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It's a common misconception that Parkinson's disease only affects movement. Many people believe PD only causes motor symptoms like tremors, stiffness and slowness of movement. However, non-movement symptoms of Parkinson's, ones you can't see, are extremely common and can be even more bothersome than movement symptoms. Here are 10 Parkinson's disease symptoms that might surprise you.
1. Loss of smell. Loss of smell, also called hyposmia, is a common early sign of Parkinson's disease, sometimes appearing years or even decades before diagnosis. Our sense of taste is enhanced by our ability to smell, meaning hyposmia can lead to a reduced enjoyment of food and reduced appetite. If you or someone you love has trouble smelling foods like bananas, dill pickles or licorice, ask your doctor about Parkinson's.
2. Dizziness. Vertigo and balance problems are common in Parkinson's, often caused by neurogenic orthostatic hypotension, medications or age-related issues. Managing symptoms can include monitoring blood pressure, staying hydrated, wearing compression garments, eating small meals, exercising gently and changing positions slowly.
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3. Vision changes. Parkinson's can cause double vision, dry eyes, blurry vision, trouble reading and difficulty opening the eyes. Management strategies include regular eye exams, using prism glasses, artificial tears, warm compresses and lifestyle adjustments, like reducing screen time and staying active.
4. Small handwriting. Handwriting can change as you age, especially if you have poor vision or stiff hands or fingers. However, small, cramped handwriting, called micrographia, is characteristic of Parkinson's. It is frequently one of the early symptoms. With this symptom, words can become small and crowded together, and the size of your handwriting might get progressively smaller as you write.
5. Mental health challenges. Mental health challenges in PD, including depression, anxiety and apathy, are part of Parkinson's itself, resulting from Parkinson's-related changes in brain chemistry. Parkinson's disease impacts areas of the brain that produce dopamine, norepinephrine and serotonin, chemicals involved in regulating mood, energy, appetite and sleep.
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6. Excessive drooling, also called sialorrhea, is caused by a reduction in automatic actions, including swallowing, that creates an inability to manage the flow of saliva in and around the mouth. In PD, usually the amount of saliva produced is normal, but swallowing issues, like swallowing less often or not completely, can lead to saliva pooling in the mouth.
7. Fatigue. Fatigue is a feeling of deep tiredness that does not improve with rest. About 50% of people with Parkinson's report that fatigue is a major problem, and one-third say it's their most disabling symptom.
8. Skin changes. Many people with Parkinson's disease develop oily or flaky skin, especially on the face and scalp. Others have trouble with dry skin or excessive sweating. Studies have also shown an increased prevalence of melanoma skin cancer among people with PD.
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9. Incontinence. Bladder problems are common in Parkinson's disease due to changes in brain signaling that affect bladder control. Bowel incontinence can also occur in PD. With careful diagnosis and treatment, many people can manage symptoms effectively with the help of their healthcare team.
10. Sleep challenges. Sleep challenges affect more than 75% of people with Parkinson's, including difficulty falling asleep, restless legs and acting out dreams. Some medications can also cause daytime sleepiness and sleep attacks.
It's important to remember that Parkinson's impacts people in different ways. Not everyone will experience all the symptoms of PD. Even if people do, they won't necessarily experience the symptoms in the same order or at the same intensity. To learn more about the symptoms of Parkinson's disease, visit Parkinson.org/Symptoms.