Parkinson’s Foundation <Learn ways to manage common PD bladder problems. | Donate NowDonate Now Join us for our Expert Briefing webinar on Parkinson’s Disease and the Bladder. Many people with Parkinson’s disease (PD) experience urinary difficulties. Knowing that urinary problems, such as urinary tract infections, can be a symptom of Parkinson’s is the first step toward management. Learn more about common bladder problems in PD, why they occur and treatment options.Parkinson’s Disease and the Bladder September 13, 2023 at 1 p.m. ET REGISTER NOWOur Expert Briefing webinars are designed with the Parkinson’s community in mind. Each hour-long webinar explores the latest Parkinson’s research and updates from experts in the field along with the opportunity to ask questions.
Parkinson’s Lifestyle Management <This weeks article is Swallowing-A major concern with Parkinson’sWhen working with clients one of the things I pay close attention to is if my clients begin to have issues with swallowing. This is a major problem and needs to be addressed immediately. In fact, if you have Parkinson’s you need to have a relationship with a speech pathologist. The reason I’m stressing this is over the 20 + years of working with Parkinson’s aspirational phenomenon caused by swallowing issues has taken a number of my clients home to the father.
So let’s talk about swallowing and Parkinson’s disease, the reality is most people with Parkinson’s disease will experience changes in speech, voice, and swallowing at some point in their disease. The same PD symptoms that occur in the muscles of the body — tremors, stiffness, and slow movement — can occur in the muscles used for speaking and swallowing. These muscle problems can cause the voice to soften, mumbling, fact speech, or the loss of facial expression commonly referred to as facial masking, and swallowing issues. I’ve had many conversations with Sarah Awde, a speech and language pathologist (Sarah does webinars on this platform) about speech and swallowing. We are both perplexed why people who have Parkinson’s aren’t working with a speech pathologist. Soft voice, facial masking, drooling, and swallowing can all be managed. However, you must start early on with Parkinson’s, unfortunately, most people wait until it is almost impossible to correct and manage. Be pro-active.
So let’s take a look at what happens with Parkinson’s disease you begin to have difficulty swallowing because of the loss of control of the mouth and throat muscles. This will result in problems chewing and managing solid foods. These symptoms are common in Parkinson’s disease and will interfere with the quality of life and the ability to eat and swallow. In Parkinson’s changes in the brain causes your movements to become smaller and less forceful leading to problems with your speech, communication, and swallowing. When you have problems with swallowing it is called Dysphagia, which means it takes more time and effort to move food or liquid from your mouth to your stomach. Symptoms include food getting stuck, coughing during eating, excess saliva, and frequent pneumonia. Dysphagia can be painful. In some cases, swallowing is impossible. Don’t wait until you get Dysphagia, find a speech pathologist and talk with them about what you can do to manage the disease. It is exercise just like PT.
With Parkinson’s, medication is part of the therapy to manage and help improve most symptoms. Medications are not the end-all of swallowing therapy. We rely too much on medications and not enough on old fashion work. Just remember medications are not as helpful with improving speech and swallowing problems as a speech pathologist. The most effective therapy is a speech and swallowing therapy program coupled with medications. What you need to do is get with a Speech Pathologist and develop an exercise program to exercise the swallowing muscles. With Parkinson’s, you have a problem with your brain sending signals to nerves and the muscles, so you exercise those muscles to work together to help you swallow.
Speech and swallowing exercises are just as important as walking, stretching, and strength training in your program to manage the disease. Be proactive with your speech and swallowing exercises as aspiration pneumonia can be devastating to your quality of life. In fact, aspiration pneumonia can end your life. Let’s not be going on to the Father just yet.
Parkinson’s Lifestyle Management — This weeks article is Dental care and Parkinson’s disease? Who would believe that Parkinson’s disease could have a terrific damaging effect on your dental care? My clients have difficulties with their dental care, to the point it is frequently ignored. The prospect of sitting in a dentist’s chair for a simple procedure such as cleaning can be a major undertaking. So what occurs with inadequate dental care, can easily affect your nutrition; increase your probability of a stroke, your cognitive thinking, and body weight loss. These challenges are significant concerns and need to be dealt with or the final results could have a direct effect on the level of quality of everyday living. To begin with, dry mouth is generally a problem with Parkinson’s disease, devoid of saliva; bacteria can easily reproduce along the gums resulting in tooth decay. Combined with almost all the functions of proper dental hygiene for instance brushing, using dental floss and rinsing will become challenging as the disease progresses. This can result in jaw, tongue, and facial muscle stiffness. The physical actions of brushing your teeth necessitates hand-eye coordination, hand dexterity, and agility. Dental health is a real challenge in the best of conditions but not taking care of your teeth when you have Parkinson’s makes you more prone to dental and bacterial infections which often contribute to health problems, that can affect your quality of life and become extremely expensive. A trip to the dentist’s office can be a major challenging experience when you have tremors, muscle stiffness, and rigidity. If you have posture instability sitting in a dentist’s chair becomes very complicated. Finally swallowing problems along with dyskinesia could affect the jaw and then add in grinding of the teeth. This journey to the dentist’s office could be extremely unpleasant. A certain degree of forethought and planning can easily make your trip to the Dentist more rewarding, pleasurable, and less of a challenge. The Old Boy Scout motto fits here “Be Prepared.” A few other elements to take into account that could have an unfavorable impact on a visit to the dentist are the emotional and psychological fluctuations associated with Parkinson’s. These consist of apathy, depression, and lapse of memory. Not only do individuals with Parkinson’s have a tendency to commit less attention to their dental hygiene but a few develop a “sweet tooth” which frequently leads to the hazard of an increase in oral cavities. We tend to overlook the expensive when dental care is overlooked. Again be prepared and planned. An electric toothbrush may become the cheapest investment with regard to dental care for those with Parkinson’s not necessarily just for the teeth but additionally the dentures. Take the challenges for hand-eye coordination with hand dexterity out of the equation and make it as easy as possible to brush the teeth and clean the dentures. Also have a conversation with your Dentist concerning additional treatment methods such as a topical stannous fluoride gel, which usually requires a doctor’s prescription. As far as mouthwashes be cautious simply because of the risk of choking. Remember dental care can be expensive. In the event you do use a mouthwash use only those which are non-alcohol base. Regarding the trips to the dental office put a plan together, with your office to time the medications so you are “ON” by taking 60-90 minutes prior to the visit. Inquire when the dentist is less crowded, which usually is earlier in the morning so you don’t have to wait. As the individual continues down this process with Parkinson’s the dental appointments may be a series of short visits instead of one long trip. Again develop your action plan in order to ensure a quality associated with daily life with regard to both the person with Parkinson’s and the caregiver. And smile and show those Pearly Whites. There are over-the-counter dental products that could be of value, do your research and take care of those Choppers.
The Parkinson’s disease (PD) staging system is a helpful tool to track movement-related symptoms and to monitor disease progression.
People with advanced Parkinson’s are typically in stages 4 or 5, at which point symptoms have become severe and limiting.
Effective treatment options are available for people with advanced Parkinson’s.
Parkinson’s disease is a neurological movement disorder that changes and often progresses the longer someone has it. There are several ways to assess and monitor disease progression of Parkinson’s. One of those ways is to understand the five stages of Parkinson’s.
It is important to note that everyone with Parkinson’s experiences their own unique symptoms and disease progression. No two people will have the same Parkinson’s journey. A person can develop advanced Parkinson’s disease after many years, or they may experience a faster disease progression.
The Five Stages of Parkinson’s
The Parkinson’s staging system is based on the Hoehn and Yahr scale introduced in 1967. The Hoehn and Yahr system focuses on disability caused by motor symptoms such as bradykinesia (slowed movements), tremor, and loss of balance. Neurologists use the scale to track motor (movement) symptoms and also monitor disease progress.
As each stage number increases, this generally accounts for more impairment, along with increased difficulty with daily activities.
Stage 1
During this early stage of Parkinson’s disease, people show mild symptoms that usually do not get in the way of their daily routines. Tremor, stiffness, and bradykinesia happen on only one side of the body.
In addition, a person with stage 1 Parkinson’s may also have:
Symptoms begin to worsen during stage 2, spreading from one side of the body to both sides. There may be difficulty walking and changes in posture, facial expression, and voice.
Individuals with stage 2 Parkinson’s can typically still live by themselves. However, daily tasks may become more difficult and time-consuming.
Stage 3
Loss of balance and bradykinesia are the most common symptoms of this stage of Parkinson’s. Individuals at stage 3 are likely to experience falls.
People who are at stage 3 of Parkinson’s can typically still carry out their daily activities by themselves, but their symptoms cause greater impairment with tasks like eating and getting dressed.
Stage 4
This stage marks the beginning of advanced-stage Parkinson’s disease. At this point, Parkinson’s symptoms have become limiting and severe. Individuals in stage 4 may be able to stand without any help, but movement throughout the home often requires a walker.
In addition, those in stage 4 typically need assistance with all of their activities of daily living. They are not usually able to live by themselves.
Stage 5
This is the most severe stage of neurological dysfunction in Parkinson’s. Rigidity (stiffness) can keep a person with stage 5 Parkinson’s from being able to either stand or walk. Individuals in this stage typically need a wheelchair to get around, and they may be bedridden.
In this advanced stage, people will require constant nursing care for all of their daily activities. In addition, they may experience many nonmotor symptoms, such as delusions and hallucinations.
Some neurologists also use the Unified Parkinson’s Disease Rating Scale (UPDRS) to track the symptoms of Parkinson’s. The UPDRS is a more extensive tool that also checks nonmotor symptoms, such as:
Mental function
Mood
Sleep problems
Pain
Urinary problems
Constipation
Lightheadedness upon standing
Fatigue
Members of MyParkinsonsTeam have discussed a wide range of experiences when it comes to how their condition progresses. “I was diagnosed with PD in 2003, and my symptoms did not advance significantly until 2019,” one member wrote. Another said, “My PD has advanced slowly and I feel pretty good most of the time.”
By understanding the stages and progression of Parkinson’s, you can anticipate and better navigate your Parkinson’s journey.
Navigating Advanced Parkinson’s Disease
Apart from neurological dysfunction, people with advanced-stage Parkinson’s may develop other problems.
Decreased Response to Medication
People with advanced Parkinson’s disease have likely been taking their medications for a long time. This means they are at risk for experiencing a wearing-off effect of their medication.
Parkinson’s research shows that this may happen for the following reasons:
The brain loses cells that make dopamine (the neurotransmitter involved in Parkinson’s disease). The brain can no longer store as much of the drug as it did, so the medication lasts for a shorter period of time.
Delayed gastric emptying can be a symptom of Parkinson’s, which means food can linger in a person’s stomach for long periods of time. This delay can limit the amount of oral medication absorbed into the bloodstream.
When someone with advanced Parkinson’s disease no longer responds well to medications taken by mouth, their doctor may recommend injectable or infused medications to manage the symptoms.
Dyskinesia
Long-term use of the drug levodopa — used to treat Parkinson’s motor symptoms — may lead to a movement disorder called dyskinesia. It’s important to understand some of the facts about dyskinesia:
It is uncontrolled.
It can involve just one part of the body or the entire body.
It can manifest as swaying, writhing, or fidgeting.
It can often happen when tremor, stiffness, and slowness are controlled.
It can appear when someone is excited or emotionally stressed.
It can be painful and can impair activities of daily living.
When a person with advanced Parkinson’s disease experiences dyskinesia, they should consider discussing the following treatment options with their doctor:
Altering the dose or timing of their levodopa — This can help you get enough of a dose to help your symptoms while avoiding taking too much to cause dyskinesia.
Changing to a different medication — If levodopa is causing dyskinesia, your doctor might recommend switching to a different formulation or changing your medication completely.
Adding apomorphine (Apokyn) — This injectable or infused medication can help you manage the symptoms you experience during levodopa’s “off” periods.
Adding amantadine (Gocovri) — This drug works on a different pathway to help decrease dyskinesia.
Talk With Others Who Understand
MyParkinsonsTeam is the social network for people with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 89,000 members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s disease.
How has your Parkinson’s progressed? Share your experience in the comments below, or start a conversation by posting on your Activities page.
Dopamine is a neurotransmitter that sends signals between nerve cells in the brain. Dopamine is produced by cells in the substantia nigra region of the brain. In people living with Parkinson’s, the dopamine-producing cells die off as the disease progresses.
Levodopa is a medication given to replace the dopamine that is lost as Parkinson’s progresses. While the drug can be effective in controlling the symptoms of Parkinson’s disease, the level of effectiveness can vary. The effectiveness of Levodopa depends upon many factors, including how far the disease has progressed, how long it has been since a dose of Levodopa was taken, and what kind of food was eaten with the medication.
Levodopa helps you maintain control of your motor function. However, it is not a perfect replacement for naturally occurring dopamine, so the level and duration of control can vary. This variation is called motor fluctuation. The frequency and severity of motor fluctuations can be like a ripple in the water or a rolling wave. Sometimes motor fluctuations can be sudden; other times they’re like a slow undulation, depending upon the level of Levodopa reaching the substantia nigra region of the brain.
Dyskinesia, involuntary and abnormal movement such as twitches, jerks, and writhing, is a common complication of some Parkinson’s medications. The form dyskinesia takes is unique to each person with Parkinson’s and to the stage of their disease. For some, those movements can happen all day long. For others, it happens right after they take Levodopa. Dyskinesia often occurs at “peak dose,” when Levodopa levels are at their highest in the blood, about one to two hours after taking it. These involuntary movements occur with more frequency as the course of the disease progresses.
Wearing off is the most common form of motor fluctuation, and it occurs as your medication wears off and you approach your next scheduled dose of Levodopa.
Morning off is when you wake up and your first dose of the day has yet to take effect.
Motor fluctuations can also be less predictable:
Partial on occurs when the Levodopa doesn’t take full effect.
Delayed on is when it takes longer than usual for the Levodopa to take effect.
Dose failure happens when no benefit is received from the Levodopa.
Unpredictable off (as its name implies) happens when there doesn’t appear to be a clear relationship between dosing and the return of symptoms.
Managing Motor Fluctuations
Lifestyle adaptations such as improving sleep habits, changing your diet, and lowering stress are often the first steps in managing motor fluctuations. Your physician plays an important role in finding the best medication and the proper dosing regimen to meet the symptoms of Parkinson’s that are unique to you.
Parkinson’s research has identified that regulating Levodopa levels in Parkinson’s patients is a key method to mitigate motor fluctuations. Dr. Peter A. LeWitt, director of the Parkinson’s Disease and Movement Disorder Program at Henry Ford Hospital, spoke on the topic at the Pan American Parkinson’s Disease and Movement Disorders Congress. Dr. LeWitt said, “For the most part, most motor fluctuations tend to be closely linked to the variable delivery of Levodopa to the brain, where, after a short delay, it undergoes conversion to dopamine. This neurotransmitter does not have long to carry out its intended signaling because enzymes and reuptake mechanisms quickly dispose of it. So, consistent delivery is the key for averting dose-by-dose motor fluctuations.”
While science is still steps away from finding an accessible, affordable, and convenient delivery system for Levodopa, there are current options available to help regulate motor fluctuations.
Dosing Strategies
Using traditional Levodopa therapy, physicians can increase the dose of Levodopa or prescribe smaller, more frequent doses to level off the motor fluctuations. This strategy works for the short term, but must be frequently reexamined. The doses must be recalculated as the disease progresses and additional neuronal degeneration occurs.
Alternative Delivery Strategies
Levodopa is most often prescribed as an oral medication in the form of a tablet. However, alternative delivery methods can improve its effectiveness in some people.
Infusion Therapy
Duopa, a formulation of Levodopa and Carbidopa that is infused directly into the small intestine, has demonstrated dramatic improvements in off time and dyskinesia. Infusion therapy requires the surgical placement of a gastrostomy tube.
Oral Inhalants
Inbrija, a form of Levodopa that is inhaled orally, may help avoid variability in gastrointestinal absorption and provide intermittent treatment of early morning “off” periods.
Pharmacological Add-Ons and Alternatives to Levodopa
There are several classes of drugs that work in addition to (or in place of) Levodopa to manage specific symptoms of motor fluctuations.
Amantadine (Gocovri, Osmolex ER, Symmetrel) works on the dopamine and glutamate brain chemical pathways. Amantadine is most often used for dyskinesia or mild Parkinson’s symptoms.
Adenosine receptor agonists (Nourianz) work as add-ons to Levodopa to treat “off” time by blocking the brain chemical adenosine to boost the signaling of dopamine.
Anticholinergics (Cogentin, trihexyphenidyl) decrease activity of acetylcholine in the brain to restore balance between acetylcholine and dopamine. They can be used alone or with other Parkinson’s therapies. They work well in treating tremors, especially in younger people, and can help treat the drooling which manifests in advanced Parkinson’s disease.
Catechol-o-methyltransferase (COMT) inhibitors (Comtan, Ongentys, Stalevo, Tasmar) are add-ons that block an enzyme in the body that breaks down Levodopa. They extend the benefit of each Levodopa dose.
Decarboxylase inhibitors (Lodosyn) are add-ons that prevent your body from converting Levodopa to dopamine, allowing more Levodopa to get to the brain and be converted there.
Dopamine agonists (Apokyn, Mirapex, Mirapex ER, Requip, Requip XL) can be taken alone or as add-ons to mimic the effect of dopamine. These can be administered as a pill, as a patch, or by injection.
Monoamine oxidase B inhibitors (Azilect, Eldepryl, Xadago, Zelapar) can be taken alone or as an add-on. They block a brain enzyme that breaks down depleted dopamine to allow the available dopamine-producing brain cells to function for a longer time.
Deep Brain Stimulation
Deep brain stimulation is a surgical option that provides relief of symptoms for many patients without the motor fluctuations that occur with Levodopa. With this procedure, electrodes are implanted in an area of your brain that is targeted based on your symptoms. A small, pacemaker device (called an implantable pulse generator) is placed subcutaneously near your collarbone. When this generator is activated, it sends continuous electrical pulses, modifying brain circuitry in the targeted area.
Finding Hope and Support
Motor fluctuations are a life-changing side effect of Parkinson’s disease that can make you lose weight, affect your sleep, and impact your mobility, directly affecting your quality of life. Whether you’re writing a letter or enjoying a cup of morning coffee, experiencing these involuntary movements is disruptive. However, with proper medication management, they can be mitigated. Ongoing research through clinical trials provides hope that the keys to unlock the mysteries of Parkinson’s will be discovered.
On MyParkinsonsTeam, the social support network for people with Parkinson’s disease and parkinsonism and their loved ones, members often discuss how to manage motor fluctuations. Have you found a dosage schedule or add-on medications that have worked to control your motor fluctuations? Comment below or post on MyParkinsonsTeam.
Neil Diamond is among the celebrities who have publicly discussed a diagnosis of Parkinson’s disease. By taking this courageous step, Diamond helped make the Parkinson’s room bigger, contributing to awareness and discussion of Parkinson’s disease (PD) around the world and helping others with Parkinson’s feel less alone.
Although the diagnosis prompted Diamond to retire from touring, he said he planned to continue writing and recording new music. Members of MyParkinsonsTeam often talk about lifestyle-related topics like retirement. “I’m about to retire in May so I can devote all my time to staying active,” one member wrote. Another said, “I was an accounts payable coordinator for over 16 years. I had to retire due to my Parkinson’s.”
Other members find that they can continue their careers while managing PD. “Had no problems with carrying on working with Parkinson’s, but I worked in IT and much of the time worked from home anyway,” one member said.
“My teaching job has been so good to me and my PD has been manageable throughout my career, but I am slower and exhausted by the end of the day,” another wrote.
Members Make the Community Stronger
Since MyParkinsonsTeam launched in 2016, we have grown to become over 74,000 members strong — that’s a big room! Just as Neil Diamond’s announcement amplifies the voice of those with Parkinson’s, each new member on MyParkinsonsTeam makes our community stronger.
Without a Parkinson’s community, it can be easy to feel isolated, like you’re the only one struggling with Parkinson’s symptoms like tremors, difficulty sleeping, and loss of balance. Whether you have spoken directly with other members or not, by joining MyParkinsonsTeam and reading shared experiences, you have become part of the community.
Here are a few easy actions you can take to welcome and support other members:
Hug or like someone’s post
Say hello to a new member
Answer a question in Q+A
Add someone to your team
Consider other ways to get started on MyParkinsonsTeam
Together we make a stronger community!
Talk With Others Who Understand
On MyParkinsonsTeam, over 74,000 people living with Parkinson’s disease come together to ask questions, give advice, and share their stories with others who understand life with PD.
Are you living with Parkinson’s disease? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
If you have Parkinson’s disease (PD), you may be wondering whether alcohol consumption affects the development or progression of your condition. Some people may wonder if they should avoid drinking completely. As one MyParkinsonsTeam member asked, “How does alcohol affect Parkinson’s — how much can I drink? Or should I avoid drinking altogether?”
Some studies haven’t found that small amounts of alcohol are associated with a higher PD risk, while others highlight the dangers alcohol can pose for anyone with a chronic condition. In addition, there may be adverse interactions between alcohol and common Parkinson’s medications. Because of conflicting information, people with PD may feel confused about whether or not to drink.
“I’ve been told by more than one doctor that I should not have any alcohol,” one MyParkinsonsTeam member wrote. “And at this point, I don’t remember which doctor or specifically why.”
So, how do you decide what approach to take?
If you have Parkinson’s disease and are trying to decide whether or not to reduce your drinking — or quit alcohol completely — here are some things to consider.
In general, alcohol can be harmful to people with chronic conditions. According to the Centers for Disease Control and Prevention (CDC), overconsuming alcohol can be a long-term risk factor for a weakened immune system, learning and memory problems, high blood pressure, digestive issues, and various types of cancer. When looking specifically at Parkinson’s symptoms, however, reports differ on how alcohol and PD may be linked.
The type of alcoholic beverage consumed may affect whether drinking has an impact on PD. A 2013 study found that the risk for developing Parkinson’s disease appeared to increase depending on the amount of liquor consumed, although no link was conclusively found between drinking wine and the development of PD.
In terms of how long-term alcohol use affects the risk of PD, one study published in 2013 followed people who had been admitted to the hospital with alcohol use disorders for up to 37 years. The study authors found that a history of alcohol abuse increased the risk of admission into the hospital for Parkinson’s for both men and women. The study authors suggested that chronically drinking too much alcohol can have neurotoxic effects on dopamine, the neurotransmitter in the brain that is relevant to Parkinson’s disease.
There may also be factors other than observable symptoms — such as how alcohol interacts with your medication — that are important to consider when making decisions about your lifestyle and drinking habits.
The interaction between Parkinson’s medications and alcohol is a common topic on MyParkinsonsTeam. “I miss my red wine and whiskey on occasion,” one member wrote. “I found that it just makes my meds stop working.” Another member said, “My husband has been told he shouldn’t drink with his meds.”
“I have to limit myself to one Scotch on the rocks now,” a MyParkinsonsTeam member said. “I used to have three or four, but the side effects are too bad.” Another wrote, “Never really a good idea to mix alcohol with meds.”
Whether you decide to continue your current drinking habits, cut down, or eliminate alcohol altogether, it’s important to listen to your body and have open conversations about these topics with your neurologist.
It is important to discuss alcohol consumption with your doctor to make sure you are approaching it safely. Elements of PD, including motor symptoms such as bradykinesia (slowed movement) and dyskinesia (involuntary movements), will vary from person to person, so it’s important to make decisions based on your medical history.
Taking into account environmental factors such as how central alcohol is to your social life can affect the decisions you make. Be honest with your doctor about your habits and preferences — remember, your doctor wants to work with you to make your symptoms as manageable as possible, not to judge or shame you.
As you decide how alcohol may fit into your life post-diagnosis lifestyle, there are many factors to consider, such as the type of alcoholic beverage, your other risk factors, and your neurologist’s recommendations specific to your medical history. Most importantly, monitor how you feel when you drink alcohol and be willing to have open and honest conversations about drinking with your doctor and other important people in your life.
“I am not even a big drinker, but miss the odd one,” wrote a MyParkinsonsTeam member. “So, I had an alcohol-free beer, which tasted OK, to be honest.”
Deciding to change your drinking habits after a diagnosis of PD isn’t easy, but if you decide to do so, you have 76,000 people to talk to who understand what it’s like to deal with Parkinson’s symptoms.
It’s important to be patient with yourself as you make any lifestyle adjustment. Whether your goal is to drink less often, reduce your moderate alcohol consumption, or cut out drinking altogether, it’s essential to have a support system around you as you make these changes.
How has your PD diagnosis affected your drinking routine? Share your experiences in the comments below, or by posting on MyParkinsonsTeam.
If you have Parkinson’s disease (PD), you may be wondering whether alcohol consumption affects the development or progression of your condition. Some people may wonder if they should avoid drinking completely. As one MyParkinsonsTeam member asked, “How does alcohol affect Parkinson’s — how much can I drink? Or should I avoid drinking altogether?”
Some studies haven’t found that small amounts of alcohol are associated with a higher PD risk, while others highlight the dangers alcohol can pose for anyone with a chronic condition. In addition, there may be adverse interactions between alcohol and common Parkinson’s medications. Because of conflicting information, people with PD may feel confused about whether or not to drink.
“I’ve been told by more than one doctor that I should not have any alcohol,” one MyParkinsonsTeam member wrote. “And at this point, I don’t remember which doctor or specifically why.”
So, how do you decide what approach to take?
If you have Parkinson’s disease and are trying to decide whether or not to reduce your drinking — or quit alcohol completely — here are some things to consider.
In general, alcohol can be harmful to people with chronic conditions. According to the Centers for Disease Control and Prevention (CDC), overconsuming alcohol can be a long-term risk factor for a weakened immune system, learning and memory problems, high blood pressure, digestive issues, and various types of cancer. When looking specifically at Parkinson’s symptoms, however, reports differ on how alcohol and PD may be linked.
The type of alcoholic beverage consumed may affect whether drinking has an impact on PD. A 2013 study found that the risk for developing Parkinson’s disease appeared to increase depending on the amount of liquor consumed, although no link was conclusively found between drinking wine and the development of PD.
In terms of how long-term alcohol use affects the risk of PD, one study published in 2013 followed people who had been admitted to the hospital with alcohol use disorders for up to 37 years. The study authors found that a history of alcohol abuse increased the risk of admission into the hospital for Parkinson’s for both men and women. The study authors suggested that chronically drinking too much alcohol can have neurotoxic effects on dopamine, the neurotransmitter in the brain that is relevant to Parkinson’s disease.
There may also be factors other than observable symptoms — such as how alcohol interacts with your medication — that are important to consider when making decisions about your lifestyle and drinking habits.
The interaction between Parkinson’s medications and alcohol is a common topic on MyParkinsonsTeam. “I miss my red wine and whiskey on occasion,” one member wrote. “I found that it just makes my meds stop working.” Another member said, “My husband has been told he shouldn’t drink with his meds.”
“I have to limit myself to one Scotch on the rocks now,” a MyParkinsonsTeam member said. “I used to have three or four, but the side effects are too bad.” Another wrote, “Never really a good idea to mix alcohol with meds.”
Whether you decide to continue your current drinking habits, cut down, or eliminate alcohol altogether, it’s important to listen to your body and have open conversations about these topics with your neurologist.
It is important to discuss alcohol consumption with your doctor to make sure you are approaching it safely. Elements of PD, including motor symptoms such as bradykinesia (slowed movement) and dyskinesia (involuntary movements), will vary from person to person, so it’s important to make decisions based on your medical history.
Taking into account environmental factors such as how central alcohol is to your social life can affect the decisions you make. Be honest with your doctor about your habits and preferences — remember, your doctor wants to work with you to make your symptoms as manageable as possible, not to judge or shame you.
As you decide how alcohol may fit into your life post-diagnosis lifestyle, there are many factors to consider, such as the type of alcoholic beverage, your other risk factors, and your neurologist’s recommendations specific to your medical history. Most importantly, monitor how you feel when you drink alcohol and be willing to have open and honest conversations about drinking with your doctor and other important people in your life.
“I am not even a big drinker, but miss the odd one,” wrote a MyParkinsonsTeam member. “So, I had an alcohol-free beer, which tasted OK, to be honest.”
Deciding to change your drinking habits after a diagnosis of PD isn’t easy, but if you decide to do so, you have 76,000 people to talk to who understand what it’s like to deal with Parkinson’s symptoms.
It’s important to be patient with yourself as you make any lifestyle adjustment. Whether your goal is to drink less often, reduce your moderate alcohol consumption, or cut out drinking altogether, it’s essential to have a support system around you as you make these changes.
How has your PD diagnosis affected your drinking routine? Share your experiences in the comments below, or by posting on MyParkinsonsTeam.
Whether you’re living with Parkinson’s disease or caring for a family member or loved one who has the condition, you’ve likely wondered whether it’s preventable. Despite ongoing research, scientists and doctors have yet to find a way to prevent Parkinson’s disease. So the quick but hard-to-hear answer is no — you can’t prevent Parkinson’s. However, promising research does show that several lifestyle factors might lower the risk of developing this condition.
What Are the Risks of Parkinson’s Disease?
Researchers have identified multiple risk factors for developing Parkinson’s disease. Remember that having one or more — or even all — of these risk factors does not mean a person will develop Parkinson’s. A complex mix of interconnected factors, starting with your genes and your environment, determines if you will develop Parkinson’s. Some of the identified risk factors include:
Age — Parkinson’s is more commonly diagnosed around age 60.
Sex — According to the Parkinson’s Foundation, men are 1.5 times more likely than women to have the disease.
Heredity — Certain genetic factors may predispose a person to Parkinson’s.
Exposure to environmental toxins — Chemicals such as pesticides and herbicides used in farming or landscaping may be linked with Parkinson’s.
Unfortunately, with the exception of environmental toxins, you can’t change most of these risks. Moreover, even long-term exposure to high amounts of environmental toxins does not necessarily cause Parkinson’s. For example, farmworkers exposed to high levels of pesticides show higher rates of the disease compared with the general population, but not in numbers high enough to indicate a simple relationship between environmental toxins and Parkinson’s disease.
Reduce Risk Through Diet
Following a brain-boosting diet might offer a way to protect your nervous system from Parkinson’s disease. When you have Parkinson’s, neurons (nerve cells) that produce the neurotransmitter dopamine break down and die, resulting in lower dopamine levels in your brain.
Researchers studying the Mediterranean diet confirm that people with diets higher in vegetables, olive oil, fish, whole grains, and fruit have a lower risk of developing Parkinson’s. If people who eat this way do eventually develop the disease, their symptoms may appear later.
Other researchers tracked Parkinson’s disease progression in people following the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, which combines a Mediterranean eating style and the Dietary Approaches to Stop Hypertension (DASH) diet. Following the MIND diet was associated with later onset of Parkinson’s, particularly among female participants, according to the study authors.
The good news is that these same diets help prevent or lower your risks of a host of health conditions in addition to Parkinson’s — high blood pressure, many types of cancer, cardiovascular disease, diabetes, and Alzheimer’s disease, just to name a few.
You might try to eat according to these shared themes from the Mediterranean and MIND diet plans:
Focus on eating more vegetables, whole grains, beans, and nuts.
Limit or avoid red meat.
Use olive oil as your primary source of fat when cooking, and avoid butter and fried foods whenever possible.
Cut down or cut out dairy (milk, cheese, and cream).
Boost your intake of berries and leafy green vegetables like spinach, chard, and collard greens — a specific recommendation of the MIND diet.
Avoid sweets and pastries.
Keep Up the Caffeine for Healthy Neurons
Coffee lovers have reason to celebrate: Several studies show a connection between drinking more caffeine and a decreased risk of Parkinson’s disease. The hypothesis is that caffeine may reduce inflammation and oxidative stress — both of which have been shown to play a role in the death of dopamine-producing neurons in Parkinson’s. Just remember not to overdo the sugar or cream in your caffeinated beverages, as both Mediterranean and MIND diets advise limiting dairy and sweets.
Get the Recommended Amount of Exercise
Research shows that regular physical activity is one of the best ways to slow the progression of Parkinson’s disease and reduce symptoms. It turns out that regular exercise may also play a role in prevention. Studies have shown that exercising more in your 30s and 40s may reduce your chances of developed Parkinson’s by about 30 percent. Regular exercise earlier in adulthood can also improve your quality of life if you are diagnosed with Parkinson’s later.
Researchers do not completely understand how exercise might prevent Parkinson’s, but some suggest that benefits may result from the release of stress-busting chemicals called endorphins. Others believe the benefit might be related to lowering inflammation and oxidative stress.
Most public health advisers and doctors recommend logging at least 150 minutes of moderate-intensity physical activity a week plus doing muscle-strengthening activities at least twice a week. To help prevent numerous chronic diseases, set a goal to:
Do aerobic exercise (vigorous enough so you are breathing heavily) three to five days a week.
Perform strength training two days a week.
Practice balance training and flexibility stretches (such as yoga) once or twice a week.
Remember, there is no one-size-fits-all exercise plan. As one MyParkinsonsTeam member — a strength coach — noted, “Your program can be customized to meet your skill level and physical abilities. Whatever you do, work hard — push yourself in a progressive manner so you safely get stronger, more mobile, or achieve your goals. And never stop moving! It’s critical.”
Take Care With Chemicals
We all come into contact with chemicals every day. Some chemicals, particularly those used in agriculture, landscaping, and industrial settings, can increase your risk for Parkinson’s disease if not handled safely.
If you must work with chemicals that have been linked to higher rates of Parkinson’s, take care to follow all safety procedures as instructed by your employer, and always use the appropriate protective equipment.
Several studies show a strong link between exposure to a specific class of pesticides — organochlorine insecticides — and developing parkinsonism. Organochlorine insecticides include DDT and dieldrin.
In your garden or yard at home, you might try organic gardening to use fewer pesticides and fertilizers. You can reduce chemical exposure by following these tips:
Have your soil tested by your local cooperative extension service office before you fertilize.
Take your shoes off at the door to avoid tracking soil into your home.
Scrub your hands after gardening.
Wash fruits, vegetables, and herbs before you eat them.
Avoid using rotenone, a pesticide used by gardeners and often listed as natural, even though studies have linked it to Parkinson’s in humans.
Some popular hobbies can also put you in contact with chemicals that may be linked to Parkinson’s disease. Woodworking and painting use solvents, thinners, and finishes. Pottery glazes can involve a mix of chemicals. Whenever you are working with chemicals at work or home, wear protective equipment such as a mask, gloves, and other appropriate clothing such as goggles and long pants.
Focus on Lifestyle Factors for Parkinson’s Prevention
Without a cure or an easily targeted cause, there is not yet a way to prevent Parkinson’s disease. Health care providers are, however, getting better at diagnosing Parkinson’s disease at earlier stages and treating symptoms.
Until the complex combination of genetic and environmental factors that may be behind Parkinson’s is better understood, focusing on lifestyle changes could be a way to affect the chance of developing the disease. If you’re concerned about your risk of developing Parkinson’s, you can take control by optimizing your diet and exercise routine to make your brain and body as Parkinson’s-resistant as possible.
Talk With Others Who Understand
MyParkinsonsTeam is the social network for people living with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 89,000 members come together to ask questions, give advice, and share stories with others who understand life with Parkinson’s disease.
Have you made any lifestyle changes to help prevent Parkinson’s disease? Do you still have questions about preventing or lowering the risk of Parkinson’s? Share in the comments below, or start a conversation by posting on your Activities page.
The winter sky is a black abyss by 6:00 PM in the Rocky Mountains, which creates a knot of inner turmoil in my gut. The evenings feel hopeless, like we’ll be stuck in a perpetual freeze, never to see the sun again. Some people call this cabin fever. Others just ignore the passage of time, knowing that the groundhog saw his shadow, and that a wave of optimism could propel us towards spring at any moment. But I’m not so quick to move on from the winter’s tragedy.
Music brings comfort
I’m feeling sorry for myself when my phone pings. It’s one of my group chats. A friend of mine is having a bad day, and he’s turning to music to help him process the agony of his existential questions. It’s Rachmaninoff to the rescue.
When he says as much, a ping of joy hits me. I love Rachmaninoff. During particularly challenging chapters, I play his Concerto No. 2 in C Minor on repeat, feeling less alone in his dark cavern of sound.
My home was filled with classical music for the first 20 years of my life. In the same way that some people look to exercise or make similar lifestyle choices to manage their sorrow, I learned to look to music. It was in the harmonies and complexities of the sounds that I found the most comfort throughout my formative years. And there are few classical pianists that can enter the human soul during its greatest state of turmoil. But Rachmaninoff is one of them.
Emotional relief
I acquired my appreciation for music from my parents, who studied piano and clarinet throughout college. Mom continues to teach piano lessons today. Although Dad doesn’t usually play anymore, he does have an intimate relationship with the record player that sits in the corner of the living room.
Dad gave up music a long time before his Parkinson’s diagnosis, but it still plays a significant role in his life. His choice of records changes with the season. After Christmas, Andy Williams takes a back seat to more classical tunes. In the summer, lighthearted music tends to fill the living room. And I can’t help but wonder if music provides some emotional relief for Dad on his hard days.
While I imagine what my dad’s life is like, I picture his small figure in his rocking chair while the record player runs. He sat in the same chair to listen to my at-home piano performances. No matter what he was doing, he’d stop as soon as he heard the spruce keys emit their first sounds. And, even as time passes, I find myself feeling grateful for the power that music has exerted over all of our lives.
Music and Parkinson’s symptoms
There’s a lot of evidence that suggests that singing or playing an instrument can help to ease some Parkinson’s symptoms. Music lights up different parts of the brain, potentially impacting things like memory, feeling, and cognition.1
Research also shows that music can even positively impact motor skills in Parkinson’s patients. And I like to think that my family’s love of music supports Dad’s health on a day to day basis – even if he doesn’t play anymore. I know it supports mine.2
So, even when the black abyss hits the mountains for months on end, there’s still comfort to be found when the first notes rumble, reminding me of the existence of music.