With March recognised as Brain Awareness Month, Professor Tim Anderson provides an insight into Parkinson’s, the fastest growing neurological disorder. It is estimated to affect more than 6 million people worldwide.

Parkinson’s is a progressive degenerative brain disease that most commonly occurs in those aged over 65 years. The number of people living with it is expected to continue to rise in the coming years due to our increasing life expectancy and ageing population. In New Zealand there are currently approximately 12,000 people with the disease. It is predicted that by the year 2040 this will increase up to 20,000.

The most common, early symptoms of Parkinson’s are shaking (tremor), slowing up (bradykinesia) and stiffness (rigidity). Curiously, it usually starts on one side of the body for reasons unknown. For example, the person might notice a mild shaking and clumsiness of one hand or foot, that their walking has slowed and with perhaps dragging one leg a little, and they may not swing the affected arm during gait. The onset of symptoms is very gradual (unlike a stroke for example) and often it is the family rather than the person themselves who notice something is amiss. Frequently there is reduced sense of smell (especially for pizza!) and many people with Parkinson’s will have been disturbing their partner’s sleep for some years by talking and acting out their dreams (e.g. shouting or hitting out when asleep).

Parkinson’s affects every individual differently – every person’s Parkinson’s is their own and no one else’s. The way it comes on, the way it responds to treatment and the manner in which it gradually progresses can be very different in different individuals. It is not just a physical (movement) disorder, and over time the person with Parkinson’s may experience dizziness from low blood pressure, constipation and urinary issues, sweats, poor balance and sometimes falls, as well as anxiety, forgetfulness and possibly even cognitive impairment and dementia.

As yet, there is no prevention or cure for Parkinson’s, but there are very good medications to treat the symptoms that arise along the way, and we now know that regular exercise, a healthy (Mediterranean-style) diet, socialising with friends and family, and keeping the mind active, are very important self-help ways of minimising the consequences. Thus having Parkinson’s can be a full-time occupation. Parkinson’s is not a fatal disorder, and the majority of people can learn to live positively with the condition.

Based in Canterbury, the New Zealand Brain Research Institute improves brain health through research, education and clinical practice. Its flagship research is the Parkinson’s Longitudinal Study, one of the world’s largest and longest-running studies into Parkinson’s. A group of extraordinarily generous patients and healthy older volunteers come back every year to be assessed. This involves clinical examination, tests of thinking and memory, brain scans, blood tests, brain wave recordings, speech and swallowing assessments. A particular focus in recent years has been identifying the progression of cognitive impairment and dementia. These problems affect the family as much as the patient and so this research has been extended to include the burden faced by caregivers.