Parkinson's disease: a long and difficult journey

PARKINSON'S DISEASE (PD) is the second most common neurodegenerative disorder to affect older adults, after Alzheimer's disease. It is a chronic, progressive disorder, characterised by resting tremor, slowed movements, rigidity and postural instability. Between one and two per cent of the population over 65 has PD. With an ageing population, numbers of people with this condition are expected to rise, placing an increasing physical, psychological, social and economic burden on individuals, their families and caregivers, and the health-care system. Therapies for PD are palliative, treating symptoms without addressing underlying causes of the disease. Very little is known about the causative events in the development of PD, and the focus for management remains largely on gross motor symptoms. It is increasingly recognised, however, that PD involves degeneration of regions in the central nervous system (CNS) other than motor pathways, affecting mood, motivation and other functions, having a major impact on the quality of life for people with the disease. Providing care for people with PD requires a detailed understanding of the events occurring in the CNS as this conditions develops. Knowledge of the effects of PD on neurological function allows a better comprehension of the benefits and limitations of current therapies. It also allows informed assessment of more recent developments in PD research and treatment. Nurses with a good working knowledge of the current status of PD research and treatments are better able to support patients and their families on this long and difficult journey.