What are the seven non-motor symptoms of Parkinson’s disease?

When it comes to Parkinson’s disease, people may only know motor symptoms, such as tremor, stiffness, slowness of movement and instability of posture, but it actually has a profound impact on the quality of life of Parkinson’s patients But those non-motor symptoms. Common non-motor symptoms include sleep disturbance, anxiety, pain, gastrointestinal problems, and sense of smell.

1. Sleep problems

Close to 80% Pa People with Kinson’s disease will have varying degrees of sleep problems, including insomnia, frequent waking, sleep apnea, rapid eye movement (REM) sleep behavior disorder, periodic limb movement disorder, and excessive daytime sleepiness, among others.

If you want to have a good sleep, you need to do some preparations. For example, develop some good sleep habits, good and unified work and rest time, comfortable sleeping environment, suitable lighting, avoid exercise and drink tea and coffee before going to bed.

In short, sleep is a big deal, prepare before going to bed, practice relaxation techniques, and don’t go to bed with worries. It is also sometimes necessary to adjust some medications because some medications can cause or worsen sleep problems. If none of these measures work, you can only use some sleeping pills.

2. Pain

about 35-80% of people with Parkinson’s disease experience pain. There is considerable variability in this statistic because subjective descriptions of pain lack standard definitions and uniform assessment tools. But regardless of its prevalence, Parkinson’s pain can affect a person’s daily life and work.

3. Mood disorders in Parkinson’s disease

Mood disorders are relatively common in Parkinson’s disease. It will not only exacerbate the symptoms of the disease, but also bring other physical and mental symptoms. Among them, depression in Parkinson’s disease is very common, and about 1/3 to 50% of people have depression, while only 1/10 in the general population. Depression can increase disability, worsen quality of life, increase caregiver stress and overall healthcare costs.

Anxiety is another kind of emotional distress, which affects about 25%-50% of patients with Parkinson’s disease, far more than the general population The proportion of 5-10%. The motor symptoms of Parkinson’s disease can increase the severity of anxiety and affect quality of life.

4. Gastrointestinal problems

Gastrointestinal problems have been recognized as part of the symptoms of Parkinson’s disease. These include deterioration of the teeth, excess saliva, difficulty swallowing, slow emptying of the gastrointestinal tract, and constipation. James Parkinson’s first description of the condition dates back to 1817, and he mentioned drooling, dysphagia, and constipation as part of the disease. However, little attention has been paid to these issues in the past.

Swallowing and digesting food may seem like a matter of course in everyday life. But in reality, the working of the gastrointestinal system is complex, involving the central nervous system (brain and spinal cord), the autonomic nervous system (the part of the nervous system that is responsible for certain voluntary movements of the body, such as the beating heart or the working of the stomach), and the enteric nerves. system (nervous system responsible for gastrointestinal function). All these systems have to work well together.

Studies have shown that the earliest cell damage and changes in Parkinson’s disease may occur in the gastrointestinal tract itself, and the changes we see in the brain , which is actually much later. Constipation may be a pre-exercise symptom or an early sign of Parkinson’s disease.

5. Dementia

about 24-31% Patients will develop dementia, and the risk increases with age.

There are two types of dementia associated with Parkinson’s disease: Parkinson’s disease dementia (PDD) and Lewy body dementia (LBD). The latter is the most common dementia after Alzheimer’s disease and vascular dementia. PDD and LBD have similar symptoms, but differ in timing and severity.

PDD generally occurs at least one year after the diagnosis of Parkinson’s disease. LBD is different. Symptoms can appear before or during the first year of onset. Moreover, LBD has more obvious symptom fluctuations in alertness and cognitive levels.

With memory problems and slowed processing speed, symptoms gradually worsen and affect daily life, self-care ability and personal financial management. Patients also experience visual and spatial problems, making it difficult to judge distance and depth. Another prominent feature of dementia in Parkinson’s disease is that patients frequently experience hallucinations, often more severe with Lewy body dementia. Hallucinations are more of a visual aspect.

Of course not all patients will develop dementia symptoms. Depression can have similar manifestations, and once the mood disorder is dealt with properly, the symptoms of “dementia” will also improve.

Certain drugs, such as sedatives and anticholinergics, can cause some elderly people to have similar symptoms. Significant improvement. Other vitamin deficiencies (particularly vitamin B12), tumors, and other types of dementia such as Alzheimer’s or post-stroke dementia may be present.

6. Parkinson’s disease indifference

With As the disease progresses, the activity ability of Parkinson’s patients decreases significantly. This may be due in part to dyskinesias, but also to apathy, a common non-motor symptom of Parkinson’s. It is estimated that about 40-45% of Parkinson’s patients have apathy, and due to the lack of awareness of this symptom, the actual occurrence may be higher.

Apathy is defined as a lack of interest or “motivation” in situations other than emotional disturbance, intellectual disability, or decreased consciousness. Unlike depression, apathy disorder is not accompanied by low mood. It can appear inactiveComplete tasks efficiently, or learn new things and self-directed future goals and plans.

This lack of goal-directed behavior and lack of emotional response has a significant negative impact on all aspects of the patient’s life, social and work. Everyone around him will misinterpret his indifference as laziness, neglect and indifference, which will affect their relationship. This greatly affects the quality of life of the patient, and it also creates a lot of pressure on other caregivers, partners or people who care about him.

7. Olfaction

Olfaction refers to Anosmia, which occurs in almost all Parkinson’s patients (more than 95%), even exceeds the proportion of resting tremor. That’s not to say that everyone with anosmia has Parkinson’s disease. Other conditions, such as sinus disease, viral infections, and trauma, can cause smell problems.

Disorders of smell impair taste experience in Parkinson’s disease patients, causing distress to patients. Due to its high incidence, it can also provide some valuable information from a clinical and research point of view.

It may be a potential biomarker that olfactory dysfunction may precede motor symptoms in Parkinson’s disease. Although it is difficult to retrospectively study the hyposmia of Parkinson’s patients, some studies have shown that relatives of Parkinson’s patients have been followed by smell tests for several years and found that hyposmia is associated with an increased risk of Parkinson’s disease within 5 years.

In the future, if there are drugs, at-risk groups can be treated to prevent the progression of the disease (we call them disease-modifying drugs). It can help differentiate Parkinson’s disease from other types of Parkinsonism.

Parkinsonism refers to movement disorders including resting tremor, rigid, bent posture, “frozen gait”, loss of postural reflexes and Bradykinetic neurological disorders such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) fall into this category. Their sense of smell is less affected than in Parkinson’s disease.

Olfaction can be used as a marker of early disease progression in Parkinson’s disease and, if carefully assessed, may provide Valuable information about the duration and progression of the disease.

The above list is only a small part of the non-motor symptoms of Parkinson’s disease, but its incidence is relatively high, and it seriously affects Parkinson’s disease patients quality of life. For these non-motor symptoms, patients and family members must first be able to identify them before seeking appropriate medical help. The current clinical standard Parkinson’s disease treatment plan is mainly aimed at improving motor symptoms, and does not involve more in non-motor symptoms, which requires self-management of patients and family members.