Depression can affect health of Parkinson’s patients

Brenda Medina                                                                          May 31,2013

Miami Herald - Mark Worsdale decided it was time to retire from his 30-year career in business when he was diagnosed with early-stage Parkinson’s disease three years ago.

“I wanted to dedicate more time to my well-being,” said Worsdale, 59. “It is important.”

Worsdale joined ParkOptimist, a group of about 100 members who meet a few times a week at St. Matthew Episcopal Church near South Miami for fitness classes like yoga, tai chi, and dance. ParkOptimist, whose umbrella organization is the National Parkinson Foundation’s South Florida chapter, also conducts a support group for Parkinson’s patients and hosts voice and music therapy classes.

Worsdale said the activities, and the friends he’s made, have made living with the disease easier.

“My only regret is not finding the group earlier, when I was diagnosed,” said Worsdale, who dedicates four to five hours a week to go to group activities, and also exercises at home. “I am doing very well, and I think it is the result of how active I keep myself.”

To date, there is no cure for Parkinson’s disease. But research has shown that diet and fitness play a big part in maintaining a healthy lifestyle, particularly curbing depression, a byproduct of the disease.

Parkinson’s disease is a neurological disorder that progresses slowly in most people, usually after age 50, although some patients can be in their 20s and 30s. It occurs when the cells in the brain that produce dopamine — a chemical that helps the brain send signals to control muscle movement — are slowly destroyed.

About one million Americans are diagnosed with the condition; Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s.

The disease causes stiffness, trouble with balance, slowness of movement and tremors, said Dr. Carlos Singer, chief of the Movement Disorders Division at the University of Miami Miller School Of Medicine. Other symptoms are lack of sleep, urinary and gastrointestinal problems and fatigue. People with the disease also can contend with depression and anxiety.

“It can be confusing at the beginning for many patients,” Singer said. “It affects their daily lives.”

A bedside examination by a neurologist remains the first and most important diagnosis tool for patients suspected of having Parkinson’s disease, according to the National Parkinson Foundation.

A neurologist will base the diagnosis on a detailed medical history of the patient, an examination of the patient’s ability to perform a number of tasks, and the patient’s response to medication that helps produce dopamine. Singer said that patients often get diagnosed when they start noticing a tendency to drag a leg and tremor of the arms either while resting or while holding an object.

“It starts taking them longer to shave,” he said. “Or it becomes difficult to get dressed, sit at the table to eat, or take a walk.”

Last fall, the National Parkinson Foundation (NPF) released a study showing that depression is one of the biggest factors influencing the health of Parkinson’s patients. Several places in South Florida offer extensive health and fitness programs for people with Parkinson’s.

In addition to the programs at St. Matthew, which cost $25 per year per membership with the National Parkinson Foundation, St. Catherine’s Rehabilitation Hospital, of Catholic Health Service, offers Parkinson’s focus groups in North Miami and Hialeah Gardens.

The Michael Ann Russell Jewish Community Center in North Miami Beach and the David Posnack JCC Fitness Center in Davie also run extensive programs for people with Parkinson’s.

“I encourage Parkinson’s patients at any stage to participate in these kinds of activities,” Worsdale said. “I am not saying it can cure the disease but you are going to look and feel better.”

For those seeking medical intervention, deep brain stimulation, or DBS, may be an option.

But this surgical technique does not slow or retard the progression of Parkinson’s disease, said Dr. Bruno Gallo, who has been the director of DBS Therapy at UM Health System for a decade.

Deep brain stimulation consists of electric wires implanted in the patient’s brain and connected to a brain pacemaker in the chest. The pacemaker sends electrical impulses to certain parts of the brain to stimulate activity in targeted areas affected by the disease.

“I like to set realistic goals of what the treatment can and cannot accomplish,” said Gallo, who explained that some patients seek the surgical procedure hoping the disease goes away. “It does improve patients’ quality of life significantly, much more than maximal medical management can in patients who qualify for therapy."