According to a study, India is home to 7 million elders with Parkinson’s Disease (PD). Usually the condition exhibits in patients after the age of 50, and the incidence increases with advancing age. PD is assumed to afflict men twice as much as women. The symptoms emerge slowly, most obvious ones include, shaking, rigidity, slowness of movement, and changes in speech.
Definition
The Rights of Persons with Disabilities Act, 2016 defines Parkinson’s disease as a progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly people. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine. It mainly affects the motor system.
As the disease worsens, non-motor symptoms become more common. The symptoms usually emerge slowly. Early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking. Thinking and behavioral problems may also occur. Dementia becomes common in the advanced stages of the disease. Depression and anxiety are also common, occurring in more than a third of people with PD. Other symptoms include sensory, sleep, and emotional problems. The main motor symptoms are collectively called "parkinsonism", or a "parkinsonian syndrome".
Variations
Causes
The exact cause of Parkinson’s is unknown. It may have both genetic and environmental
components. Some scientists think that viruses can trigger Parkinson’s as well. Low levels of dopamine and norepinephrine, a substance that regulates dopamine, have
been linked with Parkinson’s. Abnormal proteins called Lewy bodies have also been found in the brains of people with Parkinson’s. Scientists don’t know what role, if any, Lewy bodies play in the development of Parkinson’s.
While there’s no known cause, research has identified groups of people who are more
likely to develop the condition. These include:
- Sex: Men are one and a half times more likely to get Parkinson’s than women.
- Race: Whites are more likely to get Parkinson’s than African Americans or Asians.
- Age: Parkinson’s usually appears between the ages of 50 and 60. It only occurs before the age of 40 in 5-10 percent of cases.
- Family history: People who have close family members with Parkinson’s disease are more likely to develop Parkinson’s disease, too.
- Toxins: Exposure to certain toxins may increase the risk of Parkinson’s disease.
- Head injury: People who experience head injuries may be more likely to develop Parkinson’s disease.
Each year, researchers are trying to understand why people develop Parkinson’s.
Treatments
Statistics in India
As per the “Global, regional, and national burden of Parkinson's disease, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016”, the prevalence in India
is 575,946 (range of 458,316 to 712,213). However, there are very few population-based studies determining the exact incidence and prevalence of PD in India.
In a door-to-door survey done in Bangalore district in South Karnataka in India in 2004, the prevalence rate of Parkinsonism was found to be 33 per 100,000 (crude prevalence) and 76 per 100,000 (age adjusted). Rural population had a higher prevalence compared to the urban population (41 vs 14). But it was less compared to other highly prevalent neurological disorders such as headache, epilepsy, stroke, and mental retardation.
rom a survey in Kolkata in 2006, the prevalence of Parkinsonism was found to be 45.82 per 100,000. In the state of Kashmir, the prevalence was 14.1 per 100,000, while the age adjusted prevalence was 134 per 100,000.
A survey, done in Parsi community in Mumbai, a small stable community, showed a prevalence of 192 per 100,000, which was higher compared to rest of the population. In a surveillance in old age homes in a Bangalore, there was very high prevalence of 17.6% (109/612 residents) of Parkinsonism. This may be due to unawareness of this disorder among the general population who do not avail the medical facilities at the appropriate time. As per another source, the incidence of PD in India is estimated to be 70 out of 100,000.