Parkinson's Disease in Massachusetts

What is Parkinson's disease?

Parkinson's disease is a slowly progressive neurological disorder affecting 1.6% of the population over the age of sixty. Although the diagnosis is typically made in the fifth and sixth decades of life, approximately seven percent of people diagnosed are younger than 40 years old.

Primary motor symptoms of Parkinson's disease include tremor, rigidity, slowness of movement, and impaired balance. In addition individuals may experience non-motor symptoms including constipation, speech difficulties, fatigue, mood, memory, and sleep disturbances. Parkinson symptoms are highly individualized from person to person. For example, not every one will experience all symptoms.

Although eighty percent of individuals will have idiopathic Parkinson’s disease as described above, twenty percent of individuals will have parkinsonism from other causes. These may include, but or not limited to, essential tremor, medication induced parkinsonism, other neurodegenerative conditions including multisystem atrophy (MSA), progressive supranuclear palsy (PSP), or parkinsonism that results from head trauma or changes in the brain due to small strokes.

What is the cause?

In idiopathic Parkinson's disease, there is a loss of dopamine-producing cells in an area of the brain called the substantia nigra. Although much research is being done, the cause of PD is remains unknown.

How is Parkinson’s diagnosed?

Diagnosis is made by a physician experienced in the management of Parkinson’s disease. This diagnosis is based on the individual’s medical history and physical examination. Neurologists are specially trained to diagnose Parkinson’s. Movement Disorder Specialists are neurologists who have received additional training in Parkinson care. Tests may be ordered to rule out other causes of Parkinsonism. Currently there is no test or biomarker available to make a 100% accurate diagnosis of idiopathic Parkinson’s disease.

How is Parkinson's disease treated?

Each persons experience with Parkinson’s is unique and therefore responds best to an individualized treatment plan. Current therapies aim to decrease the symptoms of Parkinson's disease. Medication, surgical interventions, rehabilitation, and psychosocial support are used. There is an increased understanding of the important role that exercise and other rehabilitative interventions play in improved function and quality of life.

Parkinson’s not only affects the person with PD but also his/her family. Comprehensive, patient-centered, interdisciplinary care considers the important role and needs of a patient, family, and social network.

What research is being done?

The realm of research aimed at treating Parkinson's more effectively and at potential cures for this disease is in an exciting phase. Currently work is in progress to replace and repair cells to be able to produce dopamine. Gene therapy, surgical therapies, and drugs that delay the progression of Parkinson's disease hold great hope for changing the disability of Parkinson's disease.

Significant work is being done to better understand the role that genetics and environment play in PD. In addition, it is important to identify a biomarker to hopefully improve diagnosis early and identify individuals at risk of developing PD.

Advances in scientific understanding of Parkinson's and its progression have led to many new avenues of investigation.

Parkinson’s Disease in Massachusetts

There is currently no method to accurately identify all cases of Parkinson’s in Massachusetts. Estimates of population by county are listed below.

PD Population by County

Massachusetts State Population (2010): 6,547,629 

Middlesex 3102 Hampden 1038
Essex 1652 Barnstable 846
Norfolk 1524 Berkshire 388
Suffolk 1224 Hampshire 323
Bristol 1219 Franklin 167
Worcester 1609 Dukes 44
Plymouth 1061 Nantucket 17
1.6%: Population over age 65

C. Thomas 2011