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Running Head: AGING & PD

Advancing Age as it Relates to Parkinson’s Disease

Erin A. Avery

School of Nursing, James Madison University

NSG 325: Concepts of Aging

Professor J. Garman

November 11, 2022

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Abstract

Increasing age is the number one risk factor for developing Parkinson’s disease. This disease is

characterized by impaired smooth muscle movement as it relates to a loss of dopamine in the

brain. Another finding in this diagnosis includes the presence of misfolded and clumped together

a-synuclein proteins, also known as Lewy bodies, in the brain. The normal age-related changes

to the dopamine system make an older adult more prone to Parkinson’s disease. These changes

aggravate the substantia nigra, weakening neurons and their ability to react to insults. Treatment

for this disease includes pharmacological and surgical options with a multidisciplinary approach.

More research needs to be done with this diagnosis to find environmental factors related to the

etiology as well as innovative treatment regimens.

Keywords: Age, Parkinson’s disease, dopamine, substantia nigra

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Advancing Age as it Relates to Parkinson’s Disease

Advancing age brings about normal and anticipatory changes in multiple body systems.

How does aging increase one’s risk for developing Parkinson’s disease (PD)? Providing a brief

overview of a typical aging neurological system, this paper will offer a look at how increasing

age and PD are related, as well as list current treatment regimens and best practices for the

management of PD.

The Impact of Age on the Neurological System

As the body ages, numerous expected consequences take effect on the neurological

system. The brain’s weight decreases as nerve cells become fewer and lose mass, while the

demyelination of some cells leaves fewer dendrites. The end result of these events leads to

reduced nerve conduction, making both reaction and response times slower, and reflexes weaker.

Another important factor that occurs in the neurological system as the body ages is a 20%

decrease in cerebral blood flow as fatty deposits collect in the vessels, increasing the risk for

stroke (Eliopoulos, 2018).

Parkinson’s Disease

As the second most commonly diagnosed neurodegenerative disorder, PD is defined as a

multisystem condition including both motor and non-motor symptoms that is very complex in

nature (Mouchaileh & Hughes, 2020). PD is associated with impaired smooth muscle movement

resulting from a decrease in dopamine and neurons of the substantia nigra (Pang et at., 2019).

Most people affected by this disease experience symptoms such as a tremor, muscle rigidity,

slowed or complete loss of automatic movements, and/or changes in their writing and speech.

Another hallmark clinical finding in a PD diagnosis is the presence of misfolded and clumped

together a-synuclein proteins, also known as Lewy bodies, in the brain (Mouchaileh & Hughes,
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2020). With the projection of doubling the amount of people diagnosed with this condition by the

year 2040, Dorsey et al.’s (2018) research concluded PD to be the world’s fastest developing

neurological disorder. This expectation is largely due to the increasing average age and longevity

of the population.

Aging as it Correlates to Parkinson’s Disease

The number one risk factor for developing PD is inescapable, that being advancing age.

The normal age-related changes to the dopamine system make older adults more prone to PD.

These aging effects cause aggravation in the substantia nigra, weakening the neurons and their

ability to react to additional insults. Those older adults who have increasing substantia nigra cell

loss are especially at risk, as substantia nigra cell loss is consistent with normal aging (Collier et

al., 2017).

Treatment Modalities and Best Practices

Main treatment options for PD include pharmacological and surgical routes.

Pharmacological options include dopamine agonists, levodopa-dopa decarboxylase inhibitors,

and monoamine oxidase-B (MAO-B) inhibitors. Other medications that may be prescribed are

anticholinergics, N-methyl-D-aspartate antagonists, and catechol-o-methyl transferase (COMT)

inhibitors (Mouchaileh & Hughes, 2020). As stated by Jankovic & Tan (2020), deep brain

stimulation and focused ultrasounds are possible surgical treatments for PD, along with cell

replacement therapies. Optimal management includes a multidisciplinary approach for both

motor and non-motor symptom relief. Other disciplines that would be beneficial in the care of

PD include physiotherapy, speech therapy, and occupational therapy. New treatment approaches

that are being explored include vaccine and cannabis-based therapies (Mouchaileh & Hughes,

2020).
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Conclusion

Normal and inevitable age-related changes increase the risk of developing PD. While age

is the number one risk factor, it is imperative that more be done in terms of discovering other

etiologies and treatment options. Though there is a general awareness of environmental factors

that are related with this diagnosis, there are no definitive answers (Pang et at., 2019). In terms of

treatment, the preferred drug for PD, Levodopa, is over 50 years old and there have been no new

developments of highly effective therapies (Dorsey et al., 2018). Conducting more research is

necessary in order to slow the increasing prevalence of this disease.

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References

Collier, T., Kanaan, N., Kordower, J. (2017). Aging and Parkinson’s disease: Different sides of

the same coin? Movement Disorders, 32(7), 983-990. https://doi.org/10.1002/mds.27037

Dorsey, E., Sherer, T., Okun, M., Bloem, B. (2018). The emerging evidence of the Parkinson

pandemic. Journal of Parkinson’s Disease, 8(1), S3-S8. DOI: 10.3233/JPD-181474

Eliopoulos, C. (2018). Gerontological nursing (9th ed.). Wolters Kluwer.

Jankovic, J. & Tan, E. (2020). Parkinson’s disease: Etiopathogenesis and treatment. J Neurol

Neurosurg Psychiatry, 91, 795-808. DOI: 10.1136/jnnp-2019-322338

Mouchaileh, N., & Hughes, A. (2020). Pharmacological management of Parkinson’s disease in

older people. Journal of Pharmacy Practice & Research, 50(5), 445-454.

https://doi.org/10.1002/jppr.1683

Pang, S., Ho, P., Liu, H., Leung, C., Li, L., Chang, E., Ramsden, D., Ho, S. (2019). The interplay

of aging, genetics and environmental factors in the pathogenesis of Parkinson’s disease.

Transl Neurodegener, 8(23). DOI: 10.1186/s40035-019-0165-9.