Parkinson’s DiseaseSheila Mulhern

Parkinson’s Disease Stats (PDF)

One million Americans live with Parkinson's disease, - more than the combined number diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig's disease.

Approximately 60,000 Americans are diagnosed with PD each year,

Worldwide: an estimated seven to 10 million people are living with Parkinson's disease.

Men are 1.5 times more likely to have Parkinson's than women.

Healthcare Costs & PD The combined direct and indirect cost of

Parkinson’s, including treatment, social security payments and lost income from inability to work, is estimated to be nearly $25 billion per year in the United States alone.

Medication costs for an individual person with PD average $2,500 a year, and therapeutic surgery can cost up to $100,000 per patient.

Parkinson’s Disease A degenerative disorder of the central nervous

system as a result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain

Nerve cells can’t send signals properly causing loss of muscle function

In response the adjacent thalamus and globus pallidus interna become overactive resulting in a tremor

Most often develops after age 50 and one of the most common NS disorders of the elderly

Named after English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817

Etiology of PD Cause not officially known but genetic and

environmental factors are linked Genetic: modern research shows six genes have

been identified as causing familial PD alpha-synuclein, parkin, UCHL1, DJ1, PINK1, and LRRK2

Environmental: not direct but demonstrated to have the ability to cause nigrostriatal cell death appear to interact by interfering with mitochondrial function, inducing oxidative stress, and modifying proteasomal function. DJ1 and PINK1 are mitochondrial proteins and

overexpression of alpha-synuclein and parkin induce mitochondrial defects

Parkinson’s Disease Characteristics

Tremor at rest Bradykinesia –

slowness of movement Rigidity and stiffness Increased resistance to

passive movement of limbs or trunk

Micrographia – small, constricted handwriting

Poor balance

Diminished arm swing

Dysphagia Hypomimia – lack of

facial expression - “Parkinson mask”

Dysarthria – diminished voice volume, stuttering

Depression Dementia

PD & Nutritional Implications

Medical Interactions: Levodopa

PD & MNT Focus on drug-nutrient interactions Minimize dietary protein at

breakfast/lunch Recommend antioxidants and anti-

inflammatory diet

Study #1: The Mediterranean diet and Parkinson's disease

Official Journal of the Movement Disorder Society – funding NIH & Parkinson's Disease Foundation (FEB 2012)

250 PD patients and 198 controls – diet questionnaire for past year

Higher Mediterranean-type diet adherence was associated with reduced odds for PD after adjustment.

Lower Mediterranean-type diet score was associated with earlier PD age at onset.

PD patients adhere less than controls to a Mediterranean-type diet. Dietary behavior may be associated with age at onset.

2009 study on 1,410 French adults showed higher adherence to Med-diet was associated with slower MMSE cognitive decline (not other tests or assoc. with dementia

Study #2

Study #3

Other study topics Caffeine may improve motor PD

symptoms Flavonoids may aid PD risk Concussions as contributing factor to

later developing PD

Resources Case study: The association between Mediterranean diet

adherence and Parkinson's disease http://onlinelibrary.wiley.com/doi/10.1002/mds.24918/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+on+8+December+from+10%3A00-12%3A00+GMT+%2805%3A00-07%3A00+EST%29+for+essential+maintenance&userIsAuthenticated=false&deniedAccessCustomisedMessage=

Parkinson’s Disease Foundation http://www.pdf.org/en/parkinson_statistics

Dopamine signaling in PD http://www.cellsignal.com/reference/pathway/parkinsons_disease.html

https://www.michaeljfox.org/ Etiology of PD http://www.ncbi.nlm.nih.gov/pubmed/16717248 http://www.pdf.org/en/science_news/release/pr_1330379372