Parkinson’s disease is a neurological disorder that adversely affects the movements, control over the muscles, balance, and coordination. It is a progressive disease and symptoms worsens over time due to the loss of dopaminergic neurons situated in the nigro striatal region of the brain.
Complications may arise in any disease if left untreated or as it progresses and Parkinson’s disease is no different. These complications may be associated with PD itself as it gets worse, or may be arise as a side effect from the medication being used for PD or at times arise separately due to the effects of Parkinson’s disease on various aspects of life and health (secondary). Parkinson’s disease itself is not fatal but some of its complications are, and therefore proper care and vigilance is necessary. The disease progresses severely in the elderly patients and the complications often incapacitates them within 10 to 20 years, thereby impairing the quality of life. It has host of far reaching physical, emotional and financial impacts on the patients and their families. Identifying these complications as early as possible and seeking treatment where possible can greatly reduce the severity of the complications.
Depression in Parkinson’s disease is common and is largely due to the impact of being diagnosed with the disease, the prognosis and living with PD. It has been concluded in a study that 50% of the patients with Parkinson’s disease experience mood disturbances at some point in their illness. People who were otherwise independent may find that the disease can ‘rob’ them of their normal level of functioning and force them to become more dependent on others. Parkinson’s disease not only affects the life of the patient but also impacts the interpersonal relationships and the lives of loved one’s, which can also lead to depression. Moreover the disease processes itself causes changes in the chemical levels of the brain which are related to mood swings and a sense of well being. Anxiety is a common occurrence and it presents in combination with depression in Parkinson’s patients. Read more on depression and Parkinson’s disease.
Compulsive gambling is one of the characteristic behaviour problem developed in the patients of Parkinson’s disease due to the treatment offered with levodopa and dopamine agonist. Interventional treatment options like deep brain stimulation surgery can also increase the risk of compulsive gambling in patients who already have a history of gambling. Read more on compulsive behavior in Parkinson’s disease.
The progressive muscle loss in Parkinson’s disease, both of the muscles under voluntary and involuntary control, affects various functions. Swallowing and chewing are some of these activities that are affected to varying degrees in Parkinson’s disease. Swallowing problems are often associated with a short survival time as, the danger with this complication lies in the risk of choking, and aspirational pneumonia particularly on larger particles of food that have not been chewed properly. In addition, difficulty and chewing may discourage food intake and cause secondary complications related to nutrition and immunity. Read more on difficulty swallowing in Parkinson’s disease.
Cognitive and Memory Problems
Defects usually occur in the thinking, language, and problem solving skills either early or later in the course of the disease, which might either be due to the advent in the disease process or because of the side effect caused by the medications.
Another most incapacitating complication, associated with Parkinson’s patients is dementia or memory loss, mostly seen in patients over the age of 60 years. It is associated with considerable loss of cognitive functions like memory and abstract thinking, and is more prevalent in older patients who have had a history of depression.
Parkinson’s patients often experience problems with the sense of vision, smell and pain.
The patients are found to report a decreased sense of smell which is called as olfactory loss, and is usually considered to be an important diagnostic marker of the disease. The olfactory loss is measured by olfactory probes. The decreased perception of smell might often appear far before the other incapacitating symptoms of Parkinson’s disease and is an important diagnostic marker of the disease.
Visual hallucination is also a common side effect of dopamine medication. Impaired color perception and contrast sensitivity and to the vision problems in Parkinson’s disease. Read more on Eye disorders and visual problems in Parkinson’s disease.
Muscle numbness, tingling sensation and pain due to the leg cramps and muscle weakness is often found to be associated with Parkinson’s disease and is an incapacitating complication.
Problems with sleep are a common complaint of PD patients. It may be directly related to the low dopamine levels, a side effect of PD medication or arise secondary to depression and dementia. The sleeping problems are not only related to difficulty falling asleep or maintaining sleep (insomnia) but also with excessive daytime sleepiness. It may also be related to other problems at night like the need to urinate frequently, night time leg cramps, and restless leg syndrome, which may disturb sleep and nightmares. Read more on sleeping problems in Parkinson’s disease.
Urinary incontinence or retention are not uncommon in Parkinson’s disease. Some patients may leak, whereas others might find it hard to completely empty their bladder properly. The bladder is a muscular hollow sac and loss of voluntary and involuntary muscle control in PD can affect urinary function. This may also be a consequence of certain medication, prostate problems in men or immobility which affects the ability to reach a toilet. Read more on urinary disturbances in Parkinson’s disease.
Constipation, is one of the most common complications of Parkinson’s disease, owing to the muscle weakness which impairs the action of the Digestive system. Also, the weak pelvic floor muscles, add to the difficulty in defecation. Read more on constipation in Parkinson’s disease.
A decrease in sex drive (libido) may be due to a combination of physical and psychological factors in Parkinson’s disease. It is more commonly seen in men with PD, who commonly suffer through erectile dysfunction. This can happen in many other chronic conditions and can also be a consequence of depression in PD and the use of certain PD medication. However, another extreme is hypersexuality which may be seen with the use of certain PD drugs. This is discussed further under compulsive behavior in Parkinson’s disease.