What you don't know about Parkinsons disease

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World Parkinson’s Disease Day marks the birthday of Dr. J Parkinson. On this day there are efforts made to increase the public awareness of this disease, as well as all the good works put forth by the world's organizations dedicated to eradicating this disease. Scientists have claimed that it is now the world's fastest-growing neurological disorder ahead of dementia and shows no signs of slowing. There are now about 6.9 million Parkinson's patients worldwide and, by 2040, the number will grow to 14.2 million as the population ages.

Parkinson’s disease (PD) is a common neurodegenerative disorder that can cause significant disability and decreased quality of life. Depression, dementia, and psychosis are common psychiatric problems associated with this condition. Dr. Pradeep Mahajan, Surgeon and Regenerative Medicine Researcher shares his valuable knowledge to create awareness amongst people

Q1. Do you agree or disagree that a Parkinson's disease pandemic is on the horizon and why?

Yes, the burden of neurological disorders is increasing in most countries, especially in populations over 65 years of age. Although there is increasing awareness of neurological conditions, the grim reality of scarcity of neurological resources and services, especially in low income and developing economies, also springs into attention. Parkinson’s Disease is now being recognised as a universal disorder/pandemic, with a crude incidence rate of 4.5–19 per 100,000 population per year. Being a chronic condition, prevalence rates (especially among those above 85 years of age) are higher than incidence rates.

Health care and insurance providers currently are facing challenges to cope with the predicted rise in the prevalence of neurological and other chronic disorders, and the disability resulting from the extension of life expectancy and aging of populations globally.

Q2. In your practice, how often do you deal with Parkinson's patients?

Regenerative medicine and cell-based therapy is a new branch of therapeutics, and awareness regarding this modality is not widespread as of date. Therefore, we may say that although the number of cases of PD that we deal with may not be at par with the reported incidence and prevalence, the condition is definitely on the rise.

Q3. Do you think cases have doubled in the last 25 years in India as well? Do you see younger patients?

Yes, the condition is common among the elderly age group. However, individuals younger than 20 years of age may also acquire ‘Juvenile Parkinsonism’ that is commonly attributed to genetic mutations. Similarly, patients presenting with the disease before 40 years of age/20 years of age are generally designated as having “early-onset” PD or “young-onset” PD, respectively. Males are generally more commonly affected than females. Though the prevalence of PD in India is less compared to other countries, the total burden of the disease is much higher as a result of a large population. The rural population was found to have a higher prevalence compared to the urban population.

Q4. What do think are the causes of Parkinson's Disease growing so rapidly?

A decrease in the number of neurons has been observed as an individual ages. In PD, cell death in certain parts of the brain occurs, which may affect up to 70% of the required neurotransmitter secreting (dopamine) neurons. Also, accumulation of a substance, known as Lewy bodies, in the remaining neurons,is responsible for most of the motor symptoms and disability.

Research indicates that environmental and lifestyle changes are potential causes for the increase in rates of PD. In earlier times, small scale farming, lesser industrial development as well as a higher level of physical activity, were responsible for good health and longevity of an individual. However, with changing times and growing population, we are seeing an increase in the use of pesticides and other chemical agents, as well as an increase in the number of individuals who follow unhealthy lifestyle practices (junk food, smoking, etc.) Studies hypothesize that changes in exposure to a number of risk factors may have caused Parkinson's Disease to rise.

Q5. What can be done to curb the rise of Parkinson's?

PD cannot be prevented. However, it is important to maintain a healthy lifestyle and avoiding deleterious habits such as smoking, etc. to reduce the chances of occurrence of the condition. Additionally, early identification of the signs and symptoms of the disease will aid in planning appropriate treatment and neuro-rehabilitation, thereby limiting the rate of disability.

It is also mandatory to increase public awareness regarding recent advances in therapeutics. As previously mentioned, regenerative medicine and cell-based therapy are now showing promise in the treatment of various acute and chronic conditions. In the context of PD, autologous cell-based therapy may aid in reducing the intensity of tremors, movement and speech issues, and can enable an individual to perform activities of daily living independently. Progenitor cells that can be obtained from a patient’s own body have multi-differentiation potential. These cells have neurotrophic and neuro-regenerative properties which may be beneficial in protecting and stimulating the regeneration of diseased neurons.