With the passing of boxing great Muhammad Ali, Parkinson’s disease has made a return to the national spotlight. The “Louisville Lip” lived with Parkinson’s disease for 32 years, having been diagnosed at the relatively early age of 42. Most diagnoses come after age 60, but about 4% of diagnoses come before age 50. How was Ali diagnosed so early, and what signs should you watch out for in yourself or someone you love?
Some Parkinson’s diseases symptoms are well known, like the tremors from which Ali suffered. But Parkinson’s is often difficult to diagnose when it’s in its early stages, and no blood or imaging test can confirm if someone has the disease.
So how is Parkinson’s diagnosed? A doctor will check your medical history and look for signs. In addition to slow movement -- aka bradykinesia – either stiffness or tremors must also be present. The doctor may also use a SPECT test that tracks the chemical dopamine in the brain. But your doctor needs to know to look for Parkinson’s, and that’s where you come in. Tell your doctor if you’ve noticed any of these early warning signs.
Early Warning Signs of Parkinson’s Disease
1. Tremors. If one of your fingers, a foot, or part of the jaw or face shakes while you’re at rest, that could be an early sign of Parkinson’s. Tremors usually start on one side of the body, and eventually progress to the whole body as the disease progresses.
2. Changes in handwriting. How can your handwriting reveal if you have a disease or not? With Parkinson’s, a person's handwriting often becomes smaller as the disease progresses. A small Israeli study from 2013 of 40 people with and without Parkinson’s found that people with Parkinson’s write smaller, with a lighter touch, and took longer to finish a writing task than healthy people. A computer analysis then accurately diagnosed all but one of the study participants.
3. Rigid limbs. Stiffness in the arms or legs is another hallmark sign. Like tremors, rigidity often starts on one side of the body before it progresses to the other. Take note if you notice that you're starting to shuffle, or not swinging one of your arms as you walk.
4. Loss of smell. Maybe you don't notice the fragrance from a bouquet of flowers, or that you kept last week’s leftovers in the fridge a little too long. What gives? Experts aren’t sure why people with Parkinson’s lose their sense of smell, but some think it might be because certain proteins that people with Parkinson's have first develop in the part of the brain that controls smell.
5. Changes in voice. A small 2011 Czech study showed that up to 78% of people with early, undiagnosed Parkinson’s disease have some kind of vocal impairment. It often takes the form of a softer voice, or could be a roughness of tone, monotone or a vocal tremor.
6. Masking. A person with Parkinson's may sometimes appear to have their “game face” on: they may look serious or depressed, or have a blank stare, sometimes even hardly blinking.
If you’ve noticed any of these symptoms in yourself or a loved one, don't be alarmed. Having just one of these symptoms doesn't mean it's Parkinson's. Talk with your doctor if you're concerned or have questions.