maliparkinsons2The shuffle, the slurring, the slow, robotic movements. These were the early signs of Parkinson's disease in the greatest, Muhammad Ali.

 Earlier this week, the legendary Ali passed away. Here in Louisville, where he was born and raised and where Kindred is headquartered, we feel that loss to our community deeply. Because many of our patients and families are impacted by Parkinson's disease, we are taking a moment to define how this condition affects those it touches.

According to the Parkinson's Disease Foundation, as many as one million Americans live with this disease. You may have a loved one, neighbor or friend who was recently diagnosed. Doctors are still researching to better understand it, but here's what we do know about the experience our loved ones face with this condition.

Parkinson's can be difficult to understand because doctors have not yet found a fool-proof test to diagnose patients. Instead, doctors rely heavily on the patients to self-report their medical history to try to determine if an individual is affected by Parkinson's. For Ali, many often blame his history in the ring as a possible cause. While there are correlations between head trauma and the development of Parkinson's, there are also many other possible causes and unknowns in genetic linkage.

maliparkinsons3The doctor can perform a physical examination to test for particular symptoms, such as tremors, stiffness, facial responsiveness and balancing ability. Many people are referred to a neurologist by their primary care physician if their doctor finds their medical history and physical examination show the possibility of Parkinson's disease.

Another reason Parkinson's is difficult to understand is it progresses differently for each individual. Two individuals with the same disease can have totally different challenges to face in their daily lives. Symptoms affecting the body's movement can include:

  • Resting tremor: a shaking movement occurring in a muscle when it is relaxed
  • Bradykinesia, or 'slow movement': a general reduction of movement, resulting in less facial expressiveness and abnormal body stillness
  • Rigidity: a stiffness of the arms, legs, body and neck
  • Postural instability: a tendency to lose balance and stability when standing

Other symptoms that usually appear after changes in movement include:

  • Loss of sense of smell
  • Sleep disorders
  • Constipation, bladder problems
  • Unexplained weight differentiation
  • Fatigue or loss of energy
  • Fear or anxiety
  • Depression

maliparkinsons4Patients may experience some or all of these symptoms, but at different rates. Some of the more commonly known 'symptoms' of Parkinson's are actually caused by the prescription of synthetic dopamine to Parkinson's patients. When Ali lit and carried the Olympic Torch in 1996, his hands quaked. This 'symptom' is a result of the dopamine treatment causing involuntary tics and jerks from over-activity, as opposed to the underactivity in neural communication that is caused by the disease.

There are three stages of the disease, each with more challenges than the prior one. For the most part, the first two stages, known as mild and moderate Parkinson's, are generally more easily managed by the individual. Treatments are still effective in both of these stages, though medications have a tendency to wear off between doses for those with moderate Parkinson's. 

The final stage, known as advanced Parkinson's, is the most debilitating. Patients with advanced Parkinson's are no longer able to live independently because they experience great difficulty with common daily activities such as walking, standing, preparing meals and taking care of their personal hygiene.

maliparkinsons5Because the disease is slowly progressive, it may take years before someone with Parkinson's advances to the next stage, if he or she advances at all. At each level, it is possible to ease symptoms with medications and therapy, but there is no cure for the disease.

Parkinson's is not considered a fatal disease, but learning proper coping methods helps to maintain a good quality of life. Most importantly, remember you are not alone. Muhammad Ali is one of the million Americans who fought Parkinson's, and he did so publically.

It is much easier to cope with Parkinson's if you educate yourself and listen to real people, like Ali's, stories about how they dealt with the disease. We take this opportunity, in the wake of his passing, to honor and remember Muhammad Ali in his historic battles both in and out of the ring.

Visit  for more information on taking charge of your life with Parkinson's.

By Claudia Lab