An insight into Parkinson’s with Dr Vachagan Krishnaswami, Consultant Geriatrician

03rd, Oct 2023

Parkinson’s is a progressive neurological condition and symptoms begin to appear when the brain can’t make enough dopamine to control movement properly. There are over 40 symptoms of Parkinson’s, but the main symptoms include a tremor, slowness of movement and rigidity. Dr Krishnaswami is a Consultant Geriatrician who has a particular interest in Parkinson’s. Read along as he sheds some light on the various challenges, treatments and misconceptions of the disease.

What are some of the unique challenges that geriatric patients with Parkinson's disease face? How can these be addressed?

Geriatric patients with Parkinson’s disease usually present with other coexisting conditions. When treating Parkinson’s disease, Geriatricians will focus on a comprehensive geriatric assessment. In order to provide the best outcome for patients, a geriatric assessment will assess a patients’ functional activities, social, environmental and living arrangements. One typical example is fall prevention intervention methods whereby physiotherapists and occupational therapists are involved at looking at living arrangements and medications which can be provided to patients specifically for fall and fracture risk reduction.

What are some of the most effective treatments or therapies you have found for managing Parkinsonian symptoms in older adults?

In my experience, older people with Parkinson’s disease benefit from a holistic approach for effective therapy.

Aside from medications, patients may benefit from physiotherapy, regular exercise and strength and balance training. Allied therapists may also be able to make modifications to a patient’s living environment which can improve daily activities. It may also be beneficial to improve effective communication, especially telephone conversations, through speech therapy. Resources for other supporting activities are available through Parkinson’s UK.

Are there any lifestyle modifications or home-based strategies that you recommend for older patients with Parkinson's to improve their quality of life?

I encourage my patients to continue with their regular daily activities, like going to do a weekly shop. It is also important to maintain hobbies and physical activities like walking or Pilates. Holidays are also a great way to promote overall wellbeing.

What are some common misconceptions about geriatric care and Parkinsonian disorders that you often encounter, and how can we educate patients and their families about these issues?

One common misconception of a Parkinson’s disease diagnosis would be that patients should show restriction in their daily activities. Instead, I encourage all patients with Parkinson’s disease to maintain functional activities. I also encourage patients to access allied health workers and encourage browsing through the Parkinson’s Disease UK website which provides a wealth of information which can help to manage daily living.