Parkinson’s Disease: Non-motor Symptoms and Interventions By Anne M. Pott The Continuum: Part Three
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n this third segment on the nature of Parkinson's disease (PD), we will provide a brief overview of PD, explore the benefits of an interdisciplinary team, describe some of the most common non-motor symptoms, and share some evidence-based interventions and activities. We hope to offer helpful information that, when shared, may lead to a better quality of life for people with Parkinson's disease (PD) and greater awareness within our community. Overview
According to the American Parkinson Disease Association, almost one million people in the U.S. live with PD. This number will continue to rise with global aging. Parkinson’s disease interrupts dopamine’s ability to regulate movement. Over time, its symptoms become more debilitating. While the cause and cure for PD are unknown, research projects such as those sponsored by the Michael J. Fox Foundation offer promise. A primary research goal is to protect and restore dopamine receptors in the brain from Parkinson’s destructive path.
Interdisciplinary Team Approach
How PD affects one’s physiological and psychological health across the disease course is different for each individual. Jackie Hunt Christiansen explains it in the very title of her article Your Symptoms are Unique to You found on the Parkinson Foundation website. Another point of diversity to remember, according to Christiansen, is what Richard describes, “The only predictable thing about this disease is that it is unpredictable.” Specialists in PD widely acknowledge the complex and progressive changes in an individual’s overall health. With the extensive knowledge, experience, and creative collaboration of a movement disorder specialist and a team of PD-related specialists, an individual, and their care partner/family can develop flexible treatment plans across the disease’s progression.
Non-Motor Symptoms
While the motor symptoms of tremors, slow movements, and muscle rigidity are PD’s most recognized symptoms, this article focuses on the varied and often-overlooked non-motor symptoms. Paul on the Davis Phinney Foundation website explains, “It’s a lot harder to explain the Parkinson’s that people don’t see.” Losses in taste or smell, trouble sleeping, constipation, and depression often appear years earlier than motor symptoms. The Parkinson’s Foundation describes other common types of non-motor symptoms: anxiety, apathy, breathing, and
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March 2021 // www.SeniorSpectrumNewspapers.com
respiratory difficulties, cognitive changes, nausea, dementia, fatigue, hallucinations/delusions, pain, skeletal & bone health, skin changes, small handwriting, speech and swallowing problems, urinary incontinence, vertigo and dizziness, vision changes, and weight management. Many of these problematic symptoms are not readily apparent to friends and families. Healthcare providers may misattribute them to other common health conditions. Surprisingly, non-motor symptoms take a more substantial toll on everyday quality of life than the more visible motor symptoms. Specialists and people living with PD often share that the non-motor symptoms outnumber and cause more significant disabilities than motor symptoms. According to the Parkinson’s Foundation, non-motor symptoms may become dominant in PD, ultimately requiring complex treatments, hospitalization, and potentially institutionalization. Five overarching health conditions caused by PD, as described by Pfeiffer (2019) in his expert briefing for the Parkinson’s Foundation, are a) sensation abnormalities, b) sleep disorders, c) automatic dysfunction, d) fatigue, and e) behavioral changes. With this article’s scope, we will focus on PD’s automatic dysfunctions that affect communication and eating.
Speech, Voice, and Swallowing Problems
As mentioned above, family, friends, and medical providers may miss the early development of some internal non-motor symptoms. On the other hand, they consistently recognize a series of noticeable automatic changes in one’s voice and speech patterns before the person with PD. The Michael J. Fox Foundation describes voice and speech symptoms as a soft or hoarse, monotone voice, mumbling, slurring words, trailing off at the end of sentences, stammering, stuttering, and difficulty regulating speech cadence. Other non-motor symptoms such as losses in facial expression, called “masking,” and cognition complicate communication efforts with mixed non-verbal cues and word retrieval problems. In the same domain, losses in autonomic muscular function affect how well one can eat and drink. Coughing becomes more frequent when swallowing, chewing food, or managing excess saliva. Dysphagia is the medical term for swallowing dysfunctions. The Parkinson’s Foundation explains how choking, dehydration, malnutrition, and aspiration are dangerous complications that may develop from dysphagia. Aspiration pneumonia which develops from aspirating food or liquid into your lungs instead of down your throat is the leading cause
