New Delhi: A neurological tsunami is looming over India as projections reveal a staggering 168% surge in Parkinson’s disease (PD) cases by 2050. This sharp rise will see India shoulder 10% of the global Parkinson’s burden, with an estimated 2.8 million cases, up dramatically from 2021 levels. Globally, Parkinson’s is set to affect 25.2 million people—an increase of 112% from 2021.Parkinson’s disease is a progressive disorder of the nervous system that primarily affects movement. It develops when dopamine-producing neurons in the brain begin to deteriorate or die. Dopamine is essential for coordinating physical activity, and its decline results in symptoms such as tremors, muscle rigidity, slowed movements and balance difficulties. While Parkinson’s is not typically fatal, it significantly diminishes quality of life and currently has no known cure.Dr Puneet Agarwal, principal director of neurology at Max Super Specialty Hospital, Saket, explains that although most cases have no clear cause, about 10–15% can be attributed to genetic mutations. Environmental triggers, such as prolonged exposure to pesticides or heavy metals, are also believed to be contributing factors. Mutations in genes, such as LRRK2, PARKIN, PINK1, DJ-1 and SNCA, are often seen in familial or early-onset Parkinson’s. While a majority of cases is diagnosed after the age of 60, early-onset PD can begin before 50, and in rare instances, juvenile cases appear before age 20, usually linked to specific genetic variants.By 2050, two-thirds of global Parkinson’s cases are projected to be concentrated in the top 10 most affected countries, with China leading the list, followed closely by India and the United States. As India prepares to face this steep rise in cases, attention often centres on patients. However, the burden on caregivers remains a deeply overlooked aspect of the disease’s impact.The story of Sunita (name changed), a resident of Delhi, reflects the personal toll Parkinson’s takes on families. Her father, Raman Kumar (name changed), now 68, was diagnosed three years ago. Once a vibrant corporate professional and frequent traveller, his world changed dramatically after the diagnosis. For Sunita, the change was equally life-altering. “I became his caregiver overnight,” she says. “It’s physically exhausting and emotionally draining, but love keeps me going.” Her daily life revolves around her father’s needs—managing his medications, helping him move around the house, and offering emotional comfort. The emotional strain is intensified by the absence of robust support systems and the stigma that still clings to neurological disorders.Providing effective care for Parkinson’s patients requires patience, empathy, and emotional strength. Dr Nitin K Sethi, chairman of neurosciences and senior consultant at PSRI Hospital, stresses the importance of encouraging regular physical activity while closely monitoring changes in movement and behaviour. He adds that medical treatments can help manage symptoms such as hallucinations and behavioural disturbances, and that modifying home environments can help prevent falls. Support groups also play a critical role, offering emotional relief and reducing the sense of isolation often felt by both patients and caregivers.Dr Sweta Singh, senior consultant of neurology at Narayana Hospital in Gurgaon, notes that while Parkinson’s is not typically hereditary, individuals may face a higher risk if a parent has early-onset PD or a known genetic mutation. However, a majority of age-related cases are not passed on to offspring and are more likely the result of acquired mutations.Although Parkinson’s cannot be entirely prevented, lifestyle choices may help delay its onset. Dr Vinit Suri, senior consultant of neurology at Indraprastha Apollo Hospitals, recommends regular exercise and antioxidant-rich diets to support brain health. Reducing exposure to environmental toxins and maintaining active social and cognitive engagement may also lower the risk, particularly for those with a family history of the disease.The early signs of Parkinson’s are often movement-related. Dr Jyoti Sehgal, director of Neurology at Medanta, Gurgaon, explains that motor symptoms typically include slower walking and movement, reduced arm swing, hand tremors, an expressionless face, and problems with balance. Non-motor symptoms such as sleep disturbances and behavioural changes are also common. Clinical diagnosis is largely based on the visible emergence of these symptoms, as there is currently no definitive test to detect the disease in its earliest stages.
