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Published on January 21, 2020

Learn how to manage this on-the-rise condition

Parkinson's Rise

The incidence of Parkinson’s disease is increasing among older Americans, and it’s critical that patients and those at risk of the condition learn as much as they can about managing it, according to Hyannis neurologist John Hamjian, MD.

“It is one of the most debilitating issues of aging,” he said. “It’s going to place just as much of a burden on society as Alzheimer’s (disease).”

In a study reported in 2016, Mayo Clinic researchers found that the incidence of Parkinson’s disease (PD) and “parkinsonism,” which is any condition that causes a combination of the movement disorders seen with PD, increased significantly in the 30 years from 1976 to 2005. The study showed that men of all ages had a 17 percent higher risk of developing PD for every 10 years. Men 70 and older had an even greater increase, according to the study.

“We have reason to believe this is a real trend,” lead author and Mayo neurologist Rodolfo Savica, MD, Ph.D. said in an article published on the Mayo Clinic web site in 2016 about the study. “We have evidence to suggest that there has been a genuine increase in the risk of Parkinson’s disease.”

Parkinson’s disease is a neurodegenerative disorder that affects dopamine-producing neurons in the brain, according to Dr. Hamjian. Changes in the brain occur 10 to 20 years before symptoms appear, he said. The progression of symptoms is specific to each patient, but generally the earliest sign is a tremor in one hand, he said.

According to the Parkinson’s Foundation, people with PD may experience:

  • Tremor, mainly at rest and described as “pill rolling” tremors in hands
  • Bradykinesia (slowness of movement)
  • Limb rigidity
  • Gait and balance problems

A diminished sense of smell and sloppy handwriting are two other symptoms, Dr. Hamjian added. He suggests one simple test that can indicate a person is dealing with PD: Draw a spiral from the inside out. People with PD tend to draw a tiny spiral, he said.

At a certain point, PD patients may develop depression, changes in bowel function and cognitive problems, Dr. Hamjian said. The diagnosis is particularly daunting because of the disease’s relentless progression.

“Unfortunately, nothing helps defray the symptoms,” he said.

Most patients develop the disease over the age of 60, he said. Actor and PD activist Michael J. Fox was much younger when his symptoms appeared, but genetic factors are involved in his diagnosis, Dr. Hamjian said.

How is it Treated?

Diagnosis is usually made based on clinical symptoms. When patients respond positively to medications to address symptoms, the diagnosis is confirmed, he said. A radiological test is available to try to determine the source of the symptoms when patients do not respond to medications.

The medications used in the treatment of PD have been on the market since the 1960s. When the brain still has some dopamine cells, medications can help even out the amount needed for smooth movement and other functions, Dr. Hamjian said.

Stereotactic surgery to implant an electrical stimulator in the brain helps improve the body’s dopamine levels and helps address debilitating tremors, he said. It usually works for a few years before there is a regression to where the patient was before the surgery.

“There is no cure, just treating symptoms,” he said. “Usually I can manage patients with medications three to four times a day.”

But pills and surgical intervention are not the only answer for living with PD, he said. Parkinson’s support groups are very therapeutic for patients, and they can be found at most town senior centers.

“It does a lot of good because people who have this can tell you strategies (to cope with the disease),” he said.

Physical therapy classes for PD patients – with things like exercise bikes and punching bags - are available in the community through the Cape Cod YMCA and a variety of physical therapy centers, he said. Dr Hamjian works with patients at his office at 2 Lynxholm Court in Hyannis on walking and getting out of a chair.

With more Americans growing older each year, particularly on Cape Cod, “it’s important for people to know there are (PD) resources in the community,” he said.

For good PD information online, Dr. Hamjian suggests the Michael J. Fox Foundation web site.

PD patients can be assured they can receive the treatment they need right here on Cape Cod, said Dr. Hamjian, who is specially trained in treating movement disorders. All neurologists practicing on the Cape are trained in the treatment of PD patients, he said.