Recognizing Late-Stage Features of Parkinson’s Disease

Parkinson’s disease primarily leads to decreased movement, known as hypokinesia. The exact origins remain unclear, and no cure exists. The primary cause of symptoms is the loss of nerve cells in the brain and a dopamine deficiency. The reason behind neuronal death is still unknown. Genetics play a minor role unless multiple family members are affected. Age is the most significant risk factor, with those over 60 commonly developing the condition. Treatment mainly involves dopamine replacement to manage symptoms.

Early symptoms are subtle and hard to detect. Typical signs include tremors at rest, slowed movement (bradykinesia), muscle stiffness, balance and posture issues, reduced automatic movements, speech changes like muffled voice, and handwriting alterations where words shrink and letters crowd together. As the disease advances, these symptoms worsen, and new ones emerge, some of which can be managed.

Cognitive and emotional impacts
Patients may experience thinking difficulties, memory loss, and even dementia that may not respond well to medication. Emotional changes, including anxiety, fear, and decreased motivation, are common but manageable with proper care.

Physical and functional symptoms
Progression may lead to swallowing difficulties, prolonging meals, and increasing reliance on liquid diets. Drooling occurs due to saliva buildup, often requiring protective bibs. Sleep disturbances become prevalent, causing frequent waking and daytime fatigue. Urinary issues such as difficulty initiating urination and incontinence may develop. Chronic constipation, dizziness on standing, loss of smell, ongoing fatigue, and erectile dysfunction can also occur, affecting the overall well-being.