Supporting patients with Parkinson’s disease, with Dr Alistair Church

So today we're gonna be focusing on Parkinson's disease, which is obviously just part of your remit.

What is the prevalence and the impact of Parkinson's disease in the UK?

It is pretty prevalent.

It's the second most common neurodegenerative condition.

Number one is Alzheimer's.

And like Alzheimer's, it- it's age dependent, it's neurodegenerative, so the older you get, the more likely you are to develop that as a diagnosis.

But actually, it's still not uncommon in young people, and I think that's probably under-recognized.

Some 10% of our patients will develop Parkinson's before the age of 45, and I think they're often the ones that take a little bit of time to diagnose because people don't really think of it as a possibility, and therefore they often come to us via physiotherapists, orthopedics, with stiff, slow hands, problems with their shoulders.

And a lot of those younger patients don't have tremor.

We're always taught one of the cardinal features of Parkinson's is tremor, and therefore, if you just see somebody with slowness and stiffness without tremor, it may not occur to them.

But actually, we know at least about a third of our patients don't have tremor, and particularly the younger ones, so it-- they can be difficult to diagnose.

It is becoming more common, and that's partly because we're aging.

There is also a thought that if you look back at the Spanish flu in 1918, there was a big upswell of Parkinson's on the back of that, and there's certainly some thoughts that maybe we're in for a bit of a wave coming through a few years after COVID, so maybe in the next five years or so.

And as you said, a, a lot of people are under-diagnosed.

Neurology coverage is pretty sparse, and it can be quite some time for patients to get to see a neurologist, if at all.

And therefore, I think that's one of the reasons why there are so many undiagnosed patients out there.

Gosh, I hadn't heard that about the Spanish flu and the wave of Parkinson's afterwards.

It's a theory.

We'll see.

Yes.

Well, I hope it doesn't come to that, but that's really interesting.

And in terms of the impact of Parkinson's disease, it sounds like it's a really debilitating condition.

Of course, primarily it impacts on, on the patient and the family.

I think we're always at pains to, or at least I am, to think this is not a condition of one person.

It's very much a family condition, and the family have to sort of go through it and, and support the patient with Parkinson's.