Complications of Parkinson’s disease

Parkinson’s disease is a neurological disease which affects a wide range of functions. The changes that occur can have a significant impact on the physical and mental aspects of a person’s life.

The hallmark symptoms of Parkinson’s disease are tremors, slow movements, and rigid muscles. A person may also have difficulty with coordination, various non-motor symptoms, and other complications.

However, there are ways to manage many of these complications. Managing symptoms effectively can contribute to a better quality of life for a person with Parkinson’s disease.

In this article, you will learn more about some of the complications associated with Parkinson’s disease and how to manage these complications.

1. Speaking activity

Complications of Parkinson’s disease

As Parkinson’s disease affects the muscles, a person’s speech can become softer and more difficult to understand. Over time, changes in thinking ability can also make it harder for them to communicate. Social activities and other activities can become challenging.

Speech therapy is important for helping people continue to communicate effectively. This therapy can help improve or maintain a person’s quality of life.

2. Chewing and swallowing

Chewing and swallowing difficulties can also occur, especially during the later stages of the disease. These difficulties result from changes in the autonomic nervous system or the muscles in the throat, known as the pharyngeal muscles.

These changes increase the risk of food getting stuck in the throat and choking, which can be life threatening. If that person accidentally breathes food particles into the lungs, pneumonia can happen.

A person may also produce too much saliva, or they may not be able to swallow the saliva easily. This problem can lead to drooling, which they may find embarrassing.

Some medications may improve these symptoms. Also, a speech-language therapist can sometimes help a person retrain their throat muscles so that they can swallow more effectively.

3. Depression and anxiety

Depression can occur with Parkinson’s disease, and it can make the symptoms worse.

Around 40%–50% of people with Parkinson’s disease also experience depression. This aspect of the disease can be harder for the individual and their loved ones to cope with than the physical symptoms.

Some other neuropsychiatric symptoms include:

  • mood disturbances
  • anxiety
  • sleep problems
  • psychosis
  • changes in behavior and thinking

However, the symptoms of depression are treatable, and recovery is possible.

Seeking medical help when the symptoms of depression start to appear can give the person a better quality of life, improved functionality, and a chance of slowing the symptoms.

4. Sexual dysfunction

Various factors in Parkinson’s disease can affect libido. A person may find it hard to have an orgasm or an erection.

The drop in sexual interest and physical functioning can happen because of a fall in dopamine levels, according to the American Parkinson Disease Association.

The impacts of this problem include:

  • a reduction in physical movement
  • reduced blood circulation, which affects the ability to have an erection
  • difficulty reaching orgasm

Vaginal dryness can also be a problem.

Depression and anxiety can reduce a person’s energy levels and their interest in things they used to enjoy, such as having sex. Fatigue may also be a factor.

Depression and mood changes can also cause changes in behavior and attitude. A partner may feel that their loved one is “not the same” as before, for example.

In rare cases, medications that increase dopamine levels in people with Parkinson’s disease may increase the person’s sex drive to an unusual level. Although this effect is rare, it can become a problem for some people.

There are some methods to treat many of the symptoms that disrupt sexual activity. For example:

  • Try seeking treatment for other symptoms and complications.
  • Lubrication oils can treat vaginal dryness.
  • Counseling may help resolve tensions within a relationship.

If a person experiences erectile dysfunction, a doctor may prescribe:

  • sildenafil (Viagra)
  • vardenafil (Levitra)
  • tadalafil (Cialis)
  • injectable medications, such as alprostadil (Caverject)
  • mechanical devices, such as vacuum pumps and penile implants

5. Sleep

Sleep problems are common among people with Parkinson’s disease.

Parkinson’s disease can affect how the body regulates sleep and wakefulness, but physical problems can also make sleeping difficult.

Some examples of sleep-related issues include:

  • sleep apnea
  • daytime sleepiness
  • nightmares and vivid dreams
  • restless legs or jerking leg movements
  • difficulty turning over in bed
  • difficulty falling asleep
  • difficulty getting back to sleep after waking up

Possible reasons for these issues include:

  • the effect of certain medications
  • physical discomfort
  • changes to the internal body clock

A doctor may suggest:

  • trying drug treatments, such as melatonin or eszopiclone
  • undergoing light therapy
  • trying positive airway pressure (for people with sleep apnea), though this method is controversial due to possible safety issues
  • removing objects from around the bed to prevent injury

Some lifestyle tips for better or safer sleep include:

  • following a regular bedtime routine, if possible
  • exercising outdoors during the day, if possible
  • avoiding coffee, alcohol, and other stimulants
  • using the bedroom only for sleeping
  • sleeping in a cool, dark room

6. Urinary problems

Around 30%–40% of people with Parkinson’s disease experience urinary problems. They may leak urine, need to urinate more often, or find it difficult to pass urine. Changes in the autonomic nervous system are one reason why this problem happens.

To reduce the need to go to the bathroom at night, the patient should:

  • Stop drinking fluids 3 hours before bedtime.
  • Go to bathroom just before going to bed.
  • Ask a doctor about medications to help manage urination.

Medications that may resolve this problem include:

  • oxybutynin (Ditropan)
  • tolterodine (Detrol)
  • solifenacin (Vesicare)
  • darifenacin (Enablex)

7. Constipation

Some statistics suggest that up to two-thirds of people with Parkinson’s disease experience constipation.

Some reasons for this problem may include:

  • muscle weakness
  • a possible reduction in fluid intake
  • side effects of certain medications
  • the impact of Parkinson’s disease on the autonomic nervous system, which includes the digestive system

Constipation can increase anxiety and discomfort and further reduce the person’s quality of life.

Some solutions to this problem are:

  • taking medications, such as laxatives
  • trying dietetic interventions, including probiotics and prebiotics
  • increasing fiber and fluid intakes
  • undergoing physical therapy

A person should speak with a doctor before taking any medications for treating constipation, as some drugs and alternative remedies can interfere with other medications.

8. Dementia

Changes to proteins in the brain, such as Lewy bodies, can lead to dementia in Parkinson’s.

The Alzheimer’s Association estimates that 50%–80% of people with Parkinson’s disease eventually develop dementia.

Some common symptoms include:

  • difficulty remembering things, difficulty focusing, and difficulty making judgments
  • unclear speech
  • hallucinations and delusions
  • depression, irritability, and anxiety
  • sleep difficulties and daytime sleepiness

Medication can help slow the progress of dementia, but the symptoms usually become more severe over time.

9. Pain

Pain is a common symptom of Parkinson’s disease. Over 60% of total patients experience pain. Of a list of bothersome symptoms, pain comes third after tremor and stiff muscles.

40%–90% of the pain associated with Parkinson’s disease is musculoskeletal, and people mostly describe this sensation as burning sensation, cramping, or aching.

Some ways of reducing the pain include:

  • taking over-the-counter or prescription medications
  • trying massage, music therapy, tai chi, or other complementary therapies
  • undergoing spinal cord stimulation

Patients can work with a healthcare team to find suitable ways of reducing pain.

10. Blood pressure

The autonomic nervous system controls blood flow and blood pressure. Parkinson’s disease affects this system, leading to changes in blood pressure throughout the day.

One problem is orthostatic hypotension, which is a drop in blood pressure that causes a person to feel dizzy or faint when they stand up.

Some people also experience high blood pressure, such as at night or when lying down. These fluctuations can lead to heart problems.

A doctor may prescribe a medication to stabilize blood pressure and prevent dramatic changes. Wearing compression stockings may also help.

11. Sense of smell

Over 95% of people with Parkinson’s disease experience some loss in their sense of smell due to the impact of the disease on their nervous system.

This is an early symptom of the disease, and it can occur years before other symptoms appear. Doctors see this symptoms as a predictor of Parkinson’s disease.

Summary

Parkinson’s disease can lead to a wide range of symptoms, but there are also many possible complications.

The medications that doctors prescribe to treat Parkinson’s disease can also lead to certain adverse effects. Some of these adverse effects overlap with the symptoms and complications of the disease itself.

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