Parkinson's burden to increase as world grows older

by Marlowe Hood
Apr 10, 2008--A surge of Parkinson's disease linked to rapidly aging populations worldwide will severely tax health care systems in coming decades, experts warned Thursday ahead of World Parkinson's Disease Day.
The burden of Parkinson's and other neurodegenerative diseases that strike later in life will be amplified, experts say, by breakdown of informal, home-based care networks that are already strained.
"In many countries, overdependence on voluntary care is a key issue caused by lack of appropriate, consistent and affordable institutional resources," said Mary Baker, president of the European Parkinson's Disease Society.
"With an ever-increasing elderly global population, the cost to nations will be astronomical if action is not taken now, at the beginning of the 21st century," she said.
The World Health Organisation (WHO) forecasts a 20 percent jump from 2005 to 2030 in the number of "disability-adjusted life years" (DALYs) attributable to Parkinson's.
DALYs is a measure that combines years of life lost due to a disability, and years of healthy life lost.
The rate of increase over the same period for Alzheimer's and other progressive neurological disorders that typically emerge in old age is even higher at 66 percent.
For 2008, World Parkinson's Disease Day is seeking to overturn myths and misconceptions about the condition, which affects 6.5 million people around the world.
Sufferers of what James Parkinson, the English doctor who first diagnosed the disease, called "the shaking palsy" are sometimes shunned due to awkward and uncontrolled movements, or mistaken for persons under the influence of alcohol or drugs.
Symptoms include muscular rigidity, difficulty with initiating movements, lack of balance, and slowness of voluntary actions.
"In today's world, it is necessary to move fast, and to communicate through body language and emotions," commented French Psychiatrist Philippe Nuss of Saint Antoine Hospital in Paris. "Parkinson's attacks exactly these three areas."
For Marie Vidhaillet, a neurologist at Pitie Salpetriere Hospital, living with the disease is like the fickle weather of March, with an unpredictable sequence of good days and bad days.
"You have to learn to live with it without succumbing to it," she added.
Parkinson's is caused by the death of neurons in the brain that produce dopamine, a chemical neurotransmitter that regulates, among other things, bodily movement.
Several medications compensate for the lack of dopamine that triggers symptoms, but only imperfectly. Neurosurgical treatments also exist, but are only appropriate in five percent of cases.
Among the misconceptions surrounding Parkinson's is the idea that it is "an old person's disease," said Vidhaillet.
At least 10 percent of patients in France are under 45, but "most doctors don't think of Parkinson's if a patient is 40 years old."
"In our society, where one does not have the right to get old, the disease is doubly stigmatising," she said.