Savvy Senior: What are the early signs of Parkinson's disease?

Dear Savvy Senior,

What are the early signs of Parkinson’s disease? My husband was recently diagnosed after noticing a slight thumb tremor but we’re wondering if we missed any other early warning signs.

-Curious Wife

Dear Curious,

Recognizing the early signs of Parkinson’s disease is challenging because the symptoms are often subtle and/or similar to those in other health conditions, which means they can easily be overlooked, dismissed or misdiagnosed.

Parkinson’s disease, which afflicts around 1 million Americans, is a degenerative disorder that occurs when the brain’s dopamine-producing neurons die or become impaired. This happens in the part of the brain that controls movement, which can cause tremors, stiffness, and difficulty with walking, balance and coordination.

The symptoms usually begin gradually and get worse over time, and the progression of symptoms is often different from one person to another. Some people with Parkinson’s become severely disabled, while others may experience only minor motor disruptions.

While the cause of Parkinson’s disease is unknown, scientists believe genetics and environmental factors (exposure to certain toxins) play a key role. Most people with Parkinson’s first develop the disease around age 60 or older, and men are more likely to develop it than are women.

Early Warning Signs
Parkinson’s disease is difficult to diagnose because there’s no definitive test to confirm it. Doctors, usually neurologists, will do an examination and evaluate a combination of warning signs, but symptoms can vary greatly by patient which often leads to confusion and misdiagnosis. That said, here are some of the key signs and symptoms everyone should be aware of.

Restless sleeping: Talking in your sleep, sleepwalking and/or acting out your dreams by kicking or jerking. This is a REM sleep behavior disorder and one of the strongest and earliest pre-diagnostic symptoms of Parkinson’s disease.

Loss of smell: Not being able to smell certain foods very well like bananas, dill pickles or licorice. This early symptom occurs in around 70 to 90 percent of Parkinson’s patients.

Constipation: Problems with digestion and bowel movements are a big problem for people with Parkinson’s, and an early sign that can occur up to 20 years before this disease is diagnosed.

Changes in handwriting: Writing may become harder to do, and your handwriting may appear much smaller than it has in the past.

Soft voice: According to the Parkinson’s Foundation, 89 percent of people with Parkinson’s will have speech and voice disorders, which often shows up first in volume of the voice, meaning that you may speak more softly.

Tremors: Slight shaking or tremor in your finger, thumb, hand or chin. The tremor usually happens at rest, and when you move the extremity, it may disappear. This is the most common and recognizable outward sign of Parkinson’s disease, but by the time tremors start, the brain has already lost more than half of its dopamine-producing cells.

Slowed movement: Over time, Parkinson’s disease can slow movements, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk.

Masked Face: The muscles in the face experience the same gradual stiffening as in the rest of the body, which results in lack of smiling and facial expressions.

Impaired posture and balance: Stooping, leaning or slouching when you stand, and/or balance problems can all be an early sign of Parkinson’s.

Having these symptoms doesn’t necessarily mean that a person has Parkinson’s disease. But if you are experiencing any of them, and you’re over age 60, you should consider talking with your doctor, who may order a DaT scan or Syn-One (Skin Biopsy) Test to help diagnose it. Early detection leads to earlier treatment, which can improve a person’s overall quality of life.

For more information, visit the Parkinson’s Foundation at Parkinson.org.

Send your questions or comments to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, email questions@savvysenior.org, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.