Parkinson's disease. Parkinson's disease and life expectancy Parkinson how many live with him

Named after the English scientist who described Parkinson's disease in 1817, the causes and treatment have since been under the close attention of physicians in all developed countries, and to date, some progress has been made in this area.

From the point of view of neurophysiology, the balance between dopamine and glutamate is disturbed in the human brain. In an effort to defeat Parkinson's disease, doctors prescribe treatment in such a way as to bring this balance back to normal, and prescribe appropriate medications.

It is important to identify the first signs that indicate that a person is threatened by parkinsonism. Parkinson's disease, the symptoms and treatment of which have been repeatedly described in scientific and popular articles, is a threat to every family if it has old man. His relatives should carefully consider the following phenomena:

tremor (tremor) of the limbs and head at rest and movement;
increased tension (rigidity) of the muscles;
instability when walking and changing body position;
violations of posture ("posture of the petitioner");
development of illegibility of speech;
slowness of movement (hypokinesia).

If at least one symptom is present, you should immediately consult a doctor and conduct the necessary studies. Diagnosis can be made on the basis of complex brain imaging. Treatment can be conservative or surgical, depending on the particular patient's condition.

Parkinson's disease and life expectancy: a lot depends on care

The doctor will prescribe drugs that can significantly alleviate the patient's condition and reduce the manifestation of symptoms. It is imperative to invite an experienced and qualified nurse to the patient, who will do everything that is necessary:

give medicines and perform other medical appointments on time;
provide a person with comprehensive assistance;
take care of his safety.

Parkinson's disease and life expectancy - this issue worries the patient's relatives. Preparations latest generations allow you to maintain relative activity and even performance in the initial stages. Now such patients can live up to 10-15 years with properly selected drugs, and their relatives must ensure the quality of their life.

Naturally, family members will not be able to stay with a patient with parkinsonism inseparably. They must work and study, and after that have a good rest. Inviting a nurse is a rational decision that will radically facilitate the existence of the patient and his family.

In a large number of cases physical exercises in Parkinson's disease become at least effective method treatment than drugs. Now there are many special techniques, and a qualified nurse will provide regular sessions with the patient.

Therapeutic exercise will alleviate the movement disorders that distinguish Parkinson's disease, and movement disorders often almost disappear if the disease has not gone too far.

In the last stage of Parkinson's disease, it is important to prevent the danger

The last stage of Parkinson's disease is the most severe: a person loses the ability to move, speak clearly and serve himself. In this situation, only a professional nurse-nurse can alleviate his suffering.

When a loved one has Parkinson's disease, the last stage, how long such patients live - this question is asked by relatives to doctors. There is no single answer. In the fifth stage of parkinsonism, death can occur not from the disease itself, but from, for example, pneumonia, kidney failure, and other causes. With qualified nursing care, these phenomena can be prevented.

Our patronage service is ready to provide competent nurses with professional education and experience in caring for patients at any stage of parkinsonism.

Doctors predict that in the future, due to the inexorable aging of the population, a powerful increase in cases of this disease is expected, and by 2030 there will be 8.7 million people with this diagnosis in the world.

Our expert is a senior researcher at the Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Medicine, Russian National Research medical University them. N. I. Pirogov" of the Ministry of Health of Russia Natalia Titova.

Myth 1: Parkinson's disease only affects the elderly.

In fact. Unfortunately no. Despite the fact that 85% of patients are indeed older than 65 years, there is also a form with an early onset (before 40 years), and even a youthful form of the disease (with a debut before 20 years). For example, the famous actor Michael J. Fox, who played the main character in the film Back to the Future, was diagnosed with Parkinson's disease at the age of 35.

Myth 2. If parents have this disease, children will also get it.

In fact. The genetic inheritance of Parkinson's disease, associated with a specific gene mutation, is detected only in 5-10% of patients and mainly in early development illness. Familial cases are quite rare.

Myth 3. An unhealthy lifestyle can lead to Parkinson's disease: frequent drinking, smoking, drug use.

In fact. With regard to alcohol, this fact has not been established. As for smoking, the opposite is true - smokers are even less at risk of disease than those who have never touched cigarettes. However, this does not negate the general harm from drinking and smoking on health. And here are some factors environment have great importance for the development of this disease, especially for people who become ill after 50 years. An increased risk of developing Parkinson's disease has been noted in people who are regularly exposed to toxic substances or have jobs related to the chemical or metallurgical industry, as well as regular contact with pesticides.

Myth 4. Boxers are more at risk of getting this disease than others.

In fact. The main reason for the development of the disease is the progressive death of the so-called dopamine neurons in the brain. But why this happens, scientists still have not guessed. Nevertheless, serious head injuries, in particular boxing, can really give impetus to the development of the disease. As proved by the example of the famous boxer Mohammed Ali.

Myth 5. Parkinson's disease is only a movement disorder, which is mainly expressed in hand tremors.

In fact. Unfortunately no. This is a complex disorder, which, in addition to motor symptoms, includes many others: emotional, vegetative, mental disorders. Despite the fact that the disease was originally called “shaking paralysis” and 70% of patients have tremor (that is, trembling) (and it can occur from the earliest stages), this symptom also occurs with other diseases.

Myth 6. Patients with this disease do not live long.

In fact. According to statistics, mortality from this disease is 1.5-3 times higher than in the population. In comparison, pneumonia increases the risk of death by 45 times. People with Parkinson's disease are often ill for 15-20 years and live to a ripe old age. Another thing is the quality of their life. At the last, fifth stage, the disease forever chains people to bed.

Myth 7. There is no cure for Parkinson's disease, so there is no point in being treated.

In fact. Despite the fact that this disease is still incurable, it is necessary to be treated. After all, without medical care the disorder can progress very quickly. In total there are 5 stages of Parkinson's disease, on average each of them lasts about 3 years, but modern drugs prolong the third stage of the disease up to 7-8 years, which can significantly delay the occurrence of severe restrictions on motor activity in patients.

There is a GENOM Patient Care Center in St. Petersburg. The staff of the center, led by its director Elena Khvostikova, organizes regular schools for patients with Parkinson's disease, which include both lectures by leading experts and practical classes that help patients learn to cope with the symptoms of the disease (for example, dance schools). By attending these events, people do not become isolated in their illness, but find a new social circle and learn to overcome the illness.

“My husband is an officer, a very balanced person. He worked all his life, did not complain about anything, I never heard from him about fatigue. But about six years ago he became too quiet, did not talk much - he just sat and looked at one point "It didn't even cross my mind that he was ill. On the contrary, I scolded that he had grown old ahead of time. Around the same time, a cousin from England came to us - she works in a hospital - and immediately said that Rafik was doing very badly, we need it tomorrow take him to the doctor. That's how we learned about Parkinson's disease," recalls Seda from Yerevan.

What is Parkinson's disease

Parkinson is one of the scariest names you'll hear in a neurologist's office. It was worn by an English physician who, in 1817, described in detail six cases of the mysterious illness. James Parkinson's birthday is April 11th and is chosen as a memorable date by the World Health Organization. Because of the main symptoms, Parkinson called the disease shaking paralysis: the movements of patients slow down, become constrained, the muscles tense up, and the arms, legs, chin, or the whole body shake uncontrollably. However, in a quarter of cases, trembling - the most famous sign of the disease - is not present.

All this is reminiscent of ordinary old age. Movement symptoms - collectively referred to as parkinsonism - occur in many healthy old people. But Parkinson's disease doesn't stop there. In the later stages, a person easily loses balance, now and then freezes in place while walking, it is difficult for him to speak, swallow, sleep, anxiety, depression and apathy appear, constipation torments, falls blood pressure, memory weakens, and in the end dementia often develops. The saddest thing is that there is no cure for Parkinson's disease yet.

At the beginning of the 20th century, the Russian neuropathologist Konstantin Tretyakov found out that cells of the substantia nigra, an area of the brain that is partially responsible for movement, motivation, and learning, die in Parkinson's disease. What causes neuron death is unknown. Perhaps the matter is in failures inside the cells, but it has also been noticed that harmful protein accumulates inside them. Both processes are probably somehow connected, but scientists do not know exactly how.

In 2013, physiologist Susan Greenfield of the University of Oxford presented a new model for the development of neurodegenerative diseases, including Parkinson's and Alzheimer's. Greenfield suggested that when the brain is damaged, for example, from a strong blow, a special substance is released. In young children, it causes new cells to grow, but in adults, it seems to have the opposite effect, further damaging the cells. This is followed by an even greater release of matter, and chain reaction gradually destroys the brain. In a cruel irony, adults fall into infancy because of an enzyme that babies need.

However, Greenfield's conjecture does not explain everything. Parkinson's disease is associated with heredity: a close relative with the same diagnosis or a tremor of a different nature - main factor risk. In second place are constipation: sometimes they are caused by changes in the brain, when motor symptoms have not yet appeared. The risk also increases if a person has never smoked, lives outside the city, drinks well water, but at the same time has come across pesticides, and decreases in coffee, alcohol and hypertensive patients. What is the secret here, it is not clear how it is not clear why Parkinson's disease usually begins in old age: if in the fifth decade about one out of 2500 people is sick, then in the ninth - already one out of 53.

A fresh piece of work from scientists at Thomas Jefferson University has provided a new clue: it is possible that Parkinson's disease is associated with immune system. The researchers took mice with a mutated gene commonly found in sick people and injected them with harmless leftover bacteria. Because of this, the animals began to have inflammation, which also affected the brain, and immune cells was 3-5 times greater than in normal mice. Because of this, processes began in the brain of mutants that were detrimental to the neurons of the substantia nigra. As in Greenfield's model, these processes turned out to be cyclical: inflammation in the brain can remain even after the body has coped with the infection. However, the authors of the study themselves admit that much is still unclear about this mechanism.

What is life like for patients and their families?

In Russia, about 210-220 thousand people have Parkinson's disease. But these data are calculated on indirect indicators, and there is no single register. Anastasia Obukhova, Ph.D. from the Department of Nervous Diseases at Sechenov University and a specialist in Parkinson's disease, believes these statistics are underestimated. “Many patients come for the first time already at the advanced stages of the disease. When questioned, it is possible to find out that the signs appeared several years ago. Most of our people have the principle “Until the thunder breaks out, the peasant will not cross himself”: they read on the Internet, ask their neighbors, and they don’t go to the doctor. This is in Moscow, and in small towns and villages they go to the doctor only if they are completely dying, "explains Obukhova.

In addition, getting an appointment is not so easy. To do this, you first need to go to a therapist to be referred to a neurologist. But even then there is no guarantee that a person will be diagnosed correctly and prescribed the right treatment. “A doctor in a polyclinic cannot understand everything, so he must send the patient to a narrow specialist. And, in my opinion, the district parkinsonologists have been removed. In any case, patients complained about this,” says Obukhova. True, if the patient still got to the right doctor, he will be treated at the world level. That is why people with Parkinson's disease fly to Russia even from other countries.

Odyssey in the offices has to be repeated often, because the disease progresses - therapy needs to be adjusted. Treatment is expensive: a monthly supply of some drugs costs 3-5 thousand rubles, and in the later stages several drugs are prescribed at once. “In district clinics, medicines are sometimes given free of charge, but only cheap generics. I won’t comment on their quality. Sometimes there are no necessary medicines. Then they are replaced with something else. Patients feel bad about this,” explains Obukhova.

Over time, the pills stop working. "The medicine takes half an hour, the rest of the time she screams and makes very loud sounds. Both day and night. Nothing helps her," says Lina from Kharkov. Her mother Larisa was diagnosed with Parkinson's disease at the age of 40. Since then, 22 years have passed. Larisa lives in Luhansk, her husband Alexander constantly looks after her. In the video Lina showed, her sweat-covered mother convulsed and moaned that she couldn't take it anymore. Lina herself is tired. When asked about hospices, she replies that they are not accepted anywhere.

In Russia, according to Anastasia Obukhova, relatives of patients are forced to either hire a nurse or leave everything and take care of the patients on their own. "[But] we have a dance school for patients with Parkinson's disease, there are special schools where they have meetings, psychotherapy, swim in the pool. But everything is based on the enthusiasm of the doctors who do this," says Obukhova.

Ordinary people also need interest: if not in helping others, then in their own health. A few years before motor symptoms, other warning signs appear. Constipation, mood disorders, impaired sense of smell, erectile dysfunction, daytime sleepiness- all this may indicate the initial stage of Parkinson's disease. If any of this bothers you or your loved ones, especially in old age, it is better to see a doctor as soon as possible. Parkinson's disease is incurable, but its development can be slowed down, and for this it must first be recognized.

Marat Kuzaev

Parkinson's disease is a chronic progressive disease nervous system, characterized by a violation of the motor sphere. Parkinson's disease in neurology is one of the most intractable problems.

Currently, the prevalence and social significance of the disease has reached an extremely high degree. So, if twenty years ago, according to statistics, the main cases of morbidity were in the group over 75 years old, now Parkinson's disease is "getting younger", cases of the disease are already noted at 40 and even 35 years. For example, it is believed that the famous boxer Muhammad Ali suffered from Parkinson's disease. Although there is an opinion about the traumatic genesis of his motor disorders. Also, Parkinson's disease is becoming one of the most common causes disability among the population neurological diseases.

All these facts indicate the need for close attention to the disease, increasing the level of literacy among the population to improve the early diagnosis of the disease, because timely therapy leads to a more adequate response to treatment.

Information for doctors. According to ICD 10, the coding of the diagnosis of Parkinson's disease passes under the code G20 (without the third digit). According to the ICD code 8A00.0. At the same time, when formulating a diagnosis, it is generally accepted to indicate the form of the disease (tremulous, rigid, akinetic) according to the leading symptom, the severity according to Hoehn-Yar is indicated (the method for assessing the severity is given below). Also, in the syndromic part, any other manifestations of the disease can be indicated: postural instability, dystonic disorders, etc.

The reasons

Unfortunately, no reliable causes leading to Parkinson's disease have been identified. A certain role is given to environmental factors (especially contact with heavy metals), hereditary factors, the presence of repeated traumatic brain injuries and other undesirable effects, including the intake of certain medicines. Some authors believe that the cause of Parkinson's disease is the presence of a prion infection.

Ultimately, the pathological cause of the disease is a malfunction of one of the parts of the brain - the substantia nigra. In this part of the brain, special neurotransmitters are produced - substances that allow the interconnection between neurons, regulate muscle tone, and much more. It is the violation of the DOPA system that leads to all manifestations of the disease.

Symptoms

A classic symptom of Parkinson's disease is tremor - trembling of the limbs, head. However, it is often this symptom, which certainly takes place, that is considered the leading and almost the only thing that leads many people to panic, with the appearance of trembling in the hands or head. However, it is not.

The main and obligatory symptom of the disease is oligobradykinesia - insufficient range of motion, their scarcity, difficulty in starting to move. Also, oligobradykinesia leads to the paucity of facial expressions and gestures. And only if there given symptom could be Parkinson's disease. Two other typical and frequent manifestations - tremor and rigidity (stiffness of the muscles due to increased muscle tone) are often found in other diseases, but also have important diagnostic value.

Also, in Parkinson's disease, there may be violations of the motor sphere, for example, postural instability or the inability to independently stop the movement, leading to a fall. It is this symptom that often becomes disabling in the later stages of the disease.

Often in Parkinson's disease there are cognitive impairments (impaired memory, concentration, learning ability), pelvic disorders (usually constipation), mental disorders. In most cases, the disease, especially in the later stages, leads to a deep psycho-traumatic effect on the patient (and often on relatives) and leads to the development of clinically or subclinically pronounced depression. This should also be taken into account, because under the guise of depression, you can not notice many problems in a patient: he simply will not talk about them on his own.

Quite often, patients change in behavior (they become pedantic, inconsistent, overly intrusive, a persistently lowered mood background develops). Patients also have disturbed quality and sleep patterns. Also characteristic are the typical posture (posture of the petitioner), gait disturbances (gait with small steps) and many other signs.

If we take the most "popular" and well-known symptom - tremor - then it has its own characteristics. Tremor in Parkinson's disease is characterized by a unilateral onset, often in the arm, with a gradual transition to the other side, and then to another anatomical zone (legs, etc.). Tremor of the jaw, head is less characteristic and usually occurs in the later stages of the disease, and even then only in rare cases. The type of tremor also draws on itself, it resembles "counting coins" or sorting out pills. The tremor is usually low-amplitude, somewhat decreases in the process of performing a purposeful movement, which is especially noticeable when performing a finger-to-nose test, there is almost no tremor during the movement of the finger, while at the end of a purposeful action (hitting the nose) a clearly distinguishable tremor appears.

Famous people with Parkinson's disease.

Diagnostics

Diagnosing Parkinson's disease is not an easy task. After all, despite common misconceptions, no neuroimaging study, except for positron emission tomography, can reliably establish a diagnosis. Neither an MRI of the brain, nor even an ultrasound examination of the substantia nigra does not allow us to speak of the presence of a disease with a high degree of probability.

Positron emission tomography (PET) is the only research method that allows us to talk about the presence of the disease. During PET, there is a decrease in the accumulation of a special radioactive drug - fluodopa in the striatum and substantia nigra. Moreover, the detection of the disease is possible even at the preclinical stage. However, the prevalence of the study is very limited, the study is extremely expensive at the present stage, and in Russia it is possible to conduct it only in large research centers.

Typically, the diagnosis is made on the basis of clinical picture. This must take into account the presence characteristic symptoms, the typicality of the clinical picture and complaints, as well as the sequence of progression of symptoms. Also, a neurological examination reveals the presence of bradykinesia, the phenomenon of "cogwheel" and other specific symptoms of the disease.

Of no small importance in the diagnosis is a good response to therapy with levodopa-containing drugs. Symptoms at the first doses usually disappear completely or almost completely.

Method for determining the severity

An adequate assessment of the severity and disability of a person is of great social importance. The Hoehn-Yar scale for assessing the severity of Parkinson's disease, introduced into practice in the late 60s of the twentieth century, has become widespread. According to this scale distinguish five degrees of severity, depending on the manifestations and consequences of the disease:

Stage 0 - no signs of disease.
Stage 1 - only unilateral symptoms.
Stage 1.5 - unilateral manifestations involving skeletal muscles.
Stage 2.0 - mild 2-sided symptoms without imbalance.
Stage 2.5 - bilateral signs, imbalance, but the preservation of the ability to overcome the induced backward movements (retropulsions).
Stage 3 - Medium bilateral symptoms. The presence of unexpressed postural instability. The patient does not need outside care.
Stage 4 - severe manifestations, immobility. It remains possible to move or stand independently on “good” days or hours.
Stage 5 - complete immobility.

It is also important to determine the progression of the disease. Allocate a fast pace, which is characterized by a change of stages according to Khen-Yar within two years, a moderate one - from three to five years per stage, a slow pace - overcoming one stage takes more than 5 years.

Video from the author of the site

Consequences and prognosis of life

According to the above tables, the need for extraneous care can be noted already at the 4th stage of the disease. However, at stages 2.5 and beyond, a person’s ability to work is practically lost.

The prognosis of life for patients with Parkinson's disease is usually favorable. With proper care and adequate therapy average duration life is practically not reduced. Timely started adequate therapy, non-drug methods of rehabilitation and the provision of psychological support allow patients to long time maintain social activity and maintain the quality of life at the proper level.

Parkinson's disease is a disease of the elderly, which affects about 5% of people. old age on our planet. Many patients and their relatives are tormented by one question, how long do they live with Parkinson's disease and is it curable? But first things first.

What is Parkinson's disease? It is a neurodegenerative disease that affects people between the ages of 40 and 85. The cause of the occurrence is a violation of the production of the hormone of happiness - dopamine.

Mechanism of dopamine production

The factors influencing the formation of the disease include:

heredity;
ecological situation;
infections or traumatic brain injury.;
the symptoms of the disease are easily recognizable for any person, these include:;
tremor of the limbs (trembling of the hands or feet);
memory impairment;
shuffling gait;
slouch;
half-bent legs and arms.

You can read more about this disease.

Parkinson's disease has a clear classification, according to the speed of the course of the disease and according to the clinical picture.

Stages of Parkinson's graphically

So, there are three forms of the disease according to the speed of the course:

Quick.
Moderate.
Slow.

And three forms according to the clinical picture:

Akinetic - rigid - trembling form.
Akinetic - rigid form
Tremulous form.

In addition, the disease is divided into six stages:

0 stage;
1 stage;
stage 2;
3 stage;
stage 4;
5 stage.

Regarding the stages of the disease and the symptoms characteristic of them, you can read our article on Parkinson's disease.

In addition, in modern neurology for more than 45 years, a specialized scale of Khen-Yar has been used. This scale classifies disease in relation to movement disorders and was developed by physicians Margaret Hehn and Melvin Jahr.

According to this scale, motor disorders go through 5 stages of development.

First (initial) stage

The patient begins a slight degree of trembling of one of the limbs, usually the hand. So called unilateral tremor. If he worries the patient, then just a little. Such trembling in no way affects the patient's ability to work. The gait does not change. Changes in facial expressions are noticeable only to close relatives.

Second stage

The trembling becomes bilateral. The tremor intensifies and a change in facial expressions appears. The face itself begins to resemble a mask more and more. Changes become visible to others.

The patient is able to move, gait does not change, balance is not disturbed.

Third stage

It is characterized by the presence of a mincing, shuffling gait in the patient. A similar type of walking is chosen by patients as a result of a possible loss of balance. In order to avoid this, the patient has to keep his feet on the ground.

The patient does not need outside help and is able to take care of himself.

Fourth stage

Serious problems with the movements of the patient are noted. He often loses his balance, shuffling becomes more pronounced. There are periods of freezing in one place, inhibition of movement. The patient can move over short distances, he begins to need outside help to perform simple, from the point of view healthy person, div.

An interesting fact is that at this stage, hand trembling can be less than 2 or 3.

Fifth (last) stage

In the last stage, the patient loses the ability to walk without assistance. He needs a wheelchair. The patient is unable to stand on his own. The patient experiences complete exhaustion organism.

Lifespan

Undoubtedly, the most burning question is what is the life expectancy of patients diagnosed with Parkinson's disease? And the answer to this question is very ambiguous.

Common Symptoms and Treatment Options

Yes, there are dry statistics that are disappointing - people who do not treat the disease in any way live up to 10 years, and those who follow all the doctor's prescriptions live up to 15 years.

Is this really so and does death come earlier? The statistics show only dry numbers, which were taken on the basis of average data. But many factors play an important role:

the quality of life of the patient (it is obvious that a person with an income below the subsistence level has a much lower quality of life);
place of residence (village, large metropolis or small town);
Lifestyle ( healthy lifestyle life, susceptibility to regular stress loads, high fatigue);
age at which the disease was diagnosed.

The most important criterion in determining how long people live with Parkinson's disease is precisely the age when the disease was discovered.

So, for people from 40 to 65 years, the average life expectancy with this disease will be 21 years.

For persons of lesser age (25–40 years), it can reach 38 years, and for patients over 65 years of age, even 5 years.

Thus, the average figure indicated above was derived.

So the prognosis for future life no longer looks so unpromising.

And one more thing, the death of patients, as a rule, occurs as a result of a disease that has joined, and in some cases as a result of suicide, since the inability to serve oneself, constant depression and the feeling that the patient is before death leaves a serious imprint on the patient's psyche and pushes him to commit suicide.

Ways to extend life

It is important not to think about how much the patient has to live with this disease, but about how to prolong it.

Group lessons

The treatment that the doctor prescribes can be quite specific and pills alone cannot seriously improve life, so it is necessary to resort to additional stimulation of motor activity and fine motor skills of the patient's hands.

First of all, this is moderate physical activity and physical education, visiting massages. These recommendations help to strengthen the patient's body in general.

Visiting dance studios or individual lessons with an instructor proved to be excellent. At present there is a large number of specialized dance studios for patients with Parkinson's disease. Dancing not only helps to keep the body in good shape, but also affects the patient's attitude to life, giving him pleasant moments.

Disability

Is there a disability for Parkinson's disease? The unequivocal answer is yes. In order to determine which group of disability will be assigned, it is necessary to refer to the Hen Yar scale, according to which doctors are guided.

So, the criteria for establishing a disability group are as follows:

the third group - corresponds to the second or third stage on the Hen Yar scale;
the second group corresponds to the third or fourth stage on the same scale;
the first group - corresponds to the fourth or fifth stage.

The second and third groups of disability are assigned for one year with the need for its subsequent confirmation. Under the same conditions, the first group is assigned, with the exception of time, it is appointed for 2 years.

In the event that medical and rehabilitation measures do not give positive result, disability can be assigned without the need for its regular confirmation.

So, life expectancy in Parkinson's disease is a rather unstable criterion, and for each person the period will be individual. Therefore, you do not need to calculate how much you have left to live, you need to do everything possible in order to increase this period and fully enjoy life. Cherish the best moments!