Wednesday, September 26, 2007

Parkinson's and Age

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What is the difference between getting old and having Parkinson’s? My 87 yr. old Mother-in-Law has much poorer balance, moves much more slowly, and is much less flexible than 65 yr. old me. Yet she’s said to be OLD and I’m said to be a PWP. The only classical symptom where she comes off looking better than me is tremors, but I’m clearly trouncing her in three of the four most prevalent symptoms.

Do the tremors make the difference? Is the speed of growing old faster for PWP’s than for others? If that’s the case, if I’m alive, should I expect to be worse off at 87 than she was at 87? Then there’s the theory that if all humans lived to be 120, they would all be PWP because of the eventual loss of Dopamine.

My tentative conclusion is that, as concerns Parkinson’s, the basic difference between her and me is that I’m probably losing Dopamine at a faster rate than she did. And that I should have at least some trepidation about the prospect of reaching 87 (or relief in knowing that I won’t).

Then again, maybe we should just say that she’s old and I’m getting older. Speaking metaphorically and with some exaggeration, that way we wouldn’t have to have a scarlet PWP stitched to our clothing and embedded in our minds.

I digress. The question remains: could you help explain the difference between getting old and having Pakinson’s?
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Dr. Fernandez



Joined: 20 Jan 2007
Posts: 90


PostPosted: Sun Sep 23, 2007 8:16 am Post subject: Reply with quote
Very good question.

You are mostly correct in your thinking and observation.

The major difference in PD and physiologic aging is the rate of deterioration of dopaminergic (and other yet unknown) cells. In PD, they deteriorate faster than in normal aging.

The reason why we can't simply state that PD is faster aging is because not every part of the body in PD ages faster...only those responsible for smooth movement. PD patients do not have a faster deterioration of their muscle strength (in general), or their vision, or their sensation, or their bone health (at least not as fast as osteoporosis), or their heart function. Thus, we cannot simply call neuropathy, macular degeneration, osteoporosis, coronary heart disease, and other disorders that occur or worsen with aging as "faster aging". They have their own label depending on the system than they affect.

If someone has 2 out of the three cardinal motor features of resting tremor, slowness and stiffness, that is not explained by other factors such as arthiritis, osteoporosis, malnutrition, other concomitant illness, then yes, that patient is classified as having parkinsonism (perhaps PD, if they respond to medications crisply, and follow other operational criteria) instead of normal aging.

I hope this helps clarify definitions for you.

Yours,
_________________
Hubert H. Fernandez
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