Parkinson’s disease: Physical Impairments and Work Retention

Parkinson’s Disease and Work Retention
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Parkinson’s disease
Parkinson’s disease (sometimes called Parkinson disease) is a general, progressive neurological disorder that affects almost 1% of the population (Forwell, Hugos, Copperman, & Ghahari, 2014). It affects men approximately 5 times more often than women, and the incidence increases steeply with age, although 10% of those with the disease are under 45 years old (Lees, Hardy, & Revesz, 2009). Never smokers are twice as likely to exhibit Parkinson's disease as smokers; and men and postmenopausal women who are not taking hormone replacement, who take no or very low quantities of daily caffeine, seem to be at increased (about 25% more) risk. These findings are controversial, however, with some studies refuting or contradicting them. The findings might be related to dopamine's role in reward pathways and premorbid novelty-seeking personality traits, rather than to any neuroprotective effect of tobacco smoke, nicotine, or caffeine (Lees et al., 2009). Unstable associations between Parkinson’s disease and head injury, rural living, middle-age obesity, lack of exercise, well-water ingestion, and herbicide and insecticide exposure have also been reported. Environmental toxins can produce a uniform, but not identical, clinical picture (Lees et al., 2009). When it comes to the number of people with chronic progressive neurodegenerative diseases, Parkinson’s is inferior only to Alzheimer’s (Christensen & Steen, 2012).
Young-onset Parkinson's disease, attack between ages 21 and 40, represents between 3 and 6% of all people with Parkinson's (Klepac et al., 2013). These individuals with young-onset are more likely to have a positive family biography for the condition and are more likely to have one of the several genes that have been associated with the disease (Sawle, 2004). Genetic studies have shown that several mutations in seven genes are linked with L-dopa-responsive parkinsonism, and hereditary risk for some of these mutations is more common among North African Arabs, Ashkenazi Jews, and Portuguese people (Lees et al., 2009).
Fatigue is a popular symptom in all chronic diseases, and it is especially prevalent in neurological disorders. Fatigue alters 33 - 70% of people with Parkinson's disease. One-third of those with Parkinson's rate fatigue as their single worst symptom and 58% rank it among their three most disabling symptoms, including motor dysfunction. People with Parkinson's disease describe their fatigue as "distinct" from the fatigue they encountered before developing the condition, using words like feeling "drained" or "exhausted", and it is reported to be more destructive to the quality of life than motor dysfunction. Fatigue usually develops shortly and, once developed, usually remains, although worsening over time. Fatigue does not, in broad, correlate with motor accuracy but is more common in those who are depressed. The exact mechanism of fatigue in Parkinson's is not clarified, and there has been a slight study on the adequate treatment of this debilitating symptom (Friedman, Abrantes, & Sweet, 2011).
Symptoms/Potential Activity Limitations