Bulletin of World Parkinson's Program

 Past Bulletins of World Parkinson's Program:

Volume 6, Number 11, November 2014

 

Parkinsonism OR Parkinson’s…

  It was somewhat confusing to Mr. JD to figure out whether he had parkinsonism or Parkinson's. As he was reading various online resources, the two terms seemed synonymous at some places and different at others. To relieve his uncertainty, he decided to ask his neurologist the next time he saw him for a follow up appointment. 

Sometimes patients and their caregivers may find it difficult to completely understand the difference between parkinsonism and Parkinson’s disease. It is necessary to differentiate some of the causes of parkinsonism from Parkinson’s disease because of the difference in prognosis as well as response to treatment.Parkinsonism is a non-specific term that is characterized by tremor, slowness of movements, rigidity or stiffness, and postural instability or balance problems. According to some experts, at least two of these clinical features should be present to consider a diagnosis of Parkinsonism. A variety of conditions may result in parkinsonism and the causes of parkinsonism can be classified as primary or idiopathic, secondary or symptomatic, parkinson plus syndromes, and hereditary neurodegenerative diseases.Parkinson’s disease is a type of primary parkinosnism. Parkinson's disease in contrast to parkinsonism is a distinct clinical and pathological entity that accounts for approximately 80% of cases of parkinsonism. The pathological definition of Parkinson’s disease entails a massive loss of pigmented neurons in the substantia nigra and the presence of Lewy bodies. Symptoms of Parkinson's disease respond well to levodopa. Overall, every patient diagnosed with Parkinson’s disease is said to have parkinsonism, but the opposite may not necessarily be true.

Dr. Ajantha Margaret Jesudasan, Central Executive Committee, World Parkinson’s Program, Toronto, Canada

 

 Volume 6, Number10, October 2014

 

Need for Parkinson’s Education…

 

Parkinson’s disease is a progressive disabling neurodegenerative condition, and poses a variety of challenges. This adversely affects the quality of life for patients and their caregivers. People with chronic illnesses, like Parkinson’s disease, often receive care that is incomplete, inefficient, and fragmented, leading to ineffective treatment. Research has shown that Parkinson’s disease patients have unmet needs in terms of education about their condition, particularly in regards to the various treatment options available to them, or accessing available care.

 

There is much need for advancing patient education, and patient-centered care in Parkinson’s disease. Addressing these issues will require enhancing patient health literacy, patient empowerment, encouraging patients to stay informed, and play an active role in the decision-making aspect of managing their condition. These components are important steps for improving patients’ quality of care.

 Haris Vaid, Media and Public relation officer, World Parkinson’s Program

 Volume 6, Number 9, September 2014

 

 

Removing Parkinson’s Stigma…

  

Healthcare professionals should educate themselves and others about the visible and invisible stigmas associated with Parkinson’s. As suggested by Dr. Rana and colleagues, using a holistic approach to assess a Parkinson’s patient as a whole person by incorporating your passion and experience may not only assist in understanding the complications of Parkinson’s disease, but can possibly reveal the visible and invisible stigmas related to this disease.

 

Healthcare teams of Parkinson’s patients should be mindful of providing comprehensive care to patients for their physical, psychological, and social well-being. Therapeutic interventions provided by healthcare professionals should target each and every motor and non- motor symptom of Parkinson’s disease. Healthcare professionals should educate caregivers and patients not only through clinical encounters, but also through Parkinson’s support groups and other educational means.

 Dr. Shulweeh Alenazi,Consultant Psychiatrist, King Khalid University Hospital, Riyadh, Saudi Arabia.

 

 

 Volume 6, Number 8, August 2014

 

BREAKING NEWS!-Vaccine for Parkinson’s - One Step Closer to Victory…

 

 

The Austrian biotech AFFiRiS AG reported positive results of its Phase I safety trial of a vaccine against Parkinson's disease on July 31, 2014. The vaccine is against alpha-synuclein, a hallmark of Parkinson's disease. The vaccine may help to slow down the progression or halt the disease by inducing antibodies against alpha-synuclein accumulation.  This experimental vaccine called PD01A was given in two different dosages and was found to be safe and tolerable.  Half of the patients who received the vaccine produced antibodies against alpha-synuclein, an encouraging finding. In further trials benefit of PDO1A to the Parkinson's patients will be tested by a boost study. The study is going to be done in Vienna, Austria and will be supported by MJ Fox foundation.

Margarte A. Jesudasan, MD, Acting Vice  Chair, Central Executive Committee, World Parkinson’s Program

 

 

Volume 6, Number 7, July 2014

 

 

Stigma of Parkinson’s…

 

 Although symptoms may vary from person to person, Parkinson’s is a multisystem disorder that affects many aspects of an individual’s physical, psychological, and social well-being. And while medications may help treat the more visible symptoms of Parkinson’s, identification of the invisible symptoms remains a challenge. Therefore, healthcare professionals need to be aware of the possible Parkinson’s stigma. The perceived stereotypical stigma of Parkinson’s and other negative attitudes may adversely affect the psychological well-being of a Parkinson’s patient. Dispelling certain myths about Parkinson’s may help address these negative attitudes. As suggested by Dr. Rana and colleagues, healthcare professionals should therefore educate themselves and others about the visible and invisible stigma associated with Parkinson’s disease.

 

Dr. Abdul Qader Al Jarad, Consultant Psychiatrist, King Khalid University Hospital Riyadh, Saudi Arabia.

 

Volume 6, Number 6, June 2014

 

 

Oral Hygiene and Parkinson’s…

 

 Growing evidence suggests that oral hygiene, which includes regular brushing of teeth and the tongue can be a major defence against the development of serious infections, particularly in the elderly and those who are physically compromised because of a neurologic diseases such as Parkinson's.

 Many medications taken for Parkinson’s or other chronic diseases may have a drying effect inside mouth and throat, further promoting bacterial overgrowth, so adequate intake of water is another important measure that can and should be undertaken.

 

 Re-printable with permission from the author: Mary Spremulli, MA,CCC-SLP. Send correspondence to: This email address is being protected from spambots. You need JavaScript enabled to view it.   http://www.voiceaerobicsdvd.com/ 

 

 

 

Volume 6, Number 5, May 2014

 

 

What indicates if swallowing may be a problem?

 

 Dysphagia, or swallowing difficulty, has been reported in as high as 95% of individuals with Parkinson’s disease. Frequently, changes in the swallowing mechanism occur gradually over time, so an individual may adapt to these changes without realizing there is a problem, until further symptoms begin to show. These symptoms may include choking on saliva, or food and liquids. 

  When the safety and efficiency of swallowing declines, material may be able to enter the airway and lungs, resulting in a lung infection referred to as “aspiration pneumonia.”

  For some persons with Parkinson’s, difficulty managing or swallowing saliva can be one of the first signs of dysphagia. Secretions normally found in the mouth and throat contain many micro-organisms, and most of those do not cause disease. However, persons with poor oral hygiene have a greater amount of pathogens and a greater risk of pneumonia when they also have a swallowing problem. 

 If you notice any swallowing difficulty, you should seek help of a swallowing therapist.

 

Re-printable with permission from the author: Mary Spremulli, MA,CCC-SLP. Send  correspondence to: This email address is being protected from spambots. You need JavaScript enabled to view it.  * learn more at: http://www.voiceaerobicsdvd.com/

 

Volume 6, Number 4 April 2014

Strategies for Swallowing Problems

 

Research estimates that as high as 95% of persons with Parkinson's disease eventually develop swallowing problems. Currently available  anti Parkinson drugs do not consistently improve swallowing function or prevent the development of swallowing problems, which has led swallowing researchers to explore other factors, such as:

 

 - Diet modifications,

- Swallowing exercises

- Strategies used when eating and drinking,

- Improving the coordination of breathing and swallowing,

- Improving oral hygiene

 

Mary Spremulli, MA,CCC-SLP. Send  correspondence to: This email address is being protected from spambots. You need JavaScript enabled to view it.  * learn more at: http://www.voiceaerobicsdvd.com/

 

Volume 6, Number 3, March 2014

Swallowing and Parkinson’s

 

Would you be surprised to know thatresearch estimates as high as 95% of persons with Parkinson disease eventually develop swallowing problems (dysphagia). This can cause food, liquids, and even saliva to slip into the airways instead of the esophagus (the tube that leads to the stomach). In healthy people, contact with the larynx(voice box) by a foreign body should trigger a cough reflex to protect the windpipe, but many people with Parkinson’s have sensory problems that reduce the larynx’ ability to tell that something is threatening the airways. Thus, food and liquids can get into the lungs, leading to aspiration pneumonia. Studies show this condition is a leading cause of death for Parkinson’s patients.

Therefore, Parkinson’s patients should seek immediate medical help, should start experiencing symptoms of dysphagia.  

 

Re-printable with permission from the author: Mary Spremulli, MA, CCC-SLP. Send correspondence to: This email address is being protected from spambots. You need JavaScript enabled to view it.  * learn more at: http://www.voiceaerobicsdvd.com/

 

Volume 6, Number 2, February 2014

 

How to get enough Vitamin D in the body?

 Research has shown that patients with Parkinson’s disease often have low levels of vitamin D. In southeastern United States, patients with Parkinson’s were noted to have lower blood levels of vitamin D than those without Parkinson’s. Those with Parkinson’s generally have lower bone mineral density and an increased risk of falls and hip fractures.

 Vitamin D is produced by the skin from sunlight exposure and it helps calcium to get in to the bones.  Therefore, sufficient levels of vitamin D in the body may improve physical strength and balance. Therefore, vitamin D levels should be checked in Parkinson’s patients and kept in the optimal range.

 What should one do?

 Outdoor activities such as regular walking, sufficient exposure to sunlight and engaging in daily physical activity may help maintain optimum levels of vitamin D. Since every individual is different and the full effects of vitamin D may occur over the course of many years, therefore it may difficult to determine the exact amount of vitamin D required by every single person. However, it is generally suggested that Parkinson’s’ patients should keep their vitamin D levels greater than 40 ng/mL (100 nmol/L). Vitamin D levels can be measured both before and three months after starting supplements to make sure that the individual has optimal blood level of vitamin D.

Dr. Awad AlShahrani, Consultant Division  of Endocrinology, Department  of Internal Medicine, King Abdulaziz Medical City, National Guards Health Affairs, Riyadh, Saudi Arabia.

 Volume 6, Number 1, January 2014

 

Vitamin D and Parkinson’s

 Vitamin D Deficiency - A finding seen in many patients with Parkinson’s disease

… Patients with Parkinson’s disease often have how levels of vitamin D. One of the research studies showed that majority of Parkinson’s disease patients had insufficient levels of vitamin D in their bodies. However, none of the research studies have established whether the vitamin D deficiency is a cause or effect of the disease.

Vitamin D3 is the active form of vitamin D, produced by the skin from sunlight exposure. The body uses it to help get calcium into the bones. Therefore, sufficient levels of vitamin D in the body may improve physical strength and balance, particularly in elderly people. Patients with Parkinson’s generally have lower bone mineral density which increases the risk of fractures if they fall.

 Dr. Awad Al-Shahrani, Consultant Department of Endocrinology, Division of Internal Medicine, King Abdulaziz Medical City, National Guards Health Affairs, Riyadh, Saudi Arabia.

 Volume 5, Number 12, December 2013

 What if You Fall?

                   

Since falls may result in serious consequences, effective fall prevention strategies should be adopted by all Parkinson’s disease Centers and explained to patients.

Our Fall Prevention Campaign aims to prevent Parkinson’s patients from falling by educating them, emphasizing gait and balance training, and donating walkers, canes and wheelchairs to those who can‘t afford these devices. Research has shown that 70% of Parkinson’s patients fall each year and 13% fall more than once a week.

What you should do if you fall?

You should try using these steps to stand up:

1. Lie down on your back

2. Swing yourself onto your side

3. Use your hands and get into a sitting position

4. Slowly crawl towards the nearest object that can support your weight

5. Put your hands on the seat of the furniture or chair and space them apart

6. Bring your strong leg up, so your knee is close to your chest

7. Push up with your feet as well as your hand to get into a standing position

 Dr. Bashir Alenazi, Consultant Orthopedic Department, Prince Sultan Military Medical City Hospital. Riyadh, Saudi Arabia

 Volume 5, Number 11, November 2013

 

It is time to Prevent Falls!

                 

Falls mean >>>>> fractures, disability, loss of independence, decreased self-respect, lack of confidence and social embarrassment.

Preventing falls means >>>>> preventing hospitalization, social isolation and depression.

Physicians should rule out other causes which may be responsible for falls such as arthritis, cardiac arrhythmias, postural hypotension, visual impairment, and medication including use of benzodiazepines, focal weakness, peripheral neuropathy, normal pressure hydrocephalus, and vertigo and seizures.

The following strategies may help to prevent falls:

 Using foot wear which is well fitted and has good support.

Leather soled shoes are usually better and ice grips should be used in the winter. 

Avoiding high heels is important in women.

Keeping adequate lighting in stairways and hallways.

Stairways should have handrails, keeping walker close to the bed at night and maintaining outdoor steps in good condition and free of ice is helpful.

Carpeted floors might soften a fall and prevent fractures.

Having a telephone on every level of the house and an alarm bracelet where one can push and call 911.

Home safety assessments, occupational therapists usually come home and provide suggestions to make the toilet, bedroom and stairways safe.

Non-slip bath tubs and floor mats should be used in the bathroom. Bath bench and hand rails are also helpful.

Showering and dressing or undressing should be done while sitting down.

Having someone to accompany the patient is always safe. The bathroom doors should not be locked while having a bath.

Dr. Bashir Alenazi, Consultant Department of Orthopedics, Prince Sultan Military Medical City Riyadh, Saudi Arabia