Parkinson disease living in older adults

Overview

Parkinson’s disease is a brain condition that affects movement. It happens when certain nerve cells in the brain slowly stop working. These cells normally produce a chemical called dopamine, which helps control movement. As dopamine levels drop, movement becomes harder to control.

Yes, it is the second most common neurodegenerative disorder (after Alzheimer’s) in older adults.

Parkinson’s most often affects people over the age of 60, but younger adults can also get it. Men are slightly more likely to develop it than women.

Symptoms

Common symptoms

• Tremor or shaking, often in one hand or arm at rest
• Slowness of movement (bradykinesia)
• Stiffness or rigidity in the arms, legs, or trunk
• Balance problems and falls
• Changes in handwriting (small, cramped writing)
• Loss of smell
• Constipation
• Sleep problems, including acting out dreams

Symptoms in children

• Parkinson’s disease is extremely rare in children. This article focuses on older adults.

Symptoms in older adults

• Tremor may be less noticeable than in younger people
• More trouble with balance and walking
• Falls are more common
• Non-motor symptoms like depression, memory problems, and urinary issues are more frequent

Causes

Main causes

• The exact cause is unknown. It is believed to be a combination of genetic and environmental factors.
• The main problem is the slow loss of dopamine-producing cells in a part of the brain called the substantia nigra.

Risk factors

• Age: risk increases after age 60
• Family history: having a close relative with Parkinson’s slightly raises the risk
• Gender: men are more affected
• Exposure to certain chemicals or toxins (e.g., pesticides) may play a role

When to see a doctor

See a doctor urgently if:

• Any sudden change in movement, balance, or alertness
• Falls that cause injury
• Signs of pneumonia, such as cough and fever

Book a routine appointment if:

• If you notice new or worsening symptoms like tremor, stiffness, or slowness
• If you have trouble with daily activities like dressing, eating, or walking
• For regular follow-ups to adjust treatment

Diagnosis

There is no single test for Parkinson’s. A doctor, usually a neurologist (a brain specialist), will take a detailed history and examine your movement and coordination. They may also check your sense of smell and balance.

Tests that may be done

• Neurological exam: checking reflexes, muscle strength, walking, and tremor
• Sometimes a dopamine transporter (DAT) scan can help confirm the diagnosis
• Blood tests or brain scans (MRI) may be done to rule out other conditions

What to expect at your appointment

The diagnosis is based on your symptoms and exam. Your doctor will talk with you about the results and what they mean. They may ask you to come back in a few months to see if symptoms have changed.

Treatment

Treatment aims to control symptoms and maintain quality of life. It often involves a combination of medication, therapy, and lifestyle changes. A team of healthcare providers—such as a neurologist, physiotherapist, and occupational therapist—can help.

Self-care at home

• Stay active: regular exercise like walking, tai chi, or stretching helps with balance and stiffness
• Eat a healthy, balanced diet with plenty of fibre to help with constipation
• Get enough sleep and rest
• Use walking aids or handrails to prevent falls
• Adapt your home: remove rugs, install grab bars, use easy-to-open containers

Medical treatments

Medications work by increasing dopamine levels or mimicking its effects. They can significantly improve movement symptoms. There are also medicines for non-motor symptoms like depression, sleep problems, and constipation. Drug adjustments are common as the disease progresses. Always work with your doctor to find the best plan for you.

When is surgery considered?

In some advanced cases, a procedure called deep brain stimulation (DBS) may be considered. It involves implanting electrodes in the brain to help control movement. This is not for everyone and requires careful evaluation by a specialist.

Living with this condition

Living with Parkinson’s means adjusting your daily routine. Some days will be better than others. A consistent schedule, regular medication times, and support from family or carers can help you stay independent longer.

Lifestyle tips

• Stay socially connected—join a support group or stay in touch with friends and family
• Plan activities for the times of day when you feel best
• Use reminder tools like alarms or pill organizers for medications
• Ask for help when you need it—it's okay to rely on others

Diet and exercise

A balanced diet with plenty of water, fruits, vegetables, and whole grains is important. Exercise is one of the best ways to manage symptoms—aim for gentle aerobic activity, strength training, and balance exercises. A physiotherapist can create a safe plan for you.

Mental health and emotional wellbeing

Parkinson’s can affect your mood and mental health. Depression, anxiety, and apathy are common. It’s important to talk to your doctor about these feelings. If you ever have thoughts of harming yourself, contact your local crisis support line or emergency services immediately.

Prevention

There is no known way to prevent Parkinson’s disease. Some studies suggest that regular exercise and a healthy diet may lower the risk, but more research is needed.

Vaccines

There is no vaccine for Parkinson’s disease.

Screening programmes

There is no routine screening test for Parkinson’s. It is usually diagnosed after symptoms appear.

Complications

If left untreated

• Falls and injuries from poor balance
• Difficulty swallowing, which can lead to pneumonia or malnutrition
• Severe stiffness or immobility
• Depression, anxiety, or dementia

Long-term outlook

Parkinson’s is a long-term condition that progresses over many years. With good medical care, therapy, and support, many people continue to lead active, meaningful lives. Researchers are working on new treatments, and the outlook continues to improve.

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