Is Parkinson’s Disease Becoming Pandemic?

Is Parkinson’s Disease Becoming Pandemic?

That’s the question the medical journal The Lancet recently discusses in one of its online “seminars,” which are basically long-form research overviews of a specific medical topic.  The article examines both sides of the question and maintains a tentative stance whether to claim that PD is becoming pandemic.  From the introduction:  “Parkinson’s disease represents a fast-growing neurodegenerative condition; the rising prevalence worldwide resembles the many characteristics typically observed during a pandemic, except for an infection cause.”

Let’s list some of the reasons why PD might soon be classified as pandemic, then look at some of the opposing arguments.  All quotes from the Lancet article are italicized.

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Yes, it’s becoming a pandemic.

• “[A] global survey of neurological diseases revealed that the incidence and prevalence of Parkinson’s disease has increased rapidly throughout the world….The growth can be explained in part by the aging of the population because the incidence of Parkinson’s disease increases with age….However, after correction for age-related factors, Parkinson’s disease is projected to continue to rise in incidence, being driven by more factors than aging….Other factors potentially contributing to this rise include prolonged survival and environmental pollution with toxins, such as pesticides (e.g., paraquat) or chemicals (e.g., trichloroethylene), known to be harmful to Parkinson’s disease-related neurons and brain circuits. The larger the societal growth in gross national income, the faster the rise in the incidence of Parkinson’s disease, perhaps because economic growth is a proxy for industrialization and environmental pollution.”
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• “One persuasive risk factor is exposure to environmental toxins such a pesticides….The introduction of pesticides after World War 2 – which was required to feed a fast-growing population – could partially explain the rise of Parkinson’s disease.”
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• COVID isn’t helping. “People with Parkinson’s disease are not at increased risk of becoming infected but seem more susceptible to particularly the respiratory complications of COVID-19.  These risks are not increased in early Parkinson’s disease, but rise for more severely affected individuals, possibly increasing their mortality risk.  Additionally, many people with the disease have a marked worsening of symptoms because of fewer physical activities and more stress – both acute and chronic stress can worsen parkinsonism.”
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• More on COVID: “Hyposmia [the loss of the ability to smell] is a feature of both COVID-19 and Parkinson’s disease, and SARS-CoV-2 could perhaps trigger a cascade of neurodegeneration following nasal entry into the brain.”

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No, it’s not a pandemic.

• Everybody has their own unique experience as a Parkie. “Various observations suggest that Parkinson’s disease might not exist as a single entity.”  And two people with the same symptoms may experience them differently.  “A prominent resting tremor might be hardly noticeable for a labourer accustomed to carrying heavy objects, but a similar tremor intensity could be debilitating for a calligraphist.”
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• Not everyone responds the same to Parkinson meds. “There are considerable individual variations in response to levodopa, and there is a sizeable subgroup of otherwise typical people with Parkinson’s disease who become progressively resistant to levodopa over time, despite an initially beneficial response.”
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• Apparently, some people start their Parkinson’s journey through problems in the gut, and others directly through the brain. All of these  reasons may eventually prove that there is more than one disease sharing the same name, Parkinson’s.

Here again is the link to the article’s abstract:  click!