Parkinson's disease is a neurodegenerative disorder that affects the neurons that produce dopamine. Normally this disorder develops slowly in people from 55 to 65 years of age.
This disorder causes a progressive deterioration of certain brain functions in the patient that manifest with various symptoms, including:
Symptoms present differently in each patient and experiences of this disorder can be very different.
The exact cause of Parkinson's is unknown, however, it can attributed to a loss of nerve cells in the part of the brain called the substantia nigra. This loss of cells causes a reduced production of dopamine which is needed to regulate movement. However, it is not known what causes this loss of nerve cells.
Parkinson’s disease can run in families, and passed from parent to child, however, this is a rare way to inherit the condition.
Since the cause of this disease is not known, there is no known way to prevent it.
There is no known cure for Parkinson’s, however, treatments can help to manage and relieve symptoms and improve quality of life. Treatments include physiotherapy and occupational therapy, medication and in some cases surgery (deep brain stimulation).
One of the important parts of the treatment is physical rehabilitation, which consists in the maintenance of muscle tone and motor functions, hence why daily physical activity is important.
Restless legs syndrome (RLS) is a nervous system disorder that causes an irrepressible urge to get up and walk or move the legs. As such, this is also considered a sleep disorder as it can cause significant sleep disruption in those with RLS. Anyone can suffer from this syndrome, although it is more common in patients with diabetes, Parkinson's, renal diseases and iron deficiencies.
The main symptom of restless leg syndrome is the unpleasant sensation in the lower part of the legs and the irresistible urge to move the legs. People with RLS may experience:
All of these symptoms make it difficult to sleep. A lack of sleep can cause daytime drowsiness, anxiety, depression, confusion or difficulty thinking clearly.
The exact cause of restless legs syndrome is not known. It can be related to other conditions such as:
Restless legs syndrome cannot be cured, and treatments look to relive the symptoms. The first step in treating RLS is making dietary changes, as certain substances can make it worse, such as caffeine, alcohol and nicotine. It can also help to stretch the legs regularly, and taking measures to reduce stress.
Certain medications can also help, but are not widely prescribed for treating RLS.
Dystonia is a type of movement disorder characterised by uncontrollable muscle contractions. The result is an involuntary twisting of of body parts and abnormal postures. This condition may affect just one muscle, a group of muscles or the entire body.
The symptoms of dystonia can vary and can be mild or severe. Common early symptoms include:
Symptoms of dystonia can be worse with stress or fatigue, and with the constand muscular contractions, pain and discomfort is common.
There are no specific causes of dystonia and it is not fully understood as a condition, however, it is thought that it can be attributed to chemical imbalances in the part of the brain called the basal ganglia. The basal ganglia is responsible for initiating muscle contractions, and if the nerve cells here are not communicating properly, muscle contractions can become involuntary and uncontorllable.
Dystonia can either be hereditary from parents, or it can be acquired if the basal ganglia is damaged. Damage to the basal ganglia can result from:
Treating dystonia depends on the severity and the part of the body affected. A fairly new treatment for dystonia makes use of botulinum toxin (Botox) injections which is injected into the affected muscles. Botox help as it blocks the chemical called acetylcholine which produces muscle contractions. With repeated injections, some control can be regained over the muscle contractions.
In more severe cases of dystonia, deep brain stimulation can be carried out as a treatment. This involves an electrode being implanted into the affected brain area which is connected to a stimulator that emits electric pulses which aim to reduce the number of involuntary muscle contractions.
There are also medications which can help dystonia patients by controlling the chemical miscommunications happening in their brain which causes the muscle contractions.
Finally, there are physical therapy, speech therapy and stress management techniques that can help dystonia patients manage their symptoms.
Dementia is the progressive loss of cognitive functions, mainly due to brain damage caused by strokes or Alzheimer’s. It greatly affects the patient´s ability to function in everyday life. It mainly affects memory, language (aphasia), attention, visual skills, praxis and executive functions such as problem solving or inhibition of responses.
A stroke is the sudden interruption of blood flow to the brain, depriving the brain cells of oxygen which causes the brain cells to rapidly die. Stroke is a serious medical condition and should be treated as an emergency as earlier action can help reduce the amount of damage done to the brain. Depending on where the stroke occurs and how much of the brain is damaged will determine a person’s ability to recover.
The existing types of stroke are Transient Ischemic attack (TIA), ischemic stroke or a haemorrhagic stroke.
The key symptoms of stroke can be remembered with the acronym ‘F.A.S.T’:
Additional symptoms include:
There are three types of stroke:
The following are risk factors for having a stroke:
As with other pathologies, the prevention of stroke can be achieved by eliminating everyday life risk factors such as smoking, excessive alcohol consumption, high blood pressure, diabetes, high cholesterol levels, obesity and certain diseases such as atrial fibrillation and coronary artery disease.
Treatment for a stroke will depend on the type of stroke suffered and which part of the brain was affected. Medications can be administered that help dissolve blood clots and reduce cholesterol and blood pressure. Surgery to remove blood clots might also be recommended or surgery to address brain swelling and cerebral bleeding resulting from a haemorrhagic stroke.
Osteoporosis, meaning “porous bone”, is a disease in which the bones become weak and brittle due to the body either losing too much bone or making too little. On a microscopic level, the structure of healthy bone resembles a honeycomb, with hollows and spaces. In bones affected by osteoporosis, these hollows and spaces are much wider, meaning the bones are less dense, and therefore weaker than they should be. This makes them susceptible to breaks and fractures.
Most of the time, a person will not realise they have osteoporosis until they break or fracture a bone. The hip and wrist are the most common places that fractures occur, while spinal fractures are also relatively common.
Stooped posture (in older people) and particularly significant loss of height (>2 inches) should always prompt investigation for osteoporosis.
The DEXA or DXA scan is a reliable method to measure bone mineral density using a low-intensity X-ray. It is painless, straight-forward, and involves minimal radiation – in fact, the operator sits in the same room as the patient. After the scan is done, the results are compared to that of a young, healthy individual, and based on accepted criteria a diagnosis of osteoporosis may be made.
Losing bone is a natural part of getting older, but some people will lose bone density faster than others. In general, women have a higher risk of getting osteoporosis than men, especially in the years following the onset of the menopause, when bone density is lost more rapidly.
Things that can increase the risk of osteoporosis include:
While it is impossible to prevent a condition like osteoporosis with 100% certainty, you can lower the risk of getting the disease by taking steps in your lifestyle to keep your bones healthy:
Treating osteoporosis revolves around treating fractures caused by the condition and trying to improve bone strength, which may involve medication. Your doctor will advise you on treatment depending on the results of your DXA scan and the cause of your osteoporosis.
Most of the therapies available slow down the rate of bone loss and decrease fracture risk except for parathyroid hormone analogues which effectively stimulate bone formation.
Possible treatments include:
Endocrinologists and rheumatologists treat osteoporosis.
Alzheimer's disease is a degenerative brain disorder that severely affects certain mental functions of the patient and interferes with their daily lives. It is the most common form of dementia in the UK.
This disease has different stages:
At the beginning of the disease, the patient shows small memory losses such as difficulty remembering recent things or names of people. These symptoms get worse until they are unable to recognise close family members and have difficulty reasoning, speaking, reading and writing.
The main neurological symptoms are:
Alzheimer's is caused by the degeneration of connections between brain cells, as well as genetic, lifestyle and environmental factors. Although the exact cause is unknown, the effect of the disease is the damaging and killing of brain cells. A brain in an Alzheimer’s patient has fewer connections between brain cells than in the brain of a healthy person.
There are also certain risk factors for Alzheimer’s, including:
There is currently no cure for Alzheimer’s disease, but some drugs can help delay the disease and its symptoms. Activities and support also play an important part in the care of Alzheimer’s patients.
Cholesterol is a fatty substance known as a lipid, which is mainly made by the liver and can also be found in some foods. It is vital for the human body to function properly but if the levels of cholesterol are too high in the blood, it can result in heart disease and heart stroke among other problems. Cholesterol can increase with age and is only detected through a blood test. There is also something else that may need to be monitored if someone has high cholesterol, and that is triglycerides. Having a high level of triglycerides, a type of fat (lipid) in the blood, can also increase the risk of heart disease.
Evidence shows that high cholesterol levels can increase the risk of having a heart attack, a stroke, a mini-stroke (known as transient ischaemic attack) or a peripheral arterial disease (PAD).
Cholesterol can build up in the artery wall, which restricts the blood flow to the heart, brain and the rest of the body. It can also increase the risk of a blood clot in other parts of the body. The risk of developing coronary heart disease is also higher when the blood’s cholesterol level increases.
There are many factors that increase the chances of having high cholesterol, which include:
Even people who eat healthily can inherit a condition called familial hypercholesterolemia, which can cause high cholesterol.
The levels of blood cholesterol is measured in millimoles per litre of blood (mmol/L.) Total cholesterol levels should be 5mmol/L or less for healthy adults or 4mmol/L or less for those who are at high risk. Low-density lipoprotein (LPL) levels should at 3mmol/L or less for healthy adults or 2mmol/L or less for those at high risk.
To reduce the level of cholesterol, it is recommended to maintain a healthy and balanced diet, which is low in fatty foods. Regular exercise and quitting smoking are also recommended to lower the levels of cholesterol. If following these steps does not reduce the cholesterol levels, a doctor may prescribe medication such as Statins to help. Statins block the chemicals in the liver that help to make cholesterol, which leads to a reduction the blood cholesterol level. They are only prescribed to people who are at a high risk of heart disease and will need to be taken for life.
A balanced diet, low in saturated fats can reduce LDL (bad cholesterol). The following foods should be avoided or the intake reduced:
A comorbidity is a primary disease or condition that co-occurs with but is often independent of, another disease or disorder. There are some conditions that are more likely than others to be comorbid with one another. As well as being a term that is used broadly in medicine, comorbidity is frequently referred to in psychology. In the context of psychology, comorbidity refers to more than one mental disorder that exists alongside a primary diagnosis, or the reason that a patient is referred to in the first place. An example of this in psychology would be a patient who may have schizophrenia combined with a personality disorder. This may be because the doctor is not able to tell much of a difference between the two conditions.
The following examples are commonly comorbid:
Depressive disorders – these often coexist with conditions such as post-traumatic stress disorder, substance abuse and serious illnesses.
Anxiety disorders – these disorders can be combined with schizophrenia, bipolar disorder and post-traumatic stress amongst others.
Schizophrenia – this condition is comorbid with depression, anxiety and addiction.
Addiction – patients develop other psychological disorders as a result of their addictions.
The combination of conditions affects case management for treatment in patients who experience comorbidity. There is no one size fits all approach to the condition.
Dementia is the progressive loss of cognitive functions, mainly due to brain damage caused by strokes or Alzheimer’s. It greatly affects the patient´s ability to function in everyday life. It mainly affects memory, language (aphasia), attention, visual skills, praxis and executive functions such as problem solving or inhibition of responses.
Depression is a mental illness characterised mainly by a prolonged and severe feeling of sadness. This feeling is associated with other symptoms and alterations of thought and behaviour. Depression can affect people of all ages; either to adults, teenagers or even children. It can vary in severity and can last a lifetime, or be temporary. As such, there are different types of depression including:
The symptoms of depression are:
There are also certain behaviours that can be characteristic of someone struggling with depression:
The symptoms of depression in children may be different from those of adults. It is important to monitor their school performance, sleep and behaviour of the child.
There is no one cause of depression, and there are many triggers. Depression can be caused by the following factors:
It is not possible to prevent depression, however, there are measures that can be taken to look after yourself and your mental well-being. These include:
It is also important to connect with other people, with friends and family to ensure that you do not isolate yourself.
There are different treatment options for depression and they depend on the severity of your symptoms and the type of treatment you are receptive to. The most common treatments used for depression are talking treatments (e.g. CBT, group CBT and psychotherapy) and medication (e.g. SSRIs, SNRIs, tricyclics and other types of anti-depressants).
If you have had depression before, but you are not currently experiencing symptoms, it is important to adopt watchful waiting (i.e. being aware of your mood and any changes in your mood).
Alternative therapies for depression can include:
Diabetes mellitus (DM), or just diabetes refers to a group of metabolic diseases which result in an inability to regulate blood sugar levels. Having too much glucose in your blood can damage the kidneys, eyes, nerves and other parts of the body, including the blood vessels themselves. In extreme cases, diabetes can cause heart disease and strokes, and patients may even require amputation of limbs.
This inability to control blood sugar comes from a problem with the hormone insulin. Insulin is produced by the pancreas, enters the bloodstream, and moves glucose out of the blood and into cells, where it is used to generate energy.
There are two types of diabetes:
Classic diabetes symptoms include:
Type 1 diabetes is an autoimmune condition – something causes the immune system to attack healthy pancreatic cells that produce insulin. It appears to run in families, so may be genetic. No one knows exactly what causes the immune system to attack the pancreas, but one theory is that it is triggered by a virus. In rare cases, neonatal diabetes can occur at birth and is usually diagnosed within the baby's first nine months.
Type 2 diabetes is acquired, and usually affects older people. It tends to be associated with obesity and lack of exercise.
Type 1 diabetes appears to be genetic, so there is no way to prevent it.
To reduce the risk of developing type 2 diabetes, it is important to have a healthy and balanced diet, take plenty of exercise, and lose weight if you are overweight or obese. Stopping smoking and drinking alcohol in moderation are also useful tips.
Diabetes can’t be cured, but the symptoms can be managed. A healthy diet, regular exercise, and regular blood tests are essential to keep blood glucose levels in check.
Type 1 diabetes patients require regular insulin injections for the rest of their lives to make up for the lack of insulin production by the pancreas.
Type 2 diabetes patients may eventually need to take tablets, as the condition is progressive (it will worsen over time).
Complications, such as diabetic foot, can sometimes be treated using vascular and microsurgery techniques.
You should see your doctor or a specialist as soon as possible if you are experiencing symptoms. If diagnosed with diabetes, a patient is usually referred to a specialist care team for treatment and long-term monitoring of the condition.
Dystonia is a type of movement disorder characterised by uncontrollable muscle contractions. The result is an involuntary twisting of of body parts and abnormal postures. This condition may affect just one muscle, a group of muscles or the entire body.
The symptoms of dystonia can vary and can be mild or severe. Common early symptoms include:
Symptoms of dystonia can be worse with stress or fatigue, and with the constand muscular contractions, pain and discomfort is common.
There are no specific causes of dystonia and it is not fully understood as a condition, however, it is thought that it can be attributed to chemical imbalances in the part of the brain called the basal ganglia. The basal ganglia is responsible for initiating muscle contractions, and if the nerve cells here are not communicating properly, muscle contractions can become involuntary and uncontorllable.
Dystonia can either be hereditary from parents, or it can be acquired if the basal ganglia is damaged. Damage to the basal ganglia can result from:
Treating dystonia depends on the severity and the part of the body affected. A fairly new treatment for dystonia makes use of botulinum toxin (Botox) injections which is injected into the affected muscles. Botox help as it blocks the chemical called acetylcholine which produces muscle contractions. With repeated injections, some control can be regained over the muscle contractions.
In more severe cases of dystonia, deep brain stimulation can be carried out as a treatment. This involves an electrode being implanted into the affected brain area which is connected to a stimulator that emits electric pulses which aim to reduce the number of involuntary muscle contractions.
There are also medications which can help dystonia patients by controlling the chemical miscommunications happening in their brain which causes the muscle contractions.
Finally, there are physical therapy, speech therapy and stress management techniques that can help dystonia patients manage their symptoms.
Heart failure is serious and results from various heart conditions. Heart failure is characterised by the heart’s inability to pump blood as well as it should be able to. Therefore, blood supply to the rest of the body is inadequate, ultimately resulting in the disruption of major bodily functions. Additionally, blood cannot carry enough oxygen or nutrients to the body and as a result, waste is not properly disposed of and fluid accumulates in some parts of the body. There are two types of heart failure: systolic, when myocardium cannot pump blood and expel it from the heart; and the diastolic, when the muscles of the heart are rigid and do not fill with blood.
The symptoms of heart failure vary according to each person. In the initial phase there are usually no symptoms, but if it progresses, the symptoms may worsen. The main symptoms include:
The most common causes of heart failure are coronary heart disease, such as angina pectoris or myocardial infarction. High blood pressure is also another common cause of this disease, as well as excessive alcohol consumption. The following can also result in heart failure:
Heart failure can be prevented by making serious lifestyle changes that will reduce cardiovascular risk factors. These changes include:
There is no certain cure for heart failure, and treatment will depend on the severity of your condition. Treatment will aim to increase your lifespan and may include taking medication to reduce clotting, reduce cholesterol levels, improve heart function or to reduce sodium levels in the blood. Surgery may also be needed, such as coronary bypass surgery. It may also be necessary to have a pacemaker or ICD fitted to control heart rhythm. The last stage for treating heart failure would be a heart transplant, but this is only done if all other treatments have failed and there is a viable heart from a donor. A large part of treatment is preventative, by adopting healthy lifestyle changes.
Hypertension, or high blood pressure, is a chronic condition where your resting blood pressure is persistently higher than what is considered a normal reading (120/80mmHg). If your diastolic pressure is persistently higher than 90 mmHg and your systolic pressure is persistently higher than 140mmHg, then you have high blood pressure. Based on different readings, hypertension can be classified as:
Hypertension is a complex condition which may lead to severe complications, such as heart attack or stroke. Hence, being aware of your blood pressure and controlling a healthy level is very important for your overall health.
The symptoms of hypertension are not specifically linked to this condition and they may be overlooked as being related to other, less severe conditions. The most common symptoms are:
Hypertension can be diagnosed with several different tests, including:
Hypertension can be caused by ageing, family predisposition, a high salt diet, smoking, obesity, having a sedentary lifestyle, drinking a lot of alcohol, stress and other concurrent conditions.
Hypertension can be treated with antihypertensive agents, diuretics, alpha-blockers, beta-blockers and sympatholytic drugs. However, it is important to keep in mind that medication therapy should always be accompanied by lifestyle changes. A low-salt diet, constant and moderate intensity exercise, weight control, stopping smoking and cutting down on alcohol can help you reduce your blood pressure.
If you are suffering from hypertension, you should see a cardiologist. In case you also have other conditions, you may have to see an internal medicine doctor, a nephrologist or a neurologist.
Memory loss, also known as amnesia, is unusual forgetting. It is a common disorder as people get older. With memory loss, the person cannot remember recent events of the past.
Memory loss can occur for a short period of time and then resolve. This is known as transient memory loss. However, depending on the cause, memory loss may not improve and actually get worse over time.
The symptoms of memory loss that should be noted are:
A considerable memory deficit can be due to other diseases such as Alzheimer's or senile dementia. Likewise, it can also be a consequence of other disorders, such as depression.
Memory loss can be caused by many factors. It can result from an injury to the brain, which is caused by or is present after:
At other times, memory loss may be related to mental health problems such as depression, bipolar disorder or after a traumatic or stressful experience.
Other causes of memory loss can be:
Although there is no treatment available to recover lost memory, the help of a speech therapist can be very useful to provide daily exercises designed to exercise memory. In addition, patients affected by memory loss need a lot of support from their family and friends to carry out their daily routines, especially if they need to take medication or follow a certain type of diet.
Mild cognitive impairment is a stage of ageing that is marked by memory failure and objective memory impairment. This cognitive impairment does not affect the performance of daily activities, nor does it meet the criteria for dementia. It is an age-related pathology, since it occurs in 1 in 10 people over 65 years of age. The disorder occurs to a different extent in men and women and is more common with advancing age.
The usual symptoms of mild cognitive impairment are difficulty in acquiring new memories, without losing knowledge or forgetting your life story. In general, the symptoms are:
The clearest cause of mild cognitive impairment is age, as difficulty remembering is associated with advancing age. Other causes associated with this deterioration are genetic factors, which also play an important role in the transition from mild cognitive impairment to dementia. Cardiovascular risk factors also play a role, as cardiovascular diseases can affect cerebral blood vessels. Lifestyle habits are also important, as obesity and alcohol or substance abuse affect the brain.
Mild cognitive impairment can be prevented by maintaining brain health. This is why it is important to maintain certain habits that ensure brain activity and keep the brain active, such as:
To control the evolution of the disorder, you should see your doctor at the first sign of symptoms.
There is currently no treatment for mild cognitive impairment, but evidence shows that maintaining mental and physical activity and eating a healthy diet reduces the risk of mild cognitive impairment.
Osteoporosis, meaning “porous bone”, is a disease in which the bones become weak and brittle due to the body either losing too much bone or making too little. On a microscopic level, the structure of healthy bone resembles a honeycomb, with hollows and spaces. In bones affected by osteoporosis, these hollows and spaces are much wider, meaning the bones are less dense, and therefore weaker than they should be. This makes them susceptible to breaks and fractures.
Most of the time, a person will not realise they have osteoporosis until they break or fracture a bone. The hip and wrist are the most common places that fractures occur, while spinal fractures are also relatively common.
Stooped posture (in older people) and particularly significant loss of height (>2 inches) should always prompt investigation for osteoporosis.
The DEXA or DXA scan is a reliable method to measure bone mineral density using a low-intensity X-ray. It is painless, straight-forward, and involves minimal radiation – in fact, the operator sits in the same room as the patient. After the scan is done, the results are compared to that of a young, healthy individual, and based on accepted criteria a diagnosis of osteoporosis may be made.
Losing bone is a natural part of getting older, but some people will lose bone density faster than others. In general, women have a higher risk of getting osteoporosis than men, especially in the years following the onset of the menopause, when bone density is lost more rapidly.
Things that can increase the risk of osteoporosis include:
While it is impossible to prevent a condition like osteoporosis with 100% certainty, you can lower the risk of getting the disease by taking steps in your lifestyle to keep your bones healthy:
Treating osteoporosis revolves around treating fractures caused by the condition and trying to improve bone strength, which may involve medication. Your doctor will advise you on treatment depending on the results of your DXA scan and the cause of your osteoporosis.
Most of the therapies available slow down the rate of bone loss and decrease fracture risk except for parathyroid hormone analogues which effectively stimulate bone formation.
Possible treatments include:
Endocrinologists and rheumatologists treat osteoporosis.
Pain management is an interdisciplinary branch of medicine, which aims to improve quality of life for patients with chronic pain by reducing their suffering. It aims to relieve long-term pain, and may be administered by a single doctor, or a pain management team, consisting of different specialists. It can involve pharmacological or psychological treatments, or a combination of both.
While many branches of medicine focus on diagnosing and treating injuries and pathologies and treating the symptoms and pain during the healing process, pain management is needed when the pain persists after the injury or disease has healed. If the cause of the pain is not clear, relieving it becomes the objective. Patients with chronic (long-term) pain are the usual recipients. Types of pain that often require management include chronic back pain and headaches.
There are many types of treatments to manage pain, which can be roughly divided into three categories: physical, psychological, and medicinal.
Physical treatments include physiotherapy, therapeutic physical exercise, the application of heat and/or ice, acupuncture, electrotherapy, and various interventional procedures, such as facet joint injections and spinal cord stimulation. Different sufferers may find different things help relieve their pain, such as massage therapy. Some treatments may have a psychological element, including the placebo effect.
Psychological treatments, such as cognitive behavioural therapy (CBT) and hypnosis have been used to treat pain, with varying reports on the efficacy. Studies have shown a small improvement in mood after CBT, but there is insufficient evidence to definitively say that it relieves pain. Similarly, studies on the effects of hypnosis have been limited, but shows signs of improvement. Some believe it the effectiveness of psychological treatments may be based on the placebo effect.
Medicinal treatments involves different kinds of drugs – mainly painkillers and anti-inflammatories. The type of drug depends on the location, severity, and probable cause of the pain. For example, mild pain can be managed with over-the-counter painkillers, while severe pain (after injury or surgery, for example) may be treated with opioids. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and for conditions like fibromyalgia, antidepressants may be prescribed.
Due to the multi-disciplinary nature of the specialty, a pain management team can consist of medical practitioners, nurse practitioners, physiotherapists, psychologists, and other mental health therapists.
The main aim of palliative care is to help people with a serious condition feel better. Many patients may have a terminal illness, a condition with no treatment available, or serious condition with life-prolonging treatment.
The following treatments are used to treat symptoms and side effects of the disease and its treatment:
Palliative care aims to prevent and alleviate suffering during a serious illness. It provides patients with a better quality of life in their difficult circumstances. The wellbeing sought is for the patient as well as their family.
Some conditions that require this care most often include:
Palliative care can be provided by any healthcare professional: a team of specialists, nutritionists, nurses, psychologists, and more. In many cases, the healthcare professional is specialised in the treatment.
Palliative care may vary according to the condition which is being treated and may include:
The patient, and their loved ones, should be aware of the seriousness of the condition, as well as the prognosis and the treatment options available to them. It is important to trust the medical team to help ensure the best quality of life possible.
Parkinson's disease is a neurodegenerative disorder that affects the neurons that produce dopamine. Normally this disorder develops slowly in people from 55 to 65 years of age.
This disorder causes a progressive deterioration of certain brain functions in the patient that manifest with various symptoms, including:
Symptoms present differently in each patient and experiences of this disorder can be very different.
The exact cause of Parkinson's is unknown, however, it can attributed to a loss of nerve cells in the part of the brain called the substantia nigra. This loss of cells causes a reduced production of dopamine which is needed to regulate movement. However, it is not known what causes this loss of nerve cells.
Parkinson’s disease can run in families, and passed from parent to child, however, this is a rare way to inherit the condition.
Since the cause of this disease is not known, there is no known way to prevent it.
There is no known cure for Parkinson’s, however, treatments can help to manage and relieve symptoms and improve quality of life. Treatments include physiotherapy and occupational therapy, medication and in some cases surgery (deep brain stimulation).
One of the important parts of the treatment is physical rehabilitation, which consists in the maintenance of muscle tone and motor functions, hence why daily physical activity is important.
Restless legs syndrome (RLS) is a nervous system disorder that causes an irrepressible urge to get up and walk or move the legs. As such, this is also considered a sleep disorder as it can cause significant sleep disruption in those with RLS. Anyone can suffer from this syndrome, although it is more common in patients with diabetes, Parkinson's, renal diseases and iron deficiencies.
The main symptom of restless leg syndrome is the unpleasant sensation in the lower part of the legs and the irresistible urge to move the legs. People with RLS may experience:
All of these symptoms make it difficult to sleep. A lack of sleep can cause daytime drowsiness, anxiety, depression, confusion or difficulty thinking clearly.
The exact cause of restless legs syndrome is not known. It can be related to other conditions such as:
Restless legs syndrome cannot be cured, and treatments look to relive the symptoms. The first step in treating RLS is making dietary changes, as certain substances can make it worse, such as caffeine, alcohol and nicotine. It can also help to stretch the legs regularly, and taking measures to reduce stress.
Certain medications can also help, but are not widely prescribed for treating RLS.
Sarcopenia is a loss of both coordination and muscle mass, which can result in poor balance, difficulty walking, and finding daily activities become more difficult to perform. Sarcopenia can lead to disability and lack of independence, as well as increasing the risk of falls, fractures or injuries. In addition to a loss of muscle mass, there is an increase in fat tissue which increases the risk of hypertension, obesity or diabetes.
Symptoms of sarcopenia are low muscle mass or gradual loss, overall weakness, and lower stamina, which affects physical activity levels. Lower physical activity levels also further contribute to muscle shrinkage.
The main cause of sarcopenia is the passage of time and ageing, as the motor neurons in the body gradually die and no longer communicate commands to the brain. Motor neurons dying causes muscle fibre to deteriorate, in a process called atrophy. Sarcopenia is usually a result of this motor unit restructure, along with protein deficiency, and changes in hormone levels.
The practice of physical activity and an active lifestyle can prevent and delay the onset and progression of sarcopenia. People who maintain an active life and eat a balanced, healthy diet with the right amount of protein can delay the onset.
There is no specific treatment for sarcopenia, but some methods are used to delay its appearance:
Patients may also be advised to take supplements such as vitamin D, and limit alcohol consumption along with quitting smoking, if necessary, as low vitamin D levels and smoking/drinking are connected to sarcopenia and its development.
A stroke is the sudden interruption of blood flow to the brain, depriving the brain cells of oxygen which causes the brain cells to rapidly die. Stroke is a serious medical condition and should be treated as an emergency as earlier action can help reduce the amount of damage done to the brain. Depending on where the stroke occurs and how much of the brain is damaged will determine a person’s ability to recover.
The existing types of stroke are Transient Ischemic attack (TIA), ischemic stroke or a haemorrhagic stroke.
The key symptoms of stroke can be remembered with the acronym ‘F.A.S.T’:
Additional symptoms include:
There are three types of stroke:
The following are risk factors for having a stroke:
As with other pathologies, the prevention of stroke can be achieved by eliminating everyday life risk factors such as smoking, excessive alcohol consumption, high blood pressure, diabetes, high cholesterol levels, obesity and certain diseases such as atrial fibrillation and coronary artery disease.
Treatment for a stroke will depend on the type of stroke suffered and which part of the brain was affected. Medications can be administered that help dissolve blood clots and reduce cholesterol and blood pressure. Surgery to remove blood clots might also be recommended or surgery to address brain swelling and cerebral bleeding resulting from a haemorrhagic stroke.
Urinary incontinence is an inability to control the bladder, meaning that urine is unintentionally passed. This is a common problem and can cause embarrassment. It is more common in older people because urinary incontinence is an inevitable part of ageing and it affects both men and women.
The symptoms can vary from a leak of light urine to the abundant and uncontrollable output of it. The type of urine loss will depend on the type of urinary incontinence experienced. The different types of urinary incontinence are:
If you experience frequent bladder incontinence, you should see a specialist as it could be indicative of an underlying health problem, and it can be managed to improve your quality of life and overall confidence.
Women are more likely to suffer from stress incontinence, but men are more likely to have urge and overflow incontinence.
Most control problems occur because the muscles that hold the bladder are too weak or too active. If they are weakened, small amounts of urine are lost when performing actions such as laughing or coughing. However, urinary incontinence is a symptom of either an underlying medical condition, everyday habits or physical problems. Some cases of urinary incontinence are temporary, caused by alcohol consumption, caffeine or medications. It may also result from urinary tract infections or constipation.
Persistent urinary incontinence, however, can be caused by:
Urinary incontinence is a problem that cannot always be prevented, but the following can reduce your risk of developing this problem:
Treatment will depend on the type and cause of your urinary incontinence. Some types can be managed with lifestyle changes (e.g. weight loss or cutting out caffeine), bladder training (learning to wait longer to urinate, guided by a specialist) or pelvic floor exercises (to strengthen the pelvic floor muscles).
The following can also help to manage urinary incontinence:
You may be offered surgery if other treatments have been unsuccessful or unsuitable. The type of surgery will depend on your type of urinary incontinence:
e-Consultation is a private messaging and video conference service that allows contact with leading specialists at the time you choose, from any place.
If you have uncontrolled and sometimes painful muscle movements, it may be a case of dystonia. It’s usually a lifelong problem, but treatment can help relieve the symptoms. Dr Prashanth Reddy is a leading consultant geriatrician and general physician who spoke to us recently to discuss some of the treatment options available.
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Parkinson's disease has some easy to spot symptoms such as tremors and balance issues, but what are the more subtle signs that are harder to notice? Dr Prashanth Reddy explains all about the symptoms and testing involved in the diagnosis of Parkinson's in this article.
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