The effects of advanced Parkinson's disease include a worsening of symptoms, poor balance and posture, and a decline in cognitive skill and ability. A patient with Parkinson's loses dopamine over time, which affects her ability to move. Though the initial symptoms are subtle and often barely noticeable, symptoms of advanced Parkinson's impact daily life and make it difficult for a patient to do the things she formerly enjoyed.
One of the key effects of advanced Parkinson's is brandykinesia, or a slowing down of movement. People with the disorder begin to have difficulty walking over time and tend to develop a shuffling gait. Some may find it difficult to lift their legs to begin walking and may feel as though their legs have frozen. Balance also typically becomes difficult as Parkinson's progresses and some patients may experience falls.
Advanced Parkinson's also affects a person's ability to speak. A patient's voice may change or become much softer. It may be difficult for others to understand what she is saying, as she may slur her words or speak rapidly. In some cases, the voice may be flat and monotone. As the disease progresses, a patient may also have trouble ingesting food as the ability to chew and swallow becomes more difficult.
Some patients with advanced Parkinson's also experience mental difficulties, including dementia, depression, and difficulty sleeping. Patients often have troubling falling and staying asleep or may suddenly fall asleep while in the midst of activity. Depression may accompany Parkinson's and may actually be an early symptom. Up to 50 percent of patients with Parkinson's are at risk for depression over the course of the disease.
Mild cognitive difficulties or full blown dementia occasionally sets in as the disease worsens. People with the disease may find it difficult to pay attention, to remember certain things or may find it difficult to think and process information. Some patients may benefit from taking medications designed to treat Alzheimer's disease.
The effects of advanced Parkinson's can also be seen in the way the patient responds to medication. Levodopa is a common medication prescribed to Parkinson's patients. It is a chemical naturally produced by the body that is transformed into dopamine in the brain, which can help alleviate symptoms. As Parkinson's advances, the drug becomes less effective and its dosage usually needs to be adjusted so that the patient gets the most benefit. Levodopa can also cause dyskinesia, or large, involuntary muscle movements, and a drop in blood pressure.
Dopamine agonists are another form of medication given to patients with Parkinson's disease. They mimic the way dopamine acts in the brain but are not as effective as levodopa. Dopamine agonists can also have intense side effects including hallucinations and compulsive behavior.