August 20, 2010

Parkinson's disease is a progressive, neurodegenerative disorder that affects

movement, muscle control, and balance as well as numerous other functions.
It is part of a group of conditions known as motor systems disorders.
Parkinson's disease was named for James Parkinson, a general practitioner in
London during the 19th century who first described the symptoms of the
disease. Symptoms describing Parkinson's disease are mentioned in the
writings of medicine in India dating back to 5,000 BCE as well as in Chinese
writings dating back approximately 2500 years. Parkinson's disease is the
most common movement disorder and the second most common
neurodegenerative disorder, the most common being Alzheimer's disease.

What is Parkinson's Disease?

Parkinson's disease is a progressive, neurodegenerative disorder that affects

movement, muscle control, and balance as well as numerous other functions.
It is part of a group of conditions known as motor systems disorders.
Parkinson's disease was named for James Parkinson, a general practitioner in
London during the 19th century who first described the symptoms of the
disease. Symptoms describing Parkinson's disease are mentioned in the
writings of medicine in India dating back to 5,000 BCE as well as in Chinese
writings dating back approximately 2500 years. Parkinson's disease is the
most common movement disorder and the second most common
neurodegenerative disorder, the most common being Alzheimer's disease.

The hallmark symptoms of Parkinson's disease (PD) are asymmetric tremors

at rest, rigidity, and bradykinesia (slowness in movement). There is currently
no cure for Parkinson's disease; it is always chronic and progressive, meaning
that the symptoms always exist and always worsen over time. The rate of
progression varies from person to person, as does the intensity of the
symptoms. Parkinson's disease itself is not a fatal disease and many people
live into their older years. Mortality of Parkinson's disease patients is usually
related to secondary complications, such as pneumonia or falling-related
injuries.

There are three types of Parkinson's disease and they are grouped by age of
onset:
  Adult-Onset Parkinson's Disease - This is the most common type of
Parkinson's disease. The average age of onset is approximately 60
years old. The incidence of adult onset PD rises noticeably as people
advance in age into their 70's and 80's.

 Young-Onset Parkinson's Disease - The age of onset is between 21-40

years old. Though the incidence of Young-Onset Parkinson's Disease is
very high in Japan (approximately 40% of cases diagnosed with
Parkinson's disease), it is still relatively uncommon in the U.S., with
estimates ranging from 5-10% of cases diagnosed.

 Juvenile Parkinson's Disease - The age of onset is before the age of 21.
The incidence of Juvenile Parkinson's Disease is very rare.

According to the American Parkinson's Disease Association, there are

approximately 1.5 million people in the U.S. who suffer from Parkinson's
disease - approximately 1-2% of people over the age of 60 and 3-5% of the
population over age 85. The incidence of PD ranges from 8.6-19 per 100,000
people. Approximately 50,000 new cases are diagnosed in the U.S. annually.
That number is expected to rise as the general population in the U.S. ages.
Onset of Parkinson's disease before the age of 40 is rare. All races and ethnic
groups are affected.

PD is the most common cause of chronic progressive parkinsonism, a term which refers to the syndrome
of tremor, rigidity, bradykinesia and postural instability. PD is also called "primary parkinsonism" or
"idiopathic PD" (classically meaning having no known cause). While many forms of parkinsonism are
idiopathic, "secondary" cases may result from toxicity most notably of drugs, head trauma, or other
medical disorders. The disease is named after English apothecary James Parkinson, who made a detailed
description of the disease in his essay: "An Essay on the Shaking Palsy" (1817).

PD traditionally has been considered a non-genetic disorder, however around 15% of patients have a
first-degree relative who also has the disease. [3] At least between 5 and 10% of the patients are now
known to have monogenic forms of the disease. [7] Other genes act as risk factors for sporadic cases of
the disease.

PD progresses with time. If not treated motor symptoms have an aggressive advance at the beginning of
the disease with an slower advance later on the disease course: untreated patients are expected to lose
independent ambulation after 8 years and be bedridden after 10 years
Two main measures are used in epidemiological studies: incidence and prevalence. Incidence is the
number of new cases per unit of person–time at risk (usually number of new cases per thousand
person–years); while prevalence is the total number of cases of the disease in the population at a given
time. PD is the most common neurodegenerative disorder after Alzheimer's disease. [34] The prevalence is
estimated at being 0.3 in the whole population in industrialized countries, rising to 1% in those over 60
years of age and to 4% of the population over 80. [34] Mean age of onset is around 60 years, although 5-
10% of cases are considered of young onset as begin between the age of 20 and 50. [3] Parkinson's
disease might less prevalent in those of African and Asian ancestry, although results are controversial. [34]
Some studies have also proposed that PD is more common in men than women while others did not
found any differences between the two groups. [34] Studies on incidence report that it is between 8 and
18 per 100.000 person-years.

The burden of Parkinson disease (PD) in developing nations is expected to double over the next
generation as the result of increasing life expectancy. 1 People aged 85 years and older are currently the
fastest growing segment of the US population. 2 Age is the strongest risk factor for PD, with a nearly
exponential increase in incidence between ages 55 and 79 years. However, the incidence of PD in
advanced age remains controversial. 3 The majority of prior studies have combined those aged 80 or 85
years and older together because of low numbers of participants in that age group, obscuring the
relationship between PD and advanced age. Accurate predictions of the future population burden of PD
depend on whether its incidence continues to increase, plateaus, or declines in those aged 80 years and
older.

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