Parkinson's disease is a neurological condition that affects a wide range of functions. The changes that occur can have a significant impact on the physical and mental aspects of a person's life.
The hallmark signs of Parkinson's disease (PD) are a tremor, slow movement, and rigidity. In addition, difficulty with coordination, a number of non-motor symptoms, and other complications are common.
However, there are ways to manage many of these complications. Doing so can ensure a better quality of life for a person with PD.
Find out more about the complications of Parkinson's disease and what you can do about them.
Speaking can become difficult over time.
As PD affects the muscles, a person's speech can become softer and harder to understand. Over time, changes in thinking ability can make it harder to communicate. This can make it hard to join in social activities.
A study published in the BMJ Open in 2017 notes that speech therapy is important for keeping people communicating effectively. It can help to improve or maintain a person's quality of life.
Chewing and swallowing difficulties can occur, especially during the later stages of the disease. These can be due to changes in function either in the autonomic nervous system or the muscles in the throat, known as the pharyngeal muscles.
These changes increase the risk of getting food stuck in the throat and choking, which can be life-threatening. If the person accidentally breathes food particles into the lungs, pneumonia can result.
The person may also produce too much saliva or they may not be able to swallow the saliva easily. This can lead to drooling, which can be embarrassing for the individual.
Some medications may improve symptoms. A speech-language therapist can sometimes help a person to retrain their throat muscles so that they can swallow more effectively.
Depression can occur with PD, and it can make symptoms worse.
Researchers suggest that around 40 to 50 percent of people with PD also experience depression. They add that this aspect of the condition can be harder for the individual and their loved ones to cope with than the physical symptoms.
Other neuropsychiatric symptoms include:
However, the symptoms of depression are treatable, and recovery is possible.
Seeking medical help when symptoms of depression start to appear can give the person a better quality of life, improved functionality, and a chance of slowing the symptoms.
It is common to experience a drop in libido, or sex drive, with PD, and it may be difficult to have an orgasm or an erection.
The drop in sexual interest and physical functioning can happen because of a fall in dopamine levels, according to the American Parkinson Disease Association.
The impact of this is:
- a reduction in physical movement
- reduced circulation, which affects the ability to have an erection
- a lack of climax
Vaginal dryness can also be a problem.
Depression and anxiety can reduce a person's energy levels and their interest in things they used to enjoy, such as sex. Fatigue may be a factor.
Depression and mood change can also cause changes in behavior and attitude. A partner may feel that their loved one is "not the same" as before.
It is important to remember that this is the same person and for both partners to communicate how they feel. A counselor can help people to find ways to enjoy a new relationship.
In rare cases, medications that increase dopamine levels in people with Parkinson's disease may increase the person's sex drive to an unusual level. This, too, can become a problem for some people.
Treatment is available for many of the symptoms that can disrupt sexual activity at this time. Medications can improve a person's mood. Lubrication, for example, might help with vaginal dryness.
People with PD are more likely to have sleep problems than those of the same age who do not have the condition.
Some people have difficulty falling asleep while others fall asleep easily, but then wake up and cannot get back to asleep again, according to the University of California Parkinson's Disease Clinic and Research Center.
Other sleep problems include:
- sleep apnea
- daytime sleepiness
- nightmares and vivid dreams
- talking during sleep
- restless legs or jerking leg movements
- difficulty turning over in bed
- waking up to use the bathroom
Possible reasons include:
- the effect of medications
- physical discomfort
- changes to the internal body clock
Establishing a pattern of good sleep hygiene may help.
- going to bed and getting up at the same time every day
- getting plenty of natural light during daytime hours
- avoiding coffee and other stimulations, especially just before bedtime
- using the bedroom only for sleeping and doing other activities — such as watching the television or using mobiles phones and other devices — in another room, where possible
- avoiding daytime napping, or napping at the same time each day
Some people may leak urine while others find it hard to pee properly. Sometimes this may be due to the medications that people are taking.
A doctor can help to find a solution. Discreet pads are available from a pharmacy.
Statistics show that up to two-thirds of people with PD experience constipation.
Reasons for this include:
- muscle weakness
- a possible reduction in fluid intake
- side effects of medications
- the impact of PD on the autonomic nervous system, which includes the digestive system
In turn, constipation can lead to anxiety and additional discomfort, and this can worsen the experience of PD and further reduce the person's quality of life.
Possible solutions to this problem might include:
- medications, such as laxatives
- dietetic interventions, including probiotics and prebiotics
- increase fiber and fluid intake
- some physical therapy
People should speak to their doctor before taking any medication for constipation, as some drugs and alternative remedies can interfere with other medications.
Changes to proteins in the brain, such as Lewy bodies, can lead to dementia in Parkinson's.
The Alzheimer's Association estimates that between 50 and 80 percent of people with Parkinson's eventually develop dementia. On average, this takes around 10 years from when symptoms first appear.
Common symptoms include:
- difficulty remembering things, focusing, and making judgments
- unclear speech
- hallucinations and delusions
- depression, irritability, and anxiety
- sleep difficulties and daytime sleepiness
Medication can help to slow the progress of dementia, but symptoms usually become more severe over time.
Pain is a common symptom of PD. Figures suggest that over 60 percent of people with the condition experience pain. Of a list of bothersome symptoms, pain comes third after tremor and stiffness.
People report that between 40 and 90 percent of the pain of PD is musculoskeletal, and they mostly describe the sensation as burning, cramping, or aching.
Suggested ways of reducing the pain include:
- over-the-counter or prescription medications
- massage, music therapy, tai chi, and other complementary therapies
- spinal-cord stimulation
Individuals should ask their doctor to recommend ways of reducing pain that are proven safe and likely to be effective.
The autonomic nervous system controls blood flow and blood pressure. This is part of the nervous system that people cannot control, as they can, for example, a hand or foot.
PD affects this system, leading to changes in blood pressure throughout the day.
One problem is orthostatic hypertension, a drop in blood pressure that causes a person to feel dizzy or faint when they stand up. It can also lead to falls and fainting.
Low blood pressure is most common with PD, but some people also experience very high blood pressure at times. These fluctuations can lead to heart problems.
A doctor may be able to prescribe a medication to stabilize blood pressure and prevent dramatic changes. Compression stockings may also help.
Over 95 percent of people with PD lose their sense of smell to some degree, because of Parkinson's impact on the nervous system.
It is an early sign of the disease, and it can occur years before other symptoms appear. Doctors see it as a possible predictor of PD.
The loss of the sense of smell is one of the top five most common symptoms of the disease.
PD can lead to a wide range of symptoms and related complications.
In addition to these, a person may also experience side effects because of the medications they use. It is important to keep in contact with a doctor to discuss any symptoms, complications, and changes as they arise.