Weight Loss Linked to Worse Outcomes in Parkinson’s Patients, Study Shows

By Patricia Inacio, PhD

Weight loss in Parkinson’s disease patients increases the risks for dementia and dependency care, and reduces patients’ life expectancy, according to a new study.

These findings suggest that monitoring weight and timely dietary interventions to counteract weight loss may significantly improve the outcome of Parkinson’s disease patients.

The study, “Early weight loss in parkinsonism predicts poor outcomes: Evidence from an incident cohort study,” was published in the journal Neurology.

Researchers at the University of Aberdeen in Scotland followed 515 participants – 187 with Parkinson’s disease, 88 with the so-called atypical parkinsonism, and 240 controls – for a median of five years. During this period they registered patients’ weight and evaluated how weight variations influenced disease outcomes.

Individuals with atypical parkinsonism are characterized by some of the signs and symptoms of Parkinson’s disease – such as tremor, slowness, and walking problems – without having a Parkinson’s disease diagnosis.

“Weight loss is a common problem in Parkinson’s but it wasn’t clear before we did this how common it was, mainly because of biases in previous studies, or what the consequences were of weight loss. Our hypothesis was that people who are losing weight were going to have adverse outcomes,” Dr. Angus Macleod, the study’s lead author, said in a press release.

The results showed that patients with Parkinson’s disease and parkinsonism have, from early on, lower body weights compared to those without the disease, or controls. Further analysis also showed that weight loss occurring within one year of diagnosis was associated with a higher risk of dependency (patients are no longer able to perform daily activities), dementia, and death.

“Our finding that those who lose weight have poorer outcomes is important because reversing weight loss may therefore improve outcomes,” Macleod said. “Therefore, it is vital that further research investigate whether e.g. high calorie diets will improve outcomes in people with Parkinson’s who lose weight.”

“While other studies have demonstrated that weight loss is common in Parkinson’s, this is the first to consider the impact this symptom may have,” said Prof. David Dexter, deputy director of research at Parkinson’s UK, a charity that contributed funding for the research.

“It has yet to be determined whether this quicker progression can be corrected by supplementation with a high calorie diet, however this could be a key potential development,” Dexter added.

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Source:: Parkinson’s Today

Caregiver Insights from the Parkinson’s Foundation

While your loved one’s Parkinson’s diagnosis probably changed your life overnight, caregiver is a role and an identity that you grow into, and it does not have to erase or replace any existing ways you self-identify. In this session from our 2016 Caregiver Summit, Susan Hedlund, MSW, LCSW, shared how you can continue to experience the love, friendship, contribution to society, ideas, and sense of wholeness that you need to grow as your own person, while you and your loved one face Parkinson’s together.

Whether you care for someone who is recently diagnosed with Parkinson’s disease (PD), are adapting to new challenges as the disease progresses or have been living with PD for a long time, a strong support network is essential for your wellbeing and the wellbeing of the person with Parkinson’s. Making sure you are taken care of, too, can help create a productive partnership that minimizes stress and conflict. Benefits include revitalized energy, renewed interest in creative endeavors, new subjects to talk about and the realization that you and your partner are not alone.

Parkinson’s is a progressive disease, meaning that it changes over time. That can make it hard to define your role, as your involvement will change along the way. Responsibilities may include helping a loved one with daily activities, managing medications and making financial decisions.

Whatever your responsibilities, define “caregiving” for yourself. Especially early in the Parkinson’s journey, you might not feel like you are actually “giving” care. Similarly, your loved one might not see himself or herself as someone in need of care. But remember, care is not limited to physical tasks. Care can be emotional and spiritual as well as physical.

Source: Parkinson’s Foundation

9 Ways to Manage Brain Fog

By Wendy Henderson

One of the most frustrating symptoms of living with a chronic illness is brain fog. There are medications to treat many symptoms of chronic diseases, but sadly there isn’t yet a pill that takes away brain fog. However, there are ways to deal with it so patients can minimize its effects and lead a normal life.

We’ve put together a list of 10 ways to help manage brain fog, with help from princessinthetower.org, newlifeoutlook.com, and Web MD.

Write Things Down
Everyone forgets things now and then, but having brain fog often means forgetting important dates and occasions. Keep a to-do list and a calendar in a highly visible location, or use an online diary to keep track of what each day holds. There are many mobile apps that can also help with organization.

Exercise the Body
Exercise offers a chance to turn off from all the usual things that occupy the mind. It can also improve sleep, which can in turn improve cognitive skills.

Exercise the Mind
Take the time to do thought-challenging exercises like crosswords, sudoku and jigsaw puzzles, or learn a new language. In addition, maintaining a hobby will keep the mind focused on something positive.

MORE: 10 benefits of having a service or therapy dog when you have Parkinson’s

Pick the Right Time of Day
Whether a morning lark or night owl, we all have certain times when we feel more alert. Choose a time each day when your concentration is at its highest to tackle difficult and complex tasks.

Eat a Brain-Healthy Diet
Eat lots of good fats known for brain health such as nuts, avocados, coconut oil, and omega-3-rich foods.

Get Plenty of Rest
Quality sleep and restorative naps (when appropriate) can dramatically improve cognitive health. Try to keep to a routine bedtime and waking time, even on the weekend, to promote a good sleep pattern.

MORE: How you can manage fatigue with corrective stretching exercises

Go Easy on Yourself
Don’t overdo it. Ask for help when needed and try to rest as much as possible to conserve energy. Participate in calming activities like taking a stroll through a peaceful spot, reading a book, or listening to music.

Organize Your Home and Workspace
Reorganize your living and working space so that everything you need regularly is easily accessible. This can help conserve energy and provide peace of mind.

Plan Ahead
If brain fog is worse first thing in the morning, laying out clothes the night before will be one less thing to have to stress over in the morning. Sort meds into a daily medication box so you know when you’re up to date and can easily make sure you haven’t forgotten to take them (or don’t take them more than once).

MORE: New Microsoft watch can quiet Parkinson’s tremors

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

The post 9 Ways to Manage Brain Fog appeared first on Parkinson’s News Today.

Source:: Parkinson’s Today

New technique scours the genome for genes that combat disease

Using a modified version of the CRISPR genome editing system, researchers have developed a new way to screen for genes that protect against specific diseases. They used this system to turn on randomly chosen genes in many different cells, allowing them to identify genes that protect cells from a protein associated with Parkinson’s disease.

Source:: Science Daily -CLICK TO READ MORE

It Doesn’t Matter What Exercise as Long as You’re Exercising

By Sherri Woodbridge

Several years ago, when I was diagnosed with young onset PD, it seemed the rage in beneficial exercise for people with Parkinson’s disease was bicycling. A few years later, the craze seemed to turn to dance. Now it seems as though boxing could be the in thing. As the others appear to come and go in cycles, one form of exercise that appears to remain consistent and advantageous is tai chi.

The question is, what exercise is best? I think the simple answer is whatever feels best and whatever you enjoy. None of it is bad for you and the most important thing is just to be doing something.

A real prospect exists that the physical movement involved in riding a bicycle, and in certain other forms of exercise, may alleviate the symptoms of the neurodegenerative condition we know more intimately as Parkinson’s disease.

The observation made by a research scientist from the Cleveland Clinic, in Ohio, that the physical symptoms associated with Parkinson’s appeared to improve in a personal friend who had ridden a tandem cycle. It seemed that there was a connection between forcing patients to move their legs faster than they would have otherwise been able to on their own, and because of this, there was a significant improvement in relieving symptoms.

In fact, further research from the Cleveland Clinic showed that forced exercise appeared to be more effective than drug treatment at improving symptoms in those with PD. They even went so far to suggest that forced exercise can also decrease some of the cognitive problems that can be associated with PD.

Studies have also shown that dance may be an effective alternative to traditional exercise for those with Parkinson’s disease. Staying active is crucial for those of us who have PD and dancing has been shown to lessen tremors and improve flexibility, as well as lifting mood.

“The positive effect that dancing has on us is quite magical,” says Alison Underwood, diagnosed with PD 10 years ago and now in her 60s. I don’t know about you, but I could use a little magic while living with this little monster we call Parkinson’s disease.

Boxing is definitely on the list of exercise popular among PD patients of late. Of course, it may not be the exercise of choice for everyone, but it has definitely become trendy. One such program is called Rock Steady Boxing. It is a non-contact program specifically designed for those with Parkinson’s to help strengthen motor skills, balance, speech, and sensory function.

A side benefit of getting out and getting some exercise is being around other people like us, those who struggle day-to-day with symptoms pertaining to PD. We can encourage each other to keep on keeping on.

 

Source:: Parkinson’s Today

Sniff Test for Parkinson’s Disease

By Michael J. Fox Foundation

Lack of objective tests to diagnose Parkinson’s disease (PD) challenges drug development and patient care. While scientists are looking to pinpoint PD earlier through skin and spinal fluid, there is also promising research on some less invasive methods. In this podcast, host Dave Iverson talks with two researchers on the significance of these non-invasive tests.

“What we’re doing now is to really try and identify whether there’s a particular secretion in the skin of Parkinson’s patients and what it smells like and then how can we detect it,” says Samantha Hutten, PhD, senior associate director at The Michael J. Fox Foundation, which is funding projects to sniff out Parkinson’s disease.

Another MJFF-funded study led by Mark Baron, MD, professor of neurology at Virginia Commonwealth University, breaks down what eye movement means in relation to PD.

“If you look at a target — assuming we aren’t going to have Parkinson’s disease — and we stare at a dot on a screen, our eye is not moving. People with Parkinson’s disease — it’s moving in all directions, so it’s not staying perfectly still,” says Dr. Baron.

Tune into to the live discussion in our next webinar this Thursday, October 19, at 12 p.m., where we discuss how these screening methods and others could lead to earlier PD diagnosis. Register today.

Like what you hear? Subscribe to The Michael J. Fox Foundation Parkinson’s Podcast in iTunes or your podcast mobile app. Please consider leaving us a rating on iTunes and sharing the series with your network.

Learn more about the search for a test for Parkinson’s disease in our guide.

View a text transcript of this podcast.

Source:: MJFF Podcasts

Parkinson’s patients find balance, stamina in ‘Rock Steady’ fitness class

By Kym Klass

Jack Noble has noticed two positive changes in his body since attending the Rock Steady Boxing class at MetroFitness: his breathing, and his stamina.

The 85-year-old was diagnosed with Parkinson’s disease four years ago, and in this new class brought to the east Montgomery fitness center that focuses on strength, balance and agility, Noble appreciates it for its movement and for “really feeling like I’m getting a workout.”

With more than 10 million people worldwide living with Parkinson’s disease — 60,000 Americans are diagnosed every year — exercise has been proven to help alleviate…CLICK TO READ FULL ARTICLE

Source: Montgomery Advertiser

 

Caregivers Are Impacted by Damaging Health Care Reform, Too

Posted by  Blake Niver

Guest blogger Blake Niver, 25, of Wasilla, Alaska, along with his brothers Grant, 28, and Bryce, 22, are caregivers to their mother who lives with Parkinson’s. Blake shares his thoughts on the importance of affordable and accessible health care and how to get involved as an advocate for the Parkinson’s community.

According to a study from the National Alliance for Caregiving and AARP, nearly 25 percent of all caregivers are millennials, ages 18 to 34. That’s not the typical image that comes to mind of a caregiver, but it’s the reality for my brothers and me.

My mother, Roberta, was 42 when she was diagnosed with Parkinson’s disease. I was in the fourth grade and still remember the exact moment she told me as we drove home from school — it’s a conversation I’ll never forget.

It took nearly a decade before my mother’s symptoms progressed to the point that it affects her daily activities. Now at 59 years old, she is not able to take the photos she used to love capturing, but she’s still working and counts herself lucky that her symptoms have progressed so slowly. However, as each year goes by, the financial and emotional toll looms larger and my brothers and I are concerned for what comes next.

My mother moved from our home state of Alaska and now lives in Minnesota with my brother Grant, a move prompted by access to more affordable health care premiums. She has insurance through her employer, but she might not be able to work for much longer. Soon, she will need to purchase private insurance and her pre-existing condition of Parkinson’s could subject her to unsustainably high premiums that my brothers and I will have to help shoulder. Right now, my mother is having issues timing her medications. My fear is that in the near future, she won’t be able to visit with a specialist who can help make adjustments to her daily therapies and subsequently, her quality of life will be severely diminished.

This future could become a reality if we don’t take action today.

Just yesterday, I called Senator Lisa Murkowski’s office to tell her to vote “no” on the latest version of damaging health care reform circulating in the Senate. There are a lot tougher conversations to have than calling your senator and sharing your story. I think about what it must have been like for my mother to tell her three young sons about her diagnosis, and I’m heartened to do all I can to help her and others in the Parkinson’s community.

We talk openly as a family about the future and try to prepare as much as possible for the financial and emotional effects of my mother’s progressing disease. My brothers and I never expected to take care of our mother in our 20s, and we hoped that when our mother needed help, we’d be in a much better financial situation to support her. That’s why I feel compelled to do something now to stop legislation that could negatively affect my mother and my family for years to come.

Together, each of us can share our story of what it’s like to live with Parkinson’s or, in my case, to care for someone living with the disease. Make a phone call, send an email or share a tweet — tell your representatives how this latest health care proposal will negatively impact our families. Let’s open up conversations about the importance of affordable and accessible health care for everyone, especially for the Parkinson’s community.

Source:: Fox Feed Blog

Telemedicine to Treat Parkinson’s?

Posted by  Rachel Dolhun, MD, and Rachel Cohen

Doctors are making house calls again. But this time, it’s virtual visits via telemedicine. And, based on a study published last month in the journal Neurology, which found that telemedicine appointments were as effective as in-person ones, this may be the way of the future for Parkinson’s disease (PD) care.

The randomized controlled trial enrolled 195 people with PD with the help of MJFF and other organizations. Participants received either their usual in-person care with their established provider or their usual care plus up to four telemedicine visits with a neurologist they had not previously seen. The study was designed to evaluate feasibility (whether participants completed at least one virtual visit on time) and effectiveness (volunteers’ reported quality of life).

Ray Dorsey, MD, MBA, a study author from the University of Rochester, said “The results showed that these virtual house calls were feasible for people with Parkinson’s disease. People’s care was as effective as with the in-office visits, and the virtual house calls provided the participants with convenience and comfort.”

Telemedicine could bring Parkinson’s specialists to the patients who need them most. Parkinson’s (and aging in general) can limit mobility and make it more difficult to travel. And, some people simply live too far away from specialists. Virtual visits could make Parkinson’s care more accessible and efficient.

Before logging on to see your doctor becomes the norm, though, there’s more to be done. Researchers will hone technology to ensure the full Parkinson’s picture can be captured from afar, and advocates will work to expand insurers’ recognition of and reimbursement for telemedicine.

Source:: Fox Feed Blog

Ask the MD: Myths about Levodopa

By Rachel Dolhun, MD

Levodopa was approved to treat Parkinson’s disease (PD) nearly 50 years ago and today it remains the “gold standard” of treatment. As levodopa is the most effective medication to ease Parkinson’s symptoms, most people will take it at some point in the course of their disease. Misconceptions surrounding it, though, can contribute to fear of starting it or taking optimal dosages. Here I address common myths about levodopa, but always discuss any apprehensions you may have about medications with your personal physician.

  • Levodopa is the only drug for Parkinson’s.
    This drug is the most commonly prescribed medication for Parkinson’s disease, but dopamine agonists (e.g., Mirapex, or pramipexole) and MAO-B inhibitors (e.g., Azilect, or rasagiline) are some of the other medications available to manage Parkinson’s motor symptoms. These can be used either instead of or together with levodopa. (Read more about Parkinson’s drugs.)
  • Levodopa loses effectiveness over time.
    After taking levodopa for some time, it certainly may feel like the drug is less effective. Often, higher and/or more frequent doses are required to control symptoms. However, this is mostly due to gradual worsening of the underlying disease rather than medication’s effects diminishing. As long as you take it, levodopa will remain beneficial. But, if the natural progression of your disease requires higher levodopa doses, side effects — including dyskinesia (irregular, involuntary, uncontrolled movement) — can occur. This may lead to a dose reduction, which, in turn, may limit some of the drug’s benefit on symptoms, such as tremor. (Note that some individuals may not tolerate a dose reduction, preferring dyskinesia to other symptoms.)
  • Levodopa always causes dyskinesia.
    Although most people with PD eventually develop dyskinesia, not everyone does. Dyskinesia’s uncontrolled movements often occur at the same time that other PD symptoms (e.g., tremor or rigidity) are suppressed. Major risk factors include higher levodopa doses, younger age at diagnosis and longer course of disease. Severity of dyskinesia varies greatly from person to person; it can look like mild leg fidgeting, bobbing of the head or body swaying. An extended-release form of the commonly prescribed drug amantadine was recently approved by the U.S. Food and Drug Administration (FDA), becoming the first drug specifically indicated to treat levodopa-induced dyskinesia. Several medical and surgical options for dyskinesia also are in development. (Find out more about dyskinesia.)
  • Avoiding levodopa is the best way to treat Parkinson’s.
    Because of the above concerns, some people may opt for other medications or even look to surgery (e.g., deep brain stimulation) to sidestep levodopa. Every person’s symptoms and medication response is different, which means not everyone will tolerate levodopa or add it to their regimen. However, it shouldn’t be avoided simply for the sake of avoidance. No drug or surgery has been shown to be superior to levodopa for PD, so avoiding levodopa may result in worse overall treatment of PD symptoms. (Previous clinical trials did show a lower dyskinesia risk in those who initially started dopamine agonists as opposed to levodopa, but those on levodopa reported an overall better quality of life.) Work with your doctor to find the best treatment(s) for you. There is no single regimen that is best for everyone.
  • Taking levodopa always requires adjustment of dietary protein intake.
    Dietary protein does affect the absorption of levodopa. (The two are absorbed at the same location in the small intestine.) For many people, this effect is small and not noticeable. For others, eating high-protein foods (e.g., certain dairy products, chicken and red meats) at the same time as levodopa can result in less medication benefit (e.g., wearing off of medication effect and return of symptoms before the next dose of medication is due). Especially in these situations, many doctors recommend separating levodopa from dietary protein intake, generally 30 minutes before or 60 minutes after a high-protein meal. (Discover more about diet and Parkinson’s.)
  • Levodopa is toxic.
    Long ago, levodopa was proven safe and effective for the treatment of Parkinson’s disease and rapidly gained acceptance around the world. However, driven largely by the frequent occurrence of dyskinesia, some researchers questioned whether the drug could potentially be harmful to dopamine-producing brain cells and thereby speed progression of disease. Many studies have failed to support these claims, and a study in newly treated patients showed that those on higher doses of levodopa had better quality of life and less disability compared to those on lower doses, which argues against toxicity.
  • Levodopa dosing is standardized.
    There are multiple FDA-approved formulations of carbidopa/levodopa (e.g., Sinemet, Sinemet CR, Rytary) and the maximum labeled dose of levodopa is not the same for each one. This can lead to patient confusion and insurance company denial of medication coverage. Sinemet’s label dictates a maximum of eight tablets per day, regardless of whether the levodopa dose is 100 or 250 mg, whereas Rytary, an extended-release formulation, lists a maximum levodopa dose of 2450 mg per day. Some of this has to do with differences in the amount of levodopa that is absorbed, but this can vary widely from person to person. An individual’s optimal levodopa dose must be determined by working closely with their movement disorder specialist. Depending on symptoms, duration of disease and efficiency of absorption, a person may require more than what’s listed on the drug’s label. As with all medications, though, the lowest dose that effectively controls symptoms is always best.

Find more on levodopa, other PD medications and things to consider throughout your journey with PD in our Parkinson’s 360 toolkit.

John Y. Fang, MD, a movement disorder specialist and associate professor of neurology at Vanderbilt University Medical Center reviewed this content.

Source:: Fox Feed Blog

* NOTE: The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson’s disease and any other medical condition be made in consultation with a physician or other qualified medical professional.