When anyone talks about any chronic disease like Parkinson’s, perhaps the most important question that comes to mind is how does it affect life expectancy? However, living for a long time is not the only important thing.
Another critical question is, what are the problems that affect the quality of life in Parkinson’s patients, apart from movement disorders? Understanding both of these things may help those who have been diagnosed with Parkinson’s. It helps them understand what lies for them in the future, and assists in planning for the imminent.
There is no doubt that those living with Parkinson’s have a much lower quality of life due to movement disorders, emotional distress, and cognitive decline. The latest research also indicates that Parkinson’s negatively affects the life expectancy. Those diagnosed with Parkinson’s would live a few years less when compared to their healthy peers. Neurodegeneration increases the risk of various ailments.
The pattern of comorbidities differs in a person living with Parkinson’s. In one of the studies done in the Japanese population, it was demonstrated that in Parkinson’s, pneumonia was the leading cause of death. 44.1 percent of deaths were caused due to pneumonia, 11.6 percent due to various cancers, 4.1 percent due to heart disease. Those living with Parkinson’s were found to be at higher risk of cerebral infarction which was responsible for 3.7 percent of deaths, and septicemia killed another 3.3 percent of patients with Parkinson’s1.
Similarly, one of the European studies involving various population groups from the UK and Western Europe found that life expectancy was reduced in Parkinson’s, irrespective of the age of onset. However, the study also demonstrated that age of onset was strongly related to the decreased life expectancy. Early age of onset meant more significant gap as compared to a late onset. Those diagnosed after the age of 65 would have only marginally reduced lifespan2. Usually, it has been found that life expectancy of those diagnosed with Parkinson’s is 5-15 years less than healthy individuals.
One of the longest studies regarding life expectancy has been done in Europe. A 38-year follow-up study done in Austria is one of the biggest of its kind. It is a study that observed 3,489 patients and found a substantially decreased lifespan in those living with Parkinson’s. The study also found the higher prevalence of pneumonia and cerebrovascular events among those with Parkinson’s, as compared to the average population3.
A decreased life expectancy and a higher risk of specific ailments is one thing, those living with Parkinson’s have a much worse quality of life, something that may be of more concern in practical terms. Parkinson’s means slowness of movements, shakiness, difficulties in walking, and changes in gait. As the disease progresses cognitive and behavioral problems start arising, with the advance of age, dementia may become worse. People living with Parkinson’s are also at a much higher risk of depression, they have speech issues, sleep disorders, and are at a higher risk of trauma from falls.
Most widespread problems associated with Parkinson’s apart from movement disorders are4:
- Cognitive decline: Parkinson’s is not just about movement disorders; there is more extensive damage to the brain that results in a progressive reduction in mental abilities, memory, ability to concentrate, carry out mentally demanding jobs. It is estimated that as many as 40-65 percent living with Parkinson’s have cognitive dysfunction.
- Depression: the prevalence of mood disorders increases with age even in those not living with Parkinson’s. However, in Parkinson’s disease, depression is much higher. It is estimated that 40-60 percent of the patients of Parkinson’s also have depression. There are perhaps two explanations for the higher prevalence depression in Parkinson’s. The first reason is similar to other chronic ailments, that is disease burden. Because of disability and constant physical suffering, many of those living with Parkinson’s develop depression. However, disease-burden alone fails to explain the higher prevalence of depression when compared to similarly debilitating conditions. Therefore, researchers think that the second cause of depression is degeneration of dopamine-producing neurons. Dopamine has been proven to be associated with mood and is an essential neurotransmitter in the limbic system.
- Anxiety: is different from depression. Depression is about low mood and being disheartened or even having thoughts of suicide. Anxiety, on the other hand, is about worry regarding the future. It is estimated that 20-46 percent of those with Parkinson’s have anxiety disorder. Though anxiety has been less studied in comparison to depression, still, it is known to have a negative impact on the quality of life and disease management.
- Fatigue: is present in almost every case of Parkinson’s. It is a feeling of a lack of energy and weakness. However, it is unrelated to depression or muscular weakness. Fatigue is often poorly understood in Parkinson’s. It is vital to realize that fatigue in Parkinson’s is a direct result of neurodegeneration and is a separate problem with movement disorders. At least half of the patients suffer from severe fatigue in Parkinson’s. Fatigue is also made worse by the drugs used to treat Parkinson’s including L-DOPA.
- Sleep disorder: sleep is perhaps affected in almost all the cases of Parkinson’s. Despite such a high prevalence, it is also the least talked about symptoms of Parkinson’s. Quite often, patients or physicians would not even pay any attention to sleep-related issues. However, it is vital to understand the changes in dopaminergic pathways that are behind the movement disorders that are also responsible for the sleep-related disorders. Diagnosis of a sleep disorder is quite complicated in Parkinson’s. Tests like polysomnography work well for obstructive sleep apnea, but they have little use in those with a sleep disorder due to Parkinson’s. At present, the physician can diagnose the sleep disorder based on the clinical experience.
This article only touched some of the significant disorders related to Parkinson’s. However, it must be understood that in Parkinson’s, just every aspect of life is affected. It is vital to understand for the patients and caretakers that Parkinson’s is not an isolated movement disorder, it is a somewhat more generalized neurodegenerative disorder.
Another thing to understand is how Parkinson’s affects the lifespan. Those who are diagnosed at a young age with Parkinson’s have a much shorter lifespan when compared to healthy individuals. Fortunately, the majority of cases of Parkinson’s are diagnosed at an advanced age, and thus in most cases, life expectancy is just a little short when compared to healthy individuals, it is especially true for a person getting adequate medical care and attention by the family members.
1. Iwasaki S, Narabayashi Y, Hamaguchi K, Iwasaki A, Takakusagi M. Cause of death among patients with Parkinson’s disease: a rare mortality due to cerebral haemorrhage. J Neurol. 1990;237(2):77-79.
2. Ishihara LS, Cheesbrough A, Brayne C, Schrag A. Estimated life expectancy of Parkinson’s patients compared with the UK population. J Neurol Neurosurg Psychiatry. 2007;78(12):1304-1309. doi:10.1136/jnnp.2006.100107
3. Pinter B, Diem-Zangerl A, Wenning GK, et al. Mortality in Parkinson’s disease: a 38-year follow-up study. Mov Disord Off J Mov Disord Soc. 2015;30(2):266-269. doi:10.1002/mds.26060
4. Opara J, Brola W, Leonardi M, Błaszczyk B. Quality of life in Parkinson`s Disease. J Med Life. 2012;5(4):375-381.