Parkinson’s disease is difficult to diagnose in the early stages. The first signs and symptoms of the disease are so subtle that its often missed. Often an observant family member or friend will notice the beginning of the changes in a person, which may be so vague that it is often dismissed as occurring due to old age. Diagnosis is frequently missed in younger people since the first signs and symptoms, even when noticed earlier, may be attributed to other conditions instead of Parkinson’s disease.

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Although the characteristic symptoms of Parkinson’s disease (PD) involve motor functions such as tremor, rigidity, slowness of movement and loss of postural reflex, there are other neurological and psychiatric symptoms present in later stages of the disease which point to definite changes in brain function and personality of PD patients.
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As Parkinson’s disease progresses, many other symptoms and problems start developing, some due to the disease process itself and others due to the effects of natural aging. Of these, dental diseases and the problems associated with them need to be tackled as soon as possible so as to make the patient’s life more comfortable.

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Normal aging should not cause breathing difficulty and people with Parkinson’s disease, although mostly elderly, should not have breathing problems unless there is some underlying cause. Getting out of breath on undertaking unaccustomed exercise is not really a cause for concern.

It is quite possible, however, for a person with Parkinson’s disease to also suffer from some pre-existing lung or heart condition which may cause some amount of breathing difficulty. If shortness of breath, wheezing, cough or chest discomfort does develop, even without a known medical problem, careful assessment and treatment is definitely indicated.

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Acid reflux, gastroesophageal reflux disease (GERD) or just simple heartburn occurs quite frequently in many people, but Parkinson’s disease patients seem to be more prone to developing this condition. There are a number of reasons why this is so.

How Does Acid Reflux Occur?

When food is swallowed, it moves down through the esophagus (food pipe) into the stomach. The esophageal sphincter, situated between the esophagus and the stomach, opens to allow this action to take place and closes back again so that the food does not go back into the esophagus. In this way, the esophageal sphincter acts as a one way-valve.
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Due to the progressive loss of muscle control – both voluntary and involuntary – many other symptoms can develop in a patient suffering from Parkinson’s disease besides the typical symptoms of tremor and rigidity. Dysphagia is one such symptom. Dysphagia or difficulty in swallowing is a common problem in people with Parkinson’s disease which can have far-reaching consequences.

Dysphagia can lead to shorter survival time in a patient with Parkinson’s disease, not only because the affected muscles of the throat may make swallowing difficult – hence less food intake and increased chances of under-nutrition of the patient – but also because it increases the possibility of aspiration pneumonia.
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Parkinson’s disease patients, especially in the end stages of the disease, often have a significant amount of muscle atrophy. This muscle wasting or loss of muscle tissue could be due to reduced physical activity because of the symptoms of Parkinson’s disease or if bedridden. Added to the reduced or lack of physical activity, an additional factor to take into account is that Parkinson’s disease is in most cases a disease of old age, a period of life where some amount of normal muscle wasting is to be expected.

Physiotherapy and a home exercise program for Parkinson’s patients do help to prevent this muscle atrophy to a certain extent. Apart from muscle atrophy, some amount of cerebral or brain atrophy is also to be expected in people suffering from Parkinson’s disease, which is in excess to that found in normal people, taking into account the age of the patient in both circumstances.

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There are innumerable minor, but nonetheless quite distressing, symptoms associated with Parkinson’s disease, with skin problems being one of them. Some of these skin problems may be due to the disease itself although drug therapy for Parkinson’s disease is often responsible. While the side effects of these medicines do cause significant distress at times, it is important to note that the drugs are essential in managing Parkinson’s disease and should not be stopped or changed without your doctor’s approval.
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Although tremor and rigidity are the typical symptoms of a patient with Parkinson’s disease, eye problems are quite common too, and are important because they can interfere with the quality of life of a person. When faced with eye disorders or vision problems in patients with Parkinson’s disease, it is important to bear in mind that some of these conditions may not be related to Parkinson’s. Old age, poor eyesight, complication from other chronic conditions, like diabetes, may impact on the eyesight in any person, even when Parkinson’s disease is not present.

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Speech problem or difficulty in speaking (dysarthria) is one of the most common symptoms that develop in a patient with Parkinson’s disease besides the major symptoms such as tremor, rigidity, slowness of movement and loss of postural reflexes. It is estimated that about 60 to 90 percent of patients with Parkinson’s disease have difficulty with their speech, which may take various forms such as a soft, monotonous, or slurred speech, speaking too fast or repeating words, or sometimes hesitating before speaking. Problems with speech can be due to reduced movement of the muscles involved in breathing, talking and voice intonation as a result of Parkinson’s disease.

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