cells responsible for the production of dopamine is the Basal Ganglia found at the centre of the brain. Lack of dopamine implies that people cannot move freely. The symptoms of Parkinson's disease build up quite slowly and progress gradually with time. Every individual is affected in a different way by the disease and the rate of progression varies from one individual to another. Naturally, Parkinson's disease does not kill people, so living with the condition for a very long time is possible, though symptoms worsen with age (Parkinson's Australia, n.d).

Incidence/Prevalence

There is no available data for ascertained PD diagnosis that can be employed for the estimation of the prevalence of this condition. This is due to the unavailability of any definitive test to confirm PD diagnosis, which leads to the possibility of misdiagnosis or under-diagnosis. The technique employed in the 2007 Access Economics research to evaluate the prevalence of PD was gotten from the analysis of Pharmaceutical Benefits Scheme (PBS) data. Conservatively, it was estimated that over 54, 700 Australians had PD in 2005. About 8,900 new cases were believed to have developed in 2005. Incidence is about how many new PD cases reported. The Access Economics research of 2007 estimated 2005 incidence employing the same methodology as Begg et al., (2007), depending on the prevalence rate estimated, the remission rate of which was believed to be zero as well as the relative mortality risk. The Access Economics research of 2007 estimated that there were approximately 8, 900 new PD cases in 2005. Employing the demographic data of 2011 to the 2007 estimated incidence rate, an estimated incidence PD from 2010-2011 was put at 10, 500 (Deloitte, 2011).

Classification

Sometimes, Parkinson's disease is described as early, moderate or advanced. Early condition is when an individual experiences minor tremors or stiffness but can still carry out daily tasks and every other important activity. People who have been newly diagnosed with the condition are in this category. Moderate condition describes individuals who start experiencing limited movement. A person with moderate PD may experience moderate tremors and very slow movements. Advanced condition describes the stage when the individual becomes obviously limited in his/her activities, irrespective of treatment.

Daily symptom changes, medicine adverse effects that hinder treatment, and lack of independence in daily life activities are quite common. A person suffering advanced Parkinson's disease may experience severe problems with speech, posture and movement (Parkinson's Disease Health Center, n.d).

Epidemiology

The etiology of most Parkinson's Disease (PD) is still unknown, with several theories on genoenvironmental communication being proposed. The incidence and PD prevalence is known to exponentially increase with age, and are a little bit higher in men than they are in women. Several putative risk factors can be linked to PD; age is the most consistently accepted factor. A major proposed risk factor is exposure to pesticides, while an inverse relationship existing between coffee consumption and smoking and PD has been reported in other studies. More cases of PD appear in Older people (Lai & Tsui, 2001).

Both the incidence and prevalence of PD are known to greatly vary among different age groups. PD is far less common in people below the age of 50 and steadily increases after that until the 9th decade. The reduction in most elderly people in some researches possibly come from the few...

Though differences that are gender-specific show higher variability than relationship with higher age, PD seems to be a slightly more common in men than they are in women according to most of the studies, mostly between the ranges of 1.2:1 ratio-1.5:1 ratio.
Though PD patients' life expectancy has been increased, PD patient's life span is still a bit less than the life span of the overall population. Increased survival from the introduction of efficient symptomatic therapies and delayed or decreased mortality from other health problems may be partly responsible for the reduced mortality rate in younger individuals.

Risk factors

Though the main cause of PD is still not clear, several factors have been linked to decreased or increased PD risk. Demographic factors like age, gender, and race are linked to higher PD risks. A significant factor in a number of epidemiological PD studies is family history, and the estimated correspondence family history falls between the ranges of 5%-6% (Lai & Tsui, 2001). All family-related PD cases is not linked to genetic conditions really, since families are known to share the same environmental conditions most times. According to suggestions from different studies, environmental factors play very important roles in PD causes. For example, in several families, so many family members with varying ages developed PD in short timeframes. The biggest twin research until date reported that these genetic factors seem to be quite important when the disease starts when the patient is below the age of 50. Though the indication from twin studies show that these genetic factors play vital roles in causing PD cases, studies carried out of a large kindred with cases of PD have reaffirmed the role of several genes like ?-synuclein and parkin (Lai sui, 2001). While emotional stress, head injury, premorbid personality, etc. have been associated with PD in several reports, the links between them and PD have remained a bit controversial due to the fact that difficulties experienced in recall bias, diagnosis and accuracy, and long period of time between an injury event and the development of PD.

Contrary to common assumptions, a current longitudinal research on 8004 subjects spanning 30 years of follow-up discovered a very notable inverse relationship between PD incidence and higher caffeine and coffee consumption with a dose-response relationship. Those who never drank coffee stood five times more risks when compared with people who drank about 28 ounces of coffee per day. The impact continued even after adjusting the results for smoking (Lai & Tsui, 2001).

Some considered possible causes of PD are infectious agents because encephalitis lethargica always preceded Parkinson Disease during the 1920s influenza pandemic. In recent times, a PD occupational risk factors study in British Columbia discovered that schoolteachers and health care workers have increased risk of PD quite significantly, and suggested that this observation might probably reflect increased exposure to some viral infections that affect the respiratory tract while touring around health centres and schools. Nevertheless, recall bias and referral bias could not be entirely ruled out in this study because the sample depended on the number of people attending a specialized referral medical facility. Additional studies with more direct and extensive exposure to respiratory ailments measures are needed to validate the results (Lai & Tsui, 2001).

According to the Australian data showed that PD was a major cause of death between 2000 and 2009 (latest data available). By 2009, 1, 194 individuals died from idiopathic PD, and another 12 people died from secondary PD (Australian Bureau of Statistics, 2011). From 2008, the number fell, when 1, 283 deceased people were found to have died from idiopathic PD while 8 died from secondary PD. The trend from 2000 to 2009 showed death rate with underlying causes as either idiopathic or secondary PD rising by 5% yearly (Deloitte, 2011). Though the death rate on specific statistics based on population has been utilized to carry out the examination of both the geographical PD distribution and the time trends, only 37% of patients with PD were found by Lai and Tsui as having died from PD as the major cause of death. The reason here is, PD on its own is not a major cause of death (Lai & Tsui, 2001).

Neuropathology

PD-Parkinson's disease is a progressive neurological problem characterized by a medical syndrome by bradykinesia, postural instability, rigidity, and tremor. The common symptom is the loss of dopaminergic neurons of the substantianigra projecting to the putamen. Most of the common prevalent degenerative disorders begin…