Parkinson's Disease has probably occurred amongst elderly people throughout history. But it is now a more serious burden to society than at any time in the past because the development of modern medicines coupled with the improvement in living standards in the industrialised countries has largely eliminated the traditional major threats to health such as the infectious diseases. The consequent rise in life expectancy has led to marked increases in the prevalence and significance of the chronic, disabling conditions of old age.
Parkinsonism and the personal and social problems it creates, typifies such illness. Although recent advances in treatment, most notably the introduction of L-dopa, have gone some way to relieving the distress it causes it remains an incurable condition, at least in the sense that diseases such as tuberculosis can now be cured by the elimination of the causative agent. As with many other degenerative conditions which affect people mainly in later life medical and social care must aim primarily at the alleviation of the patient's handicaps and, where possible, the prevention of further limitations to the individual's freedom in life.
Considered in isolation none of the major symptoms of Parkinson's Disease are associated exclusively with the condition, a factor which sometimes leads to confusion regarding the definition and identification of the disease amongst the general public. For example, the development of tremor in, say, the hands of elderly people may have many causes other than Parkinsonism. Yet the full clinical picture usually presents an unmistakable pattern. And although in a minority of cases Parkinson-like syndromes may be attributed to various known causes, such as the side effects of certain medicines (fortunately reversible), pathological investigations show that Parkinson's Disease may be considered to be a specific neurologic disorder of as yet unknown aetiology. Such idiopathic Parkinsonism probably affects 60-80,000 people in the United Kingdom, the great majority of them aged over 60 years.
This paper describes the symptoms, occurrence and, as far as they are known, the causes of Parkinson's Disease in order to clarify the extent and nature of the problems the condition generates in our society. It also examines questions relating to the organisation and objectives of the National Health Service and the Local Authority social services.