Health & Fitness

Poor diagnosis hurts Parkinson’s disease treatment

Parkinson’s disease is one of ailments that are common among older people.

But due to difficulties in diagnosing the condition, affected people usually suffer from it needlessly over a long period of time before they find solutions to the problem.

“For close to three years, I would suffer from stiffness that would make movement close to impossible. The situation kept getting worse but doctors just took it for granted and blamed the pain on normal bone problems associated with old age,” said 60-year-old Joseph Owino in Siaya County.

“It’s when I started having body balance issues that my children got worried and brought me to Nairobi where after running many tests, I was eventually diagnosed with Parkinson’s disease.”

The disease affects nerve cells in the brain and proceeds to cause mobility problems that start mildly but continue to worsen over time.

Its symptoms are usually not apparent until the disease has destroyed more than 70 per cent of brain cells (producing a chemical known as dopamine) that enable the brain to effectively control body movements.

Hellen Mwithiga, chief executive at the Africa Parkinson’s Disease Foundation says Kenya still lags behind in the diagnosis and management of the disease due to low awareness about the condition among lay Kenyans as well as health workers.

The situation is especially dire in rural areas since diagnostic facilities and experts in the conditions (neurologists) are few and mainly based in Nairobi and other major towns.

Unlike most illnesses, the diagnosis of Parkinson’s disease is complicated hence requiring a keen ‘eye’ and someone with experience in identifying the disease whose symptoms often appear similar to other degenerative bone or muscle disorders.

There still no objective test or a single approach (such as a blood test or brain scan) for making a definitive diagnosis of Parkinson’s disease.

As such, health experts usually rely on classical symptoms of the disease in combination with different diagnostic tests used to eliminate other conditions that resemble Parkinson’s.

Frequently, the doctor will also look for responsiveness to Parkinson’s disease medications as further evidence that Parkinson’s is the correct diagnosis.

Due to the complex nature of these diagnostic procedures, catching the disease in its early stages is difficult unless patients can benefit from services of skilled practitioners during their initial hospital visits.

But these diagnosis challenges may soon be no more.

A new study published in the Neurology journal shows that testing blood caffeine levels may provide a simple way to aid the diagnosis of the disease.

The research found that people with Parkinson’s had significantly lower levels of caffeine in their blood compared to those without it even if both groups consumed the same amount of caffeine.

Results of the study’s statistical analysis found that the caffeine test could be used to reliably identify the people suffering from Parkinson’s disease with a score of 0.98 where a score of 1 means that all cases are identified correctly.

“Previous studies have shown a link between caffeine and a lower risk of developing Parkinson’s disease. But we haven’t known much about how caffeine metabolises in people with the disease,” said Dr Shinji Saiki, lead author of the study from the Juntendo University School of Medicine in Tokyo, Japan.

Major sources of caffeine include coffee and tea that are a favourite among many Kenyans.In the study, people with more severe stages of the disease did not have lower levels of caffeine in their blood.

This was an indication that decrease in caffeine quantities occurs during the very early stages of the disease. “If these results can be confirmed, they would point to an easy test for early diagnosis of Parkinson’s, possibly even before symptoms are appearing,” said Dr David Munoz, lecturer at the Canadian University of Toronto who wrote an analysis editorial accompanying the study.

He added: “This is important because Parkinson’s disease is difficult to diagnose, especially at the early stages.”

The study involved 108 people who had Parkinson’s disease for an average of about six years and 31 people of the same age who did not have the illness.

Their blood was tested for caffeine and for 11 by-products the body makes as it metabolises caffeine. They were also tested for mutations in genes that can affect caffeine metabolism.

The three main symptoms of the disease include involuntary shaking (body tremors), slow movement, stiff and inflexible muscles. This causes body balance difficulties that increase the risk of frequent falls.

Aside from losing their sense of smell, people with Parkinson’s disease can also experience depression, memory problems, chronic fatigue and sleeping difficulties. There is no cure for the disease.

Current available treatments help to alleviate symptoms and maintain life quality of affected individuals for as long as possible. Mwithiga says a majority of insurers including NHIF do not cover the disease.

“Some may pay doctors consultation fees. But they never cover the medicine.”

She notes that this neglect has made healthcare and treatment costs unbearable to most patients yet many need to take recommended drugs on a daily basis for life.

Despite the severity of the ailment, there is still no data on the number of Kenyans suffering from. “There’s a lot of stigma surrounding this disease and we have many people thinking it’s witchcraft as the cause and cure of the disease is unknown. So many people just choose to hide their condition.”

Parkinson’s disease affects one in every 500 people worldwide. It is the second most common neurodegenerative disease globally.