PARKINSON’S DISEASE

1. PARKINSON’S DISEASE BY: NICOLE MABARDI & SHAINA JOSEPH

2. Clinical Agency • Bay Pines VA Hospital (St. Petersburg, Fl.) • Out Patient Clinic-5D Medical Specialty Floor • Contains: • Sleep Apnea, Neurological Diseases, Respiratory and Infectious Disease.

3. Clinical Population • Gender: • males • Ages: • middle to older adults • Race: • typically more Caucasians

4. Goals & Objectives • Goal #1- • Veterans will have a better understanding of Parkinson’s and their symptoms. • Goal #2- • Veterans will understand Parkinson’s is a treatable disease though it has no cure. • Objectives: • Upon reading the Parkinson’s brochure, patients will be able to explain how Parkinson’s occurs. • Patients will be able to list at least 3 signs of Parkinson’s and describe them. • The patients will be able to name 2 ways of treating symptoms of Parkinson’s.

5. Pathophysiology • Neurodegenerative brain disease • Loss of dopamine • Muscle function slowly deteriorates

6. How it occurs… • http://www.youtube.com/watch?v=XFcmuRgOWQU

7. Demographics • 50 years + • Males • Not race related • Not status related

8. Diagnosis • No particular diagnostic test • Genetic testing • PET Scan

9. Signs and Symptoms • Tremors • Ÿ Slowness in movement (bradykinesia) • Ÿ Muscle rigidity (akinesia) • Ÿ Problems with digestion • Ÿ Depression • Ÿ Low blood pressure • Ÿ Sensitivity to temperature • Ÿ Leg cramping/burning • Ÿ Loss of balance

10. Extra Pyramidal Symptoms (EPS) • Muscle rigidity • Repetitive muscle movement • Involuntary movements (Dystonia) • Bradykinesia

11. Extra Features of Parkinson’s • Dementia • Ÿ Autonomic instability • Ÿ Drooling • Ÿ Impotency • Ÿ Prostate enlargement

12. Videos • http://www.youtube.com/watch?v=JoDvGh4egFI (MJF) • http://www.youtube.com/watch?v=sf1N0Zf5IqA (shuffling)

13. Treatment • NO CURE! • Meds • Surgery

14. Deep Brain Stimulation • http://www.youtube.com/watch?v=oe9rSJo62bY 4:30

15. Importance of Early Treatment? • You want to catch symptoms early • Early treatment can slow progression of • Dopamine loss • Symptoms • Maintain muscle function

16. PEER REVIEW JOURNAL • The benefits of a standardized patient education program for patients with Parkinson's disease and their caregivers • “The Patient Education Program Parkinson (PEPP) is a standardized psychosocial intervention aiming at improving the health-related quality of life (Hr-Qol) of patients with Parkinson's disease (PD) and caregivers. A randomized controlled trial was performed to assess its effectiveness. Sixty-four PD patients and 46 caregivers were allocated to either the intervention group (PEPP) or the control group (usual care). The intervention consisted of eight weekly sessions of 90-minute duration. Assessments were performed on psychosocial problems (BELA-P/A-k), Hr-Qol (PDQ-39/EQ-5D) and depression (SDS) at baseline and one week after the end of the PEPP. Participants rated their mood on a visual analogue scale before and after each session. A significant effect for the caregivers on psychosocial problems and need for help was found and a trend for significance for patients' quality of life. Patients' and caregivers' mood improved significantly after each session. This study provides indications that PD patients and caregivers benefit from the PEPP. ” • L.E.I., A., E.M., W., N.G.A., S., S. Le, C., & R.A.C., R. (n.d). The benefits of a standardized patient education program for patients with Parkinson's disease and their caregivers. Parkinsonism And Related Disorders, 1689-95. doi:10.1016/j.parkreldis.2009.07.009

17. Healthy People 2020 • Older Adults • Goal: Improve the health, function, and quality of life of older adults. • Through programs that address chronic illnesses, Federal Government agencies are improving the quality of life for older adults. To combat existing health disparities, many of these programs target minorities and underserved populations. • The ability to complete basic daily activities may decrease if illness, chronic disease, or injury limit physical or mental abilities of older adults. These limitations make it hard for older adults to remain at home. Early prevention and physical activity can help prevent such declines. Unfortunately, less than 20 percent of older adults engage in enough physical activity, and fewer do strength training.5, 6 Minority populations often have lower rates of physical activity. • Most older adults want to remain in their communities as long as possible. Unfortunately, when they acquire disabilities, there is often not enough support available to help them. States that invest in such services show lower rates of growth in long-term care expenditures. • Healthy People (2013). Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=31

18. Contacts • American Parkinson’s Disease Association • 1-800-223-2732 • 727-898-2732 • APDA Sun Coast • Parkinson Chapter • Largo, Florida • 727-391-8214 • Parkinson’s Disease Foundation • 1-800-457-6676 • The National Institute of Neurological Disorders and Stroke • 1-800-352-9424 • www.ninds.nih.gov