Stages of Parkinsons Disease - Research Paper Example

Parkinson’s disease Parkinson’s disease Part I Parkinson’s disease (PD) or Primary Parkinsonism is a disorder involving the progressive degeneration of neuromelanin cells located in the brainstem (Merritt, 2010). In particular, the affected area is the ventral tier of the pars compacta in the locus ceruleus and substantia nigra (Merritt, 2010). One pathognomic feature of the remaining neurons in patients suffering from Parkinson’s disease is that they contain Lewy bodies. These are protein whose main structural component is alpha synuclein. At the early stages of the disease, the patients remain asymptomatic and the first signs only begin to show after approximately sixty percent of the dopaminergic neurons have been destroyed (Merritt, 2010). In addition, at this stage dopamine levels are approximately eighty percent below normal values. The exact etiology of PD is unknown, however, the disease has been found to have some genetic predisposition. The epidemiology of PD illustrates a bell shaped graph with ages of affected individuals ranging from twenty to eighty years. The average age of affected individuals is approximately fifty five years. The disease is more prevalent among males with a ratio of 3:2 (Wirdefeldt et al., 2011). The disorder is also more common among the elderly, with juvenile PD occurring rarely between individuals aged twenty to forty years (Wirdefeldt et al., 2011). Despite the conflicting findings, the majority of studies show the similarity in prevalence among both Whites and non-Whites. The total prevalence of the disorder is approximately 160 cases for every 100 000 individuals (Wirdefeldt et al., 2011). In addition, there are approximately twenty new cases annually for every one hundred thousand individuals (Wirdefeldt et al., 2011). There are several signs that are associated with PD; however, there are three main characteristic features of the disorder. The first sign to occur among the patients is resting tremor which takes place in approximately 70% of Parkinson’s cases (Merritt, 2010). The onset of the disease is insidious, with symptoms being unilateral at the onset and then bilateral as the disease progresses. However, it is worth noting that the disorder has the possibility of remaining unilateral in some rare cases. Other signs displayed by PD patients include bradykinesia and hypertonia (Merritt, 2010). PD patients may also display signs of behavioral changes, reduced attention span, and personality changes such as the development of a fearful character, dependency, and reduction in visuospatial impairment. There are also signs of depression among PD patients as well as slight cognitive impairment which is not as marked as in other neurodegenerative disorders like Alzheimer’s disease (Cummings, 1992). PD patients have an intact memory; however, they often display signs of bradyphrenia. Some signs of impairment of sensory function are noticeable in PD patients, however, these are just subjective and the objective impairment of sensory function is not noticeable. There are also autonomic disturbances and some reflexes may also be diminished. The current treatment for PD is only symptomatic, and aims to reduce the progression of the disease as well as improve the patient’s quality of life. The groups of drugs used in the treatment for PD include dopamine agonists, levadopa, carbidopa, COMT inhibitors, and anticholinergics (Merritt, 2010). The treatment plan depends on the stage of the disease and the age of the patient. Part II The alarm rings, and just like every other day he wakes up early in the morning at 5am. This is not by choice as he requires a significant amount of time to get mentally and physically ready for the day. In fact, in the last few months he needs some assistance in doing up his buttons and tying his shoe laces. Regardless of the long hours he takes to prepare for his day, he is grateful that he is still capable of performing these activities. He wakes up feeling stiff, not knowing how his body will react during the day. He immediately has the thought to take some drugs that will help loosen him up; however, at the back his mind he feels it may be too early. He has read many articles indicating the adverse effects of this medication and how it may worsen his condition and natural coping mechanisms. There is just too much research and contradicting information online that he does not know what to believe. He hardly got any sleep last night and his body longs for the peaceful, uninterrupted nights of his teenage years. Its funny, one might ask why a 67 year old man who spends his day at home doing absolutely nothing would need any rest at all. Mr. X was diagnosed with Parkinson’s disease eight years ago when his hands adopted a mind of their own and began to shake on their own accord. Only his movements could put an end to these tremors. At first these tremors bothered Mr. X, however, now he has learnt to cope with them. Furthermore, the amantadine is helpful in reducing their severity. Most people at this age have a day dominated by long walks in the park and endless conversations with friends and grandchildren. However, this is not the situation for Mr. X as there are things in his life which limit his freedom and daily activities. He wonders if the medications he has for his stiffness will be enough to even get him through the day as they continue to lose their effect. He must choose the appropriate time to take the medication to ensure that it will give him enough time to get through his daily activities. He once dreamt of long walks in the park after retirement, however, he knows that soon these will only be a mere figment of his imagination. Instead of playing with his grandchildren, he knows soon he can only watch them play. The toll of all these fears of the future is too much for him to bear and make him depressed during the day when he has time alone to think. These are the typical feelings an individual with PD experiences on a daily basis, and as the disease progresses they get worse. It is essential for members of the community to be supportive of PD patients as they are sometimes reluctant to ask for assistance despite the fact that they need it. References Cummings, J. L. (1992). Depression and Parkinsons disease: a review. The American journal of psychiatry. Merritt, H. H. (2010). Merritts neurology. L. P. Rowland, & T. A. Pedley (Eds.). Lippincott Williams & Wilkins. Wirdefeldt, K., Adami, H. O., Cole, P., Trichopoulos, D., & Mandel, J. (2011). Epidemiology and etiology of Parkinson’s disease: a review of the evidence.European journal of epidemiology, 26(1), 1-58. Read More