Ending Parkinson's Disease

1. Parkinson's disease is rapidly becoming a global pandemic

From 1990 to 2015, the number of people with Parkinson's more than doubled from 2.6 million to 6.3 million.

Staggering growth. Parkinson's disease is the fastest-growing neurological disorder in the world. By 2040, it is projected to affect at least 12.9 million people globally. This rise cannot be explained by increased awareness or aging populations alone. The disease is characterized by tremors, slow movements, stiffness, and balance difficulties, along with non-motor symptoms like loss of smell and depression.

Widespread impact. Parkinson's affects people from all walks of life, including prominent figures like Muhammad Ali, Michael J. Fox, and Alan Alda. It typically develops in people over 50, but up to 10% of cases occur in those under 40. The disease significantly impacts quality of life and places a heavy burden on caregivers and healthcare systems.

2. Environmental toxins are major contributors to Parkinson's rise

Humans have helped create this pestilence. And we can now work to end it.

Industrial culprits. The surge in Parkinson's cases closely tracks the growth of industrialization. Pesticides, solvents, and air pollution have all been linked to increased risk of the disease. Specific chemicals like paraquat, rotenone, and trichloroethylene (TCE) have been shown to cause Parkinson's-like symptoms in laboratory animals and are associated with higher rates of the disease in humans.

Widespread exposure. These harmful substances are not limited to occupational settings:

• Pesticides contaminate food and water supplies
• TCE is found in many household products and pollutes groundwater
• Air pollution affects urban populations globally

Countries undergoing rapid industrialization, like China, are experiencing the fastest increases in Parkinson's rates.

3. Head trauma and lack of exercise increase Parkinson's risk

Exercise that was moderate to vigorous and done consistently (e.g., 7 to 8 hours of walking or 3.5 to 4 hours of lap swimming each week) pushed that number even higher—to a 29% decreased risk of developing the disease.

Brain injuries. Traumatic brain injuries, even a single incident resulting in loss of consciousness, can triple the risk of developing Parkinson's. This risk is particularly concerning for:

• Athletes in contact sports like football
• Military veterans exposed to explosions

Power of prevention. Regular exercise, especially vigorous activities, can significantly reduce the risk of Parkinson's:

• 4 hours of vigorous exercise weekly can lower risk by 20% or more
• Consistent, moderate exercise also provides substantial benefits

Other protective factors include following a Mediterranean diet and moderate caffeine consumption.

4. Most Parkinson's cases go undiagnosed or receive inadequate care

None of the individuals researchers identified in rural Bolivia as having Parkinson's had ever been diagnosed.

Diagnostic challenges. Despite its visible symptoms, Parkinson's often goes unrecognized:

• In rural areas of developing countries, up to 100% of cases are undiagnosed
• Even in developed nations, 40-50% of cases may be missed

Care disparities. Those who are diagnosed often receive suboptimal treatment:

• Only 58% of Medicare beneficiaries with Parkinson's see a neurologist within 4 years
• African Americans, women, and the elderly are less likely to receive specialist care
• Up to 40% of people with Parkinson's end up in nursing homes, where care is often inadequate

Telemedicine and innovative care models like ParkinsonNet in the Netherlands show promise in improving access to specialized care.

5. Activism and advocacy have driven progress in other diseases

If we succeed, future generations will not have to confront the hardship and disability that Parkinson's brings. If we fail, a needless pandemic will be our legacy.

Historical successes. Diseases like polio, HIV/AIDS, and breast cancer have seen remarkable progress due to sustained activism:

• The March of Dimes campaign funded polio research and care
• AIDS activists pressured for faster drug approvals and increased research funding
• Breast cancer awareness campaigns destigmatized the disease and raised billions for research

Lessons for Parkinson's. The Parkinson's community can learn from these movements:

• Raise public awareness and challenge stigma
• Advocate for increased research funding
• Push for policy changes to ban harmful chemicals
• Empower patients to participate in clinical trials and research

6. New treatments and technologies offer hope for Parkinson's patients

Little is new under the sun for treating Parkinson's disease.

Treatment landscape. While levodopa remains the gold standard treatment after 50 years, new approaches are emerging:

• Deep brain stimulation surgery can dramatically improve symptoms for some patients
• Gene-targeted therapies for specific mutations (e.g., LRRK2, GBA) are in development
• Immunotherapies and vaccines targeting alpha-synuclein protein are being tested

Technological advances. Innovations in diagnosis and monitoring are improving care:

• Smartphone apps can measure symptoms and track disease progression
• Wearable sensors allow for continuous monitoring and personalized treatment adjustments
• Telemedicine expands access to specialist care, especially in rural areas

7. Prevention is key: Banning harmful chemicals can reduce Parkinson's risk

Paraquat has been banned in thirty-two countries, including China, due to health concerns.

Regulatory action needed. Banning specific chemicals linked to Parkinson's could significantly reduce disease risk:

• Paraquat, a pesticide that doubles Parkinson's risk, is still used in the US despite being banned in 32 countries
• Trichloroethylene (TCE), a common solvent linked to Parkinson's, contaminates up to 30% of US drinking water

Success stories. Countries that have taken action have seen results:

• The Netherlands, which banned paraquat and other harmful pesticides early, has seen decreasing rates of Parkinson's
• Removing lead from gasoline led to dramatic reductions in lead exposure and associated health problems globally

8. A multi-faceted approach is needed to end the Parkinson's pandemic

We have to take action against Parkinson's now—through prevention, advocacy, care, and treatment.

Comprehensive strategy. Ending the Parkinson's pandemic requires action on multiple fronts:

1. Prevention:

   • Ban harmful pesticides and industrial chemicals
   • Promote exercise and healthy lifestyles
   • Reduce exposure to air pollution and other environmental toxins

2. Improved care:

   • Increase access to neurologists and specialized care
   • Implement telemedicine and innovative care models
   • Train more Parkinson's specialists

3. Research and treatment:

   • Boost funding for Parkinson's research
   • Accelerate development of new therapies
   • Improve early diagnosis and monitoring technologies

4. Advocacy and awareness:

   • Raise public awareness about Parkinson's and its risk factors
   • Advocate for policy changes and increased research funding
   • Empower patients and caregivers to become activists

By addressing these areas simultaneously, we can work towards preventing new cases of Parkinson's, improving the lives of those affected, and ultimately ending this growing pandemic.

Last updated: November 19, 2024