Old age comes with its own set of challenges. As the individual grows older, certain reflexes, bodily functions, movement, balance, speech, etc. are affected. With Parkinson’s disease (PD), the intensity of these symptoms may be augmented. Studies show that age-related damage of the somatic nervous system (responsible for voluntary movement) combined with the deterioration of supporting mechanisms can lead to the acceleration of PD with age.
Simply put, normal ageing doesn’t necessarily have a fixed pattern to it. But Parkinson’s ageing will have some predictable deterioration in motor function, balance, etc. An 80 year old may be able to run the marathon. But an 80 year old with advanced PD will not be able to compete in a marathon.
In this article, we will discuss the similarities and the differences between normal ageing and Parkinson’s ageing.
What is Parkinson’s?
Parkinson’s is a chronic and degenerative brain disorder that impairs muscle control, balance, and movement. PD causes the cells in substantia nigra (in the basal ganglia) to deteriorate, thereby inhibiting the brain’s ability to produce dopamine. As the disease progresses, the neurons in the brain completely deteriorate, causing severe motor impairment, tremor, stiffness, slowed or delayed movement, dysphagia, sleep issues, fatigue, difficulty in speech, and so on.
Although anyone is at the risk of getting PD, age is still the largest risk factor.
Symptoms of Parkinson’s
The three main motor symptoms of Parkinson’s are:
- Tremor: uncontrollable and unintended shaking that affects a body part is one of the most common and main symptoms of Parkinson’s.
- Dystonia or stiffness: this occurs when the brain sends incorrect signals to the muscles getting them to contract, and become tighter and shorter than normal.
- Bradykinesia or slowed movement: loss of muscle control results in muscle weakness and deterioration.
Other symptoms include:
- Reduced blinking
- Drooling
- Hypomimia or masked face
- Dysphagia
- Micrographia or small handwriting
- Hypophonia or unusually soft voice
- Dyskinesia or involuntary movement such as jerks, twitches, and twisting movements that are uncontrollable
- Dizzy spells (attributed to levodopa-based treatments)
- Stooped posture
- Shuffling of feet, stopping short or inability to take steps ahead (freezing), and quickened pace with short steps.
- Difficulty in standing up after sitting for a long duration and vice versa
The role of age in the clinical progression of PD
Research indicates that age plays a critical role in the clinical progression of Parkinson’s. Advancing age is directly linked with a faster rate of decline in motor function, reduced levodopa responsiveness, impaired gait and posture, development of dementia, and cognitive impairment in patients with PD.
Decline in motor function
Several cross-sectional studies have indicated that patients with a later onset of PD have shown faster decline in motor function than those with an earlier onset.
Levodopa responsiveness
Levodopa is an amino acid that is converted to dopamine and is generally the most prescribed treatment for Parkinson’s. Several studies have demonstrated a lesser degree of response (to the treatment) in older patients than in younger patients.
Gait and Postural Impairment
Postural and gait impairment are not always resolvable by levodopa therapy, especially for patients in the middle and later stages of PD. On the other hand, symptoms like rigidity, bradykinesia, and tremors have responded to levodopa at all stages of the disease. This may be regarded as one of the reasons for old age being a major factor in the clinical progression of PD.
Development of dementia and cognitive impairment
Several cross-sectional neuropsychological studies have demonstrated that older patients with PD have greater chances of severe cognitive impairment and development of dementia.
A comparative analysis of Parkinson’s and age-related gait disturbance
| Middle to Later stages of PD | Mild PD symptoms | Old age | |
|---|---|---|---|
| Tremor | Rest | Absent in 90% of patients | Absent |
| Stiffness | Typical cogwheel and lead pipe rigidity | Variable | Musculoskeletal stiffness |
| Slowness | Typical with fatigue | Variable | General age-related slowness |
| Gait and balance disturbance | Appears in later stages | Appears at early onset | Age-related axial impairment* |
| Symmetry** | Asymmetrical | Symmetrical | Symmetrical |
| Dementia risk | Increased | Slightly increased | Age related memory problems |
| Levodopa response | Good | Poor | None |
Table reference from here
*Ageing can result in axial impairment of gait and postural control in PD.
**Body movement symmetry is essentially identical movement on the right and left sides of the body. While asymmetrical body movements need not necessarily come with age, it is one of the symptoms of the middle and later stages of PD when motor function and coordination are severely impaired.
The undeniable
That ageing plays a crucial role in the pathogenesis (development) of PD is indisputable. The mechanisms of deterioration caused by degenerative neurological diseases and ageing can be complex and interrelated. Normal ageing may contribute mildly to the advancement of a patient who has already been diagnosed with PD earlier. However, a PD diagnosis in old age, can have decidedly different implications. Since PD results in the impairment of dopamine secretion by the brain, the disease becomes even more pronounced by genetic and environmental factors, and most importantly old age.
As an individual grows older, the somatic nervous system begins to decline in function. This somatic damage along with the degeneration of cellular function, balance, coordination, and other motor symptoms prevalent in PD increases the acceleration of the disease.
Stem cell therapy: the dopamine-maker
Stem cell therapy has brought about remarkable progress in the treatment and care of patients with PD. While aiming to restore and enhance functionality, stem cell therapy improves the quality of life of the individual.
Stem cells are injected directly into the basal ganglia. These injected cells have the potential to develop into dopamine-secreting neurons thereby reducing the progression of Parkinson’s and giving the individual with a fighting chance to not let the disease get the better of them.
At Plexus Neuro and Stem Cell Research Center, we use only autologous stem cells taken from the patient’s own body. As India’s leading stem cell specialists, we assure you of a safe treatment with absolutely no adverse effects.
Plexus Parkinson’s Disease Rehabilitation Program
Our PD rehabilitation program works towards reducing the severity of symptoms and progression of PD. Our team of experts, headed by Dr. Na’eem Sadiq, founder of Plexus, will recommend only the best treatment for you or your loved one. Our treatment plan targets specific aspects of your health such as gait, mobility, and speech. Enrolling in our rehabilitation program is the first step to a healthier and positive outlook towards life.
Book an appointment with us today.
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FAQs
Is Parkinson’s a normal part of old age?
Old age is one of the most significant factors influencing the clinical presentation (stage), course, and progression of PD. This means older people are at greater risk of getting the disease. Having said that, Parkinson’s can also present in adults as young as 20 years old.
How does ageing cause Parkinson’s?
As an individual grows older, their chances of being diagnosed with PD increases significantly. This is because the somatic nervous system (responsible for voluntary action) begins to decline in function. Somatic damage as well as degeneration of motor function, balance, coordination, and other symptoms prevalent in PD increases the acceleration of the disease. Advancing age is associated with a faster rate of decline in motor function.
What are the 5 early signs of Parkinson’s disease?
The 5 early signs of PD are:
- Shaking or twitching (involuntary)
- Micrographia or small handwriting due to dystonia and deterioration of fine motor skills
- Loss of sense of smell
- Sleep issues
- Walking or moving difficulties – inability to sit down after standing up for too long, or vice versa
What is the biggest risk factor for Parkinson’s disease?
Age, genetics, environmental triggers (exposure to toxins), presence of Lewy bodies in the brain (microscopic markers of PD) are some of the causes of PD, with age posing as the biggest risk factor.
