Stating that Parkinson's, a disease directly related to age, occurs in 1 out of every 100 people aged 60, experts say that the disease is 1.5 times more common in men than in women. Stating that the use of well water and pesticides are among the risk factors, experts recommend a diet that protects cardiovascular health, regular exercise, cycling or swimming. Experts warn that poor sleep significantly increases the patient's complaints the next day.
Parkinson's disease was determined as the theme this year by the World Federation of Neurology within the scope of World Brain Day on July 22.
Üsküdar University NPISTANBUL Hospital Neurology Specialist Prof. Dr. Sultan Tarlacı made evaluations on Parkinson's disease.
Using well water and pesticides are risk factors
Noting that Parkinson's disease occurs directly with age, Prof. Dr. Sultan Tarlacı said, "The disease occurs directly with age, in 1 out of every 100 people aged 60. Its frequency increases with increasing age. Since it is a condition that occurs with certain risk factors and to a lesser extent due to genetics, it may not be possible to be 100 percent protected. However, eliminating known risk factors can provide protection. It occurs more frequently in those who use well water and those who use pesticides such as insecticides, herbicides and fungicides in agriculture. In such applications, the relevant area in the brain is probably affected by direct exposure. Therefore, adequate protection measures should be taken in such practices. It occurs more frequently in rural areas," he warned.
It is more common in men than women
Prof. Dr. Sultan Tarlacı noted that the incidence is higher in men than in women and said, "We do not know the reason for this. It is 1.5 times higher in men. Some diseases, such as depression and anxiety disorders, and immune system diseases such as Multiple Sclerosis, SLE, rheumatoid arthritis are more common in women. There is probably a relationship between sex genes and immune genes, HLA or immune genes, and we do not yet know this exactly in terms of Parkinson's."
It starts with tremors or lack of movement
Prof. Dr. Sultan Tarlacı noted that the disease usually starts with tremor or lack of movement and stiffness on one side of the body, and after a year or so, it affects the other half of the body, and in the following year, it affects the midline of the body. Prof. Dr. Sultan Tarlacı said, "This effect may be in the form of writing like ant writing, slowness in movements, loss of smell, constipation, hoarseness in voice, drooling on the pillow, slowness and slowing down when sitting and getting up. In the first 2-3 years, the response to medication is very good and this period is called the honeymoon period. After that, the dose of medication needs to be increased. After 5-10 years, the number of medications needs to be increased. During these periods, mental slowdowns are also added to the picture. Gradually, daily life can become dependent after 10-15 years. After 15-20 years, medication non-responsiveness or medication side effects occur. However, with methods such as brain pacemakers, quality of life can be significantly improved in appropriate patients."
Prof. Dr. Sultan Tarlacı pointed out that in the 1960s, patients could lose their lives due to Parkinson's disease, but with the drugs developed since the 1960s, people no longer die from Parkinson's disease. Tarlacı noted that life expectancy with the drugs is like normal people.
Step width decreases significantly
Prof. Dr. Sultan Tarlacı noted that in a typical course of Parkinson's disease, there is a slowdown and aggravation in movements, the patient says "I cannot command my muscles" and said, "There is a decrease in the number of blinks and mimicry on the face, a mask face appearance. Speech is hoarse, monotonal and drooling occurs due to decreased swallowing. In the trunk, there is difficulty in getting up from the chair, difficulty in turning or walking in bed, sitting as a whole and difficulty in turning in bed. The width of the stride is markedly reduced, and in the advanced stage, sudden freezing while walking and sudden acceleration forward as if running fast develop. There may be visual disturbances. However, it is not very noticeable. Cell loss in the brain that causes Parkinson's also occurs in the eye. However, it does not attract attention. Loss of smell, constipation, gradually turning into ant writing in writing, withdrawal-depression-like appearance and sometimes dullness, stiffness and pain of unknown cause in one arm and shoulder may be the first complaint. In some cases, it is understood in the orthopedic clinic after a fall and hip fracture that the patient actually has Parkinson's disease."
Nutrition that protects cardiovascular health is recommended
Pointing out the importance of nutrition in Parkinson's disease, Prof. Dr. Sultan Tarlacı said, "Cardiovascular health protective nutrition is important. As body movement slows down, bowel movements also slow down. There is often constipation. For this reason, they should eat plenty of fiber, plenty of fluids and foods such as apricots and figs that increase bowel movement and keep fluid inside. At the same time, plenty of seafood and calcium are also important."
Forgetfulness occurs in the following period
Stating that almost as a rule, forgetfulness occurs in 30 percent of people in the later years of Parkinson's disease, after 10-15 years, Prof. Dr. Sultan Tarlacı said, "This is a common condition that complicates the treatment process of Parkinson's disease."
Parkinson's is a manageable disease
Underlining that Parkinson's is a disease that can be managed rather than treated, Prof. Dr. Sultan Tarlacı said, "Brain pacemaker or drug therapy is used in appropriate patients. But Parkinson's is actually managed, not treated. Medications have certain effects and side effects according to patient conditions. The effects are sometimes 4-6 hours. The patient or his/her relatives should monitor themselves and record the times of ineffectiveness. Regular exercise should include cycling or swimming. If the bicycle cannot be used with wheels, it may be difficult, half an hour and 45 minutes of pedaling should be done with a bicycle without wheels. Sleep should be regular and of good quality. Poor sleep significantly increases the patient's complaints the next day."
Brain pacemaker is also used in treatment
Noting that medication is always indispensable in the treatment of Parkinson's, Prof. Dr. Sultan Tarlacı said, "Appropriate medication in the appropriate period, appropriate medication and appropriate adequate dose of medication. The other treatment is brain pacing. Sometimes medication may be preferred according to patient choice. It is a very effective method, but we need to have rules about which patients it will be implanted in, as well as knowing which patients it will not be implanted in. It is not a completely harmless method."
Every treatment in Parkinson's is personalized
Noting that the medication and brain pacemaker methods applied in the world are applied in the same way in our country, Prof. Dr. Sultan Tarlacı said, "Every treatment is personalized. Parkinson's is no exception. Each person reacts very differently to the drug in terms of effect, side effects and unexpected side effects. Some patients are ready to hallucinate with low doses of Parkinson's medication, while others do not with high doses. Or the most common side effects of the drugs are nausea and vomiting. In some patients it does not occur at all. Personal differences exist both in the effect and in the side effect. This is why Parkinson's disease is not treated, but actually managed. Sometimes it can also be confused with similar diseases that are confused with classical Parkinson's but whose process is more difficult. It is necessary to make a good distinction," he said.
