Parkinson's disease is not one, but two diseases

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Parkinson’s disease is a debilitating and progressive neurologic condition that frequently causes symptoms of hand tremor, slow body movement, rigid muscles, and impaired balance and posture. It is caused by nerve damages in neurons (a kind of brain cells), leading to impairment of the brain’s dopamine system.



Interestingly, a new study that has been published in the leading neurology journal Brain suggested that Parkinson’s disease is not one but two diseases.


Parkinson’s disease is two diseases


Researchers used state-of-the-art imaging scans (PET scan and MRI scan) to examine both patients diagnosed with Parkinson’s disease and individuals who are at a high risk of developing Parkinson’s disease (people with rapid eye movement sleep behavior disorder).


The results showed that Parkinson’s disease can be divided into two variants, starting either in the brain or other body parts. "For some patients, the disease starts in the intestines and spreads from there to the brain through neural connections. For others, the disease starts in the brain and spreads to the intestines and other organs such as the heart," explains Professor Per Borghammer.




The study also noted that by the time of diagnosis, many patients have lost more than half of the brain’s dopamine system and it is very difficult to find patients early enough for treatment.


Life expectancy for Parkinson’s disease


The life expectancy for Parkinson’s disease varies from a few years to a few decades, depending on factors such as choking/aspiration pneumonia, gender (female patients live shorter than male patients), and falls with broken bones. Among those factors, aspiration pneumonia is the most concerning one.


Watch out for aspiration pneumonia


The most common cause of death for patients with Parkinson’s disease is aspiration pneumonia, which is lung inflammation by aspiration of foods into the bronchus and the lungs. Doctors believe that the aspiration pneumonia is caused by dysphagia, which literally means swallowing difficulty. This, in part, may be related to muscle rigidity, a characteristic finding in patients with Parkinson’s disease.



So, how to avoid and prevent aspiration pneumonia? The patients and their caregivers need to follow these tips:


1) Put the patient in a sit position when feeding: Keep the head slightly up when feeding the patient is a very useful way to avoid aspiration.  

2) Make soft foods: Hard foods may be very difficult for the patient to chew and swallow effectively. Soft foods like pasta, cooked cereal, mashed potatoes, tuna fish mixed with mayonnaise, well-cooked fruits and vegetables, and scrambled eggs are easy to eat. Make sure that the patient eats the foods she/he likes.

3) Drink thickened liquids, such as yogurt, apple sauce, and oatmeal.

4) Pay attention to the patient’s oral hygiene: Make sure that the patient gets adequate teeth brushing. Dentures should be removed when sleeping and soaked and thoroughly cleaned in the cleaning solutions.

5) Consult a speech therapist, if necessary.



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