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Updated: Jun 23, 2025

The Use of the Puzzle Box as a Means of Assessing the Efficacy of Environmental Enrichment
Published on: December 29, 2014
The Parkinson's Puzzle Box
Shafaq Hussain-Al1, Jane Alty2,3,4, Michele Callisaya5,6,7
1Yorkshire, UK.
Introduction:
Women and those with younger onset Parkinson's Disease (YOPD) are typically diagnosed later and face unique situations and challenges. This essay aims to raise awareness of the difficulties in diagnosing YOPD and the need for a personalised approach to care for women with YOPD.
Methods:
Two professional women with YOPD (academic physiotherapist and practicing dentist) and a female neurologist (clinician academic) came together to write a narrative essay on their personal experience and perspectives in relation to women and YOPD.
Results:
The essay outlines how the experience of diagnosis is likened to a complex puzzle box with many interlocking components that are hidden and difficult to solve. The concerns of the women about their identity, work, family and the future, with most supports targeting those that are older and retired are outlined.
Conclusion:
It is concluded that YOPD is a complex puzzle to solve, but can be done by understanding all the intricate interlocking components of the puzzle and combined with greater awareness could lead to earlier diagnosis and the delivery of successful person-centred care.
Patient Or Public Contribution:
People with lived experience were involved in the essay conception and writing.
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