QI am 75-years-old and experiencing a few of the symptoms mentioned in the article published in Health Capsule on signs of Parkinson’s disease. My sense of balance and my ability to turn and go backwards are the immediate problems. So far, I have no trembling factors. I use a walking stick at times to overcome balancing problems. As I am a diabetic, I need to follow Ayurveda medicine to avoid damage to my kidneys. Please advise me on how I can take preventive measures and other procedures that maybe required. - Jith Wijeyesekera

A. Judging by the problems you have indicated, it does not sound as if you have symptoms of Parkinson’s disease. Parkinson’s disease is a fairly common brain disorder among senior citizens. It is primarily identified with the onset of a few significant symptoms. Parkinson’s disease (PD) causes shaking and stiffness and affects the balance and coordination of a person.   

On average, those with Parkinson’s are diagnosed around age 60, although the risk increases with age. According to the National Institutes of Health, this is because it’s easy to confuse early symptoms of the disease with things that happen normally during the aging process. This means that some may suffer simply from difficulties of old age and not necessarily PD.   

Given your advanced age and your diabetic condition, my judgement is that you are not suffering from PD. Long term treatments for Diabetes can have side-effects which usually include the problems you have mentioned. However it is advisable that you also seek the advice of your doctor if problems persist.   

Out of the problems we face during our advanced years, many illnesses, disabilities and risks associated with chronic disease are avoidable through known prevention measures. These include leading a healthy lifestyle, early detection of diseases, injury prevention, and self-managing certain conditions such as pain and difficulty upon a doctor’s advice.   

The balance in a normal person’s body is dependent on many factors, including multiple systems of the body. These however could change according to some external factors as well, in your case; I suspect this to be the treatment of Diabetes. The body has three primary sensory systems that work together to create postural stability. With normal brain function, the vestibular system of the inner ear coordinates with the visual system and proprioceptors that sense the position and movement of your body in space. These three systems work together while we perform simple tasks, such as standing and walking.   

When self-managing your condition, you must take caution in your movements. When you wake up in the morning, do not attempt to walk a long distance as soon as you get out of bed. You must first stretch your limbs while seated in bed and straighten up. Only after a few minutes following some mild stretches, should you attempt to keep your feet on the floor and walk. Brief bouts of dizziness may be provoked in some people by changing the orientation of the head to gravity. Seek the advice of your doctor for the best type of exercises for you as your body. Conditions may respond to different forms of exercise, while your capabilities must also be taken into consideration. It must be noted that this is however a common side-effect of Diabetes medication.   

You must also avoid bending over for prolonged periods of time as this could also affect your stability. Stressing your neck while raising your head upwards for a long period should also be avoided. You must always maintain a comfortable posture that does not strain your neck when carrying yourself.   

With proper diagnosis, many of the causes that result in imbalance, dizziness or falls can be treated with lifestyle changes. You can also make lifestyle choices that have been shown to improve balance and facilitate good health as we age. But first, it is important to have adequate nutrition which includes a balanced diet of fruits, vegetables, protein and low-sugar foods.   

Regular exercise and staying active also can reduce the risk of you suffering stability and imbalance problems. A progressive exercise programme with a moderate to high level of balance exercises and cardiovascular conditioning performed according to your physician’s advice can be an effective way to manage your difficulties.   

It is advisable to continue the use of your walking stick as this may give you more stability and increase your confidence. This will also prevent you from suffering a fall and suffering fractures to your bones which are in a vulnerable stage given your age.