What seems like aging could be Parkinson’s disease, experts say

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As South Korea rapidly ages, Parkinson’s disease is emerging alongside dementia and stroke as one of the country’s fastest growing neurological conditions. The number of patients has risen by nearly 50 percent over the past decade, and experts warn that the upward trend is likely to accelerate.

Named for British physician James Parkinson, who first identified the disease, Parkinson’s is a degenerative brain disorder characterized by motor symptoms caused by the decline of dopamine-producing nerve cells. While there is no known cure, regular exercise and early intervention can help slow its progression. April 11, Parkinson’s birthday, is designated as World Parkinson’s Day annually.

According to data released by the Health Insurance Review and Assessment Service on Monday, the number of Parkinson’s patients in Korea increased from 84,333 in 2014 to 125,526 in 2023. Of these, 116,723 patients were over the age of 65, meaning 93 percent of patients are elderly.

“The number of cases will continue to rise sharply as Korean society enters a super-aged phase,” said Park Jung-hoon, head of the Neurology Center at Himchan General Hospital in Incheon. Korea reached “super-aged society” status — where 20 percent or more of the population is over 65 — last year, just 24 years after becoming an “aging society.” That’s 11 years faster than Japan, which previously held the record.

Although the exact cause of Parkinson's remains unknown, a combination of genetic and environmental factors is suspected.

Early signs often resemble ordinary aging, including forgetfulness, sleep issues and urinary problems, making early diagnosis difficult. Key symptoms include bradykinesia (slowness of movement), muscle stiffness, tremors that subside during motion, shuffling steps and dragging one leg. Non-motor symptoms such as depression, anxiety, cognitive decline, constipation and orthostatic hypotension may also appear.

“Because these symptoms develop gradually and overlap with common signs of aging, many overlook them,” said Professor Yoo Dal-la of Kyung Hee University Hospital’s Department of Neurology. “If symptoms persist, it’s important to consult a doctor for proper diagnosis.”

Since lost brain cells cannot be restored, treatment focuses on managing symptoms and delaying progression. “The goal is to improve the patient’s quality of life through medication, surgery and physical activity,” said Yoo.

Drug treatments include levodopa, which converts to dopamine in the body, dopamine agonists, dopamine reuptake inhibitors and agents that enhance dopamine release. However, their effectiveness diminishes over time. After five to seven years — the so-called “honeymoon period” — patients may experience shortened relief periods and involuntary movements known as dyskinesia.

At that point, deep brain stimulation may be considered. This treatment involves implanting electrodes into specific brain areas to regulate nerve activity with electrical pulses. The surgery is most effective before stage 3 on the Hoehn and Yahr scale, a five-stage classification of Parkinson’s symptoms. Stage 3 includes symptoms such as impaired balance and difficulty rising from a chair or turning.

Physical therapy is also crucial, as patients may suffer joint stiffness or pain due to muscle loss and contractures. Therapy can ease stiff joints and muscles, improve posture, enhance gait and breathing and prevent rapid decline. Without exercise, even medicated patients may experience faster deterioration due to muscle atrophy.

Daily practices such as stretching, walking, jogging and swimming are recommended. Facial muscle exercises like frowning or puffing the cheeks can help prevent facial paralysis.

Patients experiencing drug resistance or dyskinesia should also be mindful of protein intake. Foods high in protein, like meat and fish, can interfere with medication absorption, so doctors recommend they are eaten separately from medications. However, cutting back on protein entirely could lead to muscle loss.

“Parkinson’s is manageable when treated early,” said Professor Jang Il of the Catholic University of Korea, Incheon St. Mary’s Hospital.

Park also emphasized preventive care. “People with metabolic syndromes are more than twice as likely to develop Parkinson’s, so managing conditions like diabetes and hypertension is essential,” he said.

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.