What is the link between Parkinson's disease and dementia?
Which therapies can ease Parkinson's disease symptoms?
If you're living with Parkinson's disease, symptoms affecting both your mobility and mental state can make daily life a struggle. There are several supportive therapies that your specialist healthcare nurse may recommend.
What are the symptoms of Parkinson's disease?
Parkinson's disease is the fastest growing neurological disease (a condition affecting the brain and nerves) in the world. Thought of by most as a movement disorder, Parkinson's disease motor symptoms include shakes (tremors), muscle stiffness and a slowing of movement (bradykinesia).
There are also many other possible Parkinson's disease symptoms - both physical and mental - which can interfere with a person's daily activities and affect their quality of life. In the vast majority of cases, symptoms get worse over time.
"There are over 40 symptoms that have been associated with Parkinson's, from tremors and pain to anxiety," says Dr Katherine Fletcher, research communications manager at Parkinson's UK.
Many people aren't as aware of the cognitive (mental) Parkinson's disease symptoms - such as memory loss, confusion and language problems. This can lead people to mistake Parkinson's for dementia or Alzheimer's disease. Parkinson's also increases the risk of two types of dementia (called Parkinson's dementia and dementia with Lewy bodies).
Is there a cure for Parkinson's disease?
Unfortunately, no existing treatment can reverse Parkinson's or stop Parkinson's disease symptoms from progressing. "Your consultant or Parkinson's nurse will discuss and review the best Parkinson's disease treatments and therapies for you," says Fletcher. "They will also be able to provide support for those that are experiencing changes in thinking, memory and concentration."
What treatments are there for Parkinson's disease?
The main Parkinson's disease treatment methods are:
- Medication - "Most of the current medications work to replace the vital brain chemical dopamine, which is reduced over time in Parkinson's. However, this only manages some of the symptoms and current options can have side effects," advises Fletcher.
- Supportive therapies - can be a useful way to ease symptoms as the disease progresses.
- Surgery - may be an option in severe cases where medicines are not working effectively.
Although Parkinson's disease affects your ability to move, it's also important to remain as active as possible. As well as improving your mobility and balance problems, exercise has also been shown to strengthen memory, improve learning, alleviate depression, and enhance your brain's ability to reorganise itself (known as neuroplasticity).
Parkinson's affects people in different ways and your specialist Parkinson's nurse will be able to create the best treatment strategy for you. Factors they will consider include your age, disease stage, most troublesome symptoms and the risks for each treatment option.
Supportive therapies for Parkinson's disease symptoms
Supportive therapies may significantly reduce Parkinson's disease symptoms and make day-to-day life easier to manage. They can work alongside medication, or as a useful alternative if you experience medication side effects.
There are several types of therapy used to treat Parkinson's disease symptoms. Finding the ones most helpful to you will depend on which symptoms cause you the most trouble.
Physiotherapy for Parkinson's disease symptoms
"People with Parkinson's disease symptoms can struggle with balance and find it hard to start movements, for example standing up or taking a first step. This can make day-to-day life a real challenge," explains Rachael Newman, physiotherapist at Ascenti.
"These symptoms also pose a real injury risk as balance problems and a loss of strength increase the chances of falling over. Published studies show that more than half of people with Parkinson's fall every year and the majority of those fall several times."
Stretches - to tackle muscle stiffness
- 'Seated hamstring stretch' - sit towards the edge of your chair with one leg in front of your body with the heel on the floor. Sit up tall to stretch your spine and hold it.
- 'Reaching in sitting' - reach as far forwards as you feel you can safely go. Then do the same, reaching out to each side.
- 'Standing side bend' (you can also do this seated) - keeping your feet and legs together, reach both arms up over your head and inhale. Putting your right arm down to your side, reach your left arm over your head and bend your body slightly to the right, as you exhale. Then repeat on your opposite side.
- 'Sitting wood chop' - while sitting down, start by touching your hand to the opposite ankle. Reach the same arm diagonally up to the sky and then back down to the ankle, as if you are chopping wood.
Strengthening exercises - to protect against falls and injuries
- 'Sit to stand with arm reach' - start in a seated position and with your weaker arm, reach diagonally up and to the side. Continue to reach while standing up from a seated position. This forces you to move your weight through your weaker leg.
- 'Marching on the spot' - really exaggerate the movement of your arm swings and knee lifts with this simple exercise.
- 'Side stepping' - stand with your legs together and step to the side, bending your knees into a squat as the foot lands on the floor. For an extra challenge, you can add a resistance band around your knees.
- 'Throw and catch a ball' - this is a good one for football fans, this simple overhead throw exercise is great for building strength. You can perform this exercise sitting or standing.
Cueing - for those who struggle with initiating movements
"This can be as simple as counting '1,2,3,4' in your head with the intention of taking the first step on one and then stepping forwards in time with the counting. Cueing strips or blocks can also be placed on the floor to help with taking larger steps. Some walking aids project lines onto the floor wherever you are walking to help with this, such as a laser cane."
"Every person's abilities will be different so, if you're unsure about what is safe for you to do, it is always best to speak with a physiotherapist to get a tailored exercise programme."
Speech and language therapy for Parkinson's disease
A speech and language therapist can help people with Parkinson's disease who struggle with speech, such as reduced volume, slower speaking rate and articulation (the ability to say words clearly). They can also help with other Parkinson's disease symptoms, including swallowing difficulties (dysphagia) and drooling, both of which can make eating and drinking hard.
A therapist can achieve this by:
- Developing a strategy - tailored to your needs.
- Teaching exercises - to help you speak and swallow.
- Introducing technological aids - for example, small devices that prompt you to swallow, voice amplifiers, and specialist digital apps on your mobile phone.
- Providing practical advice - for example, ways to cope when communication is difficult, and different methods of communication in certain situations/settings.
How can occupational therapy help Parkinson's disease symptoms?
Occupational therapy for Parkinson's disease involves identifying areas of difficulty in a person's life and working out ways to make these easier and more achievable. Research suggests that therapy plans tailored to an individual's goals can improve their quality of life.
If you are living with Parkinson's, an occupational therapist can develop a treatment plan centred around the Parkinson's disease symptoms that interfere with your daily life.
This could include plans to help you:
- Live with fatigue (excessive tiredness) - e.g., how to pace yourself, plan for tasks that make you tired, get enough rest and undertake gentle physical activity.
- Communicate - e.g., how to avoid distractions and pay attention while you are writing and support or training for using email correspondence.
- Manage tremors - e.g., exercises to improve your hand function, recommendations for home adaptations which can ease everyday tasks and methods for better controlling shakes.
- Improve your anxiety - e.g., find strategies to help you deal with anxiety and refer you to a mental health professional if necessary.
Psychotherapy for Parkinson's disease
Sadly, depression is common among people with Parkinson's. Depressive symptoms - such as becoming slower, sleep problems and a lack of energy - can make it seem like your Parkinson's disease symptoms are getting worse. If you find that your symptoms escalate quite fast, depression could be the cause.
If this is the case, depression can be treated with both medication and psychotherapy. The most common form of psychotherapy is cognitive behavioural therapy (CBT), which can significantly improve depression.
CBT is based on the idea that certain ways of thinking can fuel mental health problems. When used as a therapy for Parkinson's and depression, a therapist can help change how you perceive certain situations that your condition makes difficult.
Complementary therapies for Parkinson's disease
Despite the lack of scientific evidence, many people turn to complementary therapies to alleviate Parkinson's disease symptoms. Unlike the above therapy for Parkinson's options, complementary therapies are not put through a thorough testing process and clinical trials that adhere to scientific standards to prove they work.
If you decide to try a complementary therapy for Parkinson's, you should do this alongside - and not in replacement of - the Parkinson's disease treatment advised by your healthcare team. Making changes to your treatment without guidance could be dangerous.
Parkinson's UK lists the most popular complementary therapies including:
- Acupuncture - using needles to stimulate sensory nerves.
- Homeopathy - substances that bring on symptoms in a healthy person are used in small doses to treat an illness that causes similar symptoms.
- Art therapy is a form of psychotherapy that uses art to help people communicate their thoughts and feelings.