"If you could design a new drug for PD symptoms, what symptoms would you want to improve?" That was a survey question that Dr. Lisa Shulman and her colleagues at the University of Maryland asked a group of PD patients. The top five symptoms that respondents would want to improve were:
- Loss of Balance
- Problems Walking
- Tremor
- Memory Loss
- Loss of Dexterity
The bottom picks from the survey were:
- Rising from a chair
- Aching sensations
- Dizziness
- Trouble sleeping
- Urinary problems
Dr. Shulman reported these results at the World Parkinson Conference, while presenting her workshop Functional Changes: What to Expect. The workshop discussed activities that are most affected by PD, how those activities affect daily function, and the functions that tend to stay in tact until the very advanced stages of the disease.
Stages of Parkinson's Disease
Every patient's PD manifests differently. However, according to our current knowledge of the disease, all patients will eventually confront progressive disability. Physicians use generalizations, called Hoehn and Yahr Staging scores to classify patients and monitor the progress of the disease's onset. The stages and simplified explanations are:
- I. Unilateral symptoms (symptoms on one side of the body)
- II. Bilateral symptoms (symptoms on both sides of the body)
- III. Loss of balance
- IV. Needs assistive devices
- V. Needs wheelchair
In Dr. Shulman's workshop she focused on stages IV and V.
What You Might Expect
"Gait impairment is the leading edge of disability in Parkinson's disease. It heralds the loss of many gait dependent activities," explained Shulman.
Walking is chief among these activities. As walking ability diminishes, so do housework, traveling and shopping. At this point the patients start to enter stage IV of the disease.
In stage V, patients lose eating ability, as well as the ability to handle money and medicine. They frequently lose other basic skill such as how to use the toilet, or dial the telephone.
Nobody likes to talk about the final stages of Parkinson's disease. Nevertheless, patients and family members need to know what to expect, so they can make plans, and prepare emotionally.
