Susan J. Penner, RN, MN, MPA, DrPH, CNL

Author, Economics and Financial Management for Nurses and Nurse Leaders, Second Edition, 2013.  Dr. Penner is also a PD caregiver.

This is the first of a three-part series focused on Parkinson’s Disease (PD), a neurological disorder that affects many elderly Americans.  This series will explore the extent and costs of PD, with ideas for nursing roles to address this health concern.  PD occurs when brain cells that make dopamine are destroyed.  People lose muscle control and often develop other symptoms.  The cause of PD is unknown and while symptoms can often be treated, there is no cure.

PD was first described as a neurological disorder in 1817 by Dr. James Parkinson.  PD is chronic and progressive, usually involving motor symptoms such as tremor, rigidity, and impaired balance.  People with PD may also have non-motor symptoms such as sleeping disorders, pain, cognitive impairment, depression and anxiety.  Caregiver services are often required over time, as the disease progresses.

Estimates of the number of Americans living with PD range from 630,000 to 1,000,000, depending on whether estimates of undiagnosed persons are included.  An estimated 60,000 Americans are diagnosed with PD each year.  Both the incidence (new diagnoses of PD) and prevalence (persons living with PD) are found to increase with age, and PD is more common among persons age 65 and over.  However, young onset PD disables thousands of Americans age 30 to 54.  Secondary PD, caused by events such as a stroke or drug reaction, also disables both younger and older adults.

PD is a growing health concern.  In 2010, PD was the tenth leading cause of death for males age 65 and over.  As our population ages, it is likely that a growing number of Americans will be afflicted with PD or secondary PD. Many nurses have family, friends, neighbors and patients living with PD.  Many nurses are providing care to persons with PD, or know people who are PD caregivers.

With the expansion of health insurance and Medicaid coverage from the Affordable Care Act, more people are likely to be diagnosed and treated for PD.  As a result, it is likely that nurses will see even more persons with PD entering the health care system.  As we examine the costs of PD in the next part of this series, nurses can think about opportunities for addressing this growing health care challenge.