Table of ContentsView AllTable of ContentsTriggers That Worsen Parkinson’s DiseaseHow to Minimize Parkinson’s TriggersCan Levodopa Worsen Parkinson’s Disease?Situations and Activities to AvoidPacing Yourself With Progressive Parkinson’s Disease
Table of ContentsView All
View All
Table of Contents
Triggers That Worsen Parkinson’s Disease
How to Minimize Parkinson’s Triggers
Can Levodopa Worsen Parkinson’s Disease?
Situations and Activities to Avoid
Pacing Yourself With Progressive Parkinson’s Disease
Parkinson’s disease(PD) is progressive, meaning symptoms such asslow movement,tremors, andstiffnessworsen over time. As the condition advances, full-time caregiver assistance is eventually required as mobility becomes minimal and symptoms turn severe.
The good news is that medication can control symptoms well, especially in the earlystages. Likewise, lifestyle interventions can minimize factors, like physical inactivity,dehydration, and stress, that may aggravate PD symptoms or worsen disease progression.
This article will review the factors that may worsen Parkinson’s disease and what you (or a loved one) can do to minimize these triggers.
moriyu / Getty Images
Advancing age is the most significant risk factor for Parkinson’s disease, but genetic and environmental (outside or external) factors are also thought to be involved.
Genes
Even though most cases of Parkinson’s disease are not directly inherited, multiplegenetic mutations(alterations in DNA sequence) have been connected to Parkinson’s disease.
This suggests that a person’s genetic makeup may make them more or less vulnerable to developing PD. Genetic factors can also possibly affect disease progression.
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Modifiable vs. Unmodifiable TriggersWhile exploring PD genetics is important for understanding the disease, a person’s DNA cannot be changed. Environmental factors, though, can be altered, which may help prevent, delay, or improve PD symptoms.
Modifiable vs. Unmodifiable Triggers
While exploring PD genetics is important for understanding the disease, a person’s DNA cannot be changed. Environmental factors, though, can be altered, which may help prevent, delay, or improve PD symptoms.
Environment
Environmental factors linked to an increased risk for Parkinson’s include:
Research also suggests that stressful life events, physical inactivity, and certain dietary patterns can increase PD risk, worsen symptoms, and contribute to greater disability.
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There is no definitive way to prevent or slow the progression of Parkinson’s disease. However, several studies suggest that healthy lifestyle behaviors could help minimize the impact of the disease and its symptoms.
Exercise
Participating in a safe, enjoyable exercise routine is a powerful tool for managing symptoms and possibly slowing down the disease.
In one Dutch study, 130 participants with mild Parkinson’s disease were randomized to undergo aerobic or stretching exercises.The exercises were performed at home (delivered via a supervised web-based system) for 30 to 45 minutes three times a week for six months.
Study findings revealed that compared to the participants who performed the stretching exercises, those who underwent the aerobic exercise intervention had significantly reduced motor symptoms (those related to movement and balance).
In addition to motor symptoms, emerging studies have also discovered that exercise effectively reduces cognitive decline in Parkinson’s disease.
Home Exercises for Parkinson’s Disease
Diet
If you or a loved one has PD, you might adopt a “brain-nourishing” diet like theMediterranean diet. The key ingredients of the Mediterranean diet are fruits, vegetables, olive oil, whole grains, nuts, legumes, and a moderate consumption of oily fish (e.g., sardines, mackerel, and salmon).
These foods are high inomega-3 fatty acidsandflavonoids(chemicals with anti-inflammatory and antioxidant properties).
Eating Flavonoid-Rich Foods May Help People With Parkinson’s Live Longer
Fruits and vegetables are also rich in vitamins A, B (riboflavin), C, and E; interestingly, these vitamins' levels are low in some people with PD.
While more investigation is needed, experts suspect the Mediterranean diet is neuroprotective in PD, meaning protecting against the damage and death of dopamine-producing nerve cells.The death or impairment of these nerve cells leads to Parkinson’s disease.
Caffeine and Tea
Several studies have found that consuming moderate amounts of black orgreen tea, has a beneficial effect on Parkinson’s disease, such as improving cognitive (thinking and memory) function.
Incorporatingcaffeine(from green tea or another source) into your daily routine is also believed to be neuroprotective. One study found that regular caffeine consumption in people with PD significantly lowered their rate of disease progression.
Water
Water is vital for life, but in Parkinson’s disease, problems swallowing (dysphagia) or age-related decline in thirst sensation can easily lead to dehydration.
Without adequate water intake, PD symptoms likeconstipationcan worsen. Moreover, dehydration in Parkinson’s disease is linked to an increased risk of deterioration.
Speak with a healthcare provider about how much water you should drink to maintain sufficient hydration based on your activity level and other medical conditions.
Stress Management
All symptoms of PD can worsen with stress. Lifestyle behaviors that can help reduce stress and improve PD symptoms include:
Some people with PD wonder if Parkinson’s disease medications, namelylevodopa, make their disease progress faster.
What Is Levodopa?Levodopa, or L-dopa, is the hallmark medication for Parkinson’s disease. It increases dopamine levels in the brain and is the most effective drug for reducing PD symptoms.
What Is Levodopa?
Levodopa, or L-dopa, is the hallmark medication for Parkinson’s disease. It increases dopamine levels in the brain and is the most effective drug for reducing PD symptoms.
After long-term use of levodopa, people may notice what are calledOFF periodswhere their symptoms return, as the levodopa wears off sooner than expected.
Despite OFF periods and other complications of long-term levodopa use, likedyskinesia(excessive movements), no research suggests levodopa accelerates Parkinson’s disease.
Parkinson’s Disease Treatment
Under the guidance of a Parkinson’s disease specialist, limiting or avoiding certain foods, supplements, or scenarios may be advised.
While adequate water intake and a well-balanced diet like the Mediterranean diet benefit people with PD, experts don’t know if there are any foods or drinks that are necessarily “bad” for Parkinson’s.
That said, early research found the following foods to be associated with more rapid progression of Parkinson’s:
As such, limiting your intake of processed foods, added sugars, andsaturated fatsis a sensible strategy.
Instead, choose alternative food options. For example, for protein sources, you could eat beans and nuts. Likewise, try leafy green vegetables and tofu instead of dairy products for calcium.
Lastly, depending on the medications you are taking for Parkinson’s, dietary changes may help avoid side effects or make the drugs work better.
For example, if you are taking anMAO-B inhibitor, such as Xadago (safinamide) or Eldepryl (selegiline), you must moderate your intake of foods rich intyramine(e.g., aged cheese and cured meats).
MAO-B inhibitors also increase tyramine in the body and can elevate blood pressure when combined with tyramine-rich foods.
Supplements
Several supplements are being evaluated for treating Parkinson’s disease, mainly creatine,coenzyme Q10 (CoQ10), inosine, andvitamin E.
Unfortunately, the research on their benefit so far is lacking. Therefore, it’s prudent to avoid them unless your provider suggests otherwise.
Glutathioneis another supplement that, unlike the ones mentioned above, is showing some promise for treating PD, although studies are still in the early stages.
PrecautionAlways speak with your provider before taking any new medication or supplement to avoid harmful interactions or worsening symptoms.
Precaution
Always speak with your provider before taking any new medication or supplement to avoid harmful interactions or worsening symptoms.
Social Isolation
Due to the physical and mental challenges of living with Parkinson’s disease, some people may withdraw from social activities and stop interacting with others, especially as the disease progresses.
Strategies to avoid social isolation include:
It’s normal to experience feelings of powerlessness living with an incurable and progressive disease like Parkinson’s disease.
Focus your energy on the parts of the condition you can control—drinking water, eating a well-balanced diet, getting regular physical activity, and reducing stress as best as possible.
Also, to keep symptoms at bay, take your medications as prescribed and see your healthcare provider for regular checkups.
Lastly, as you navigate the ebbs and flows of this unpredictable disease, don’t hesitate to reach out to your healthcare team and loved ones for support and connection.
Summary
Parkinson’s disease is progressive, so symptoms (e.g., slow movements, shaking, and stiffness) naturally worsen with time. Several environmental factors, namely physical inactivity, dehydration, poor diet, and stress, can aggravate symptoms and, perhaps, worsen disease progression.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Parkinson’s Foundation.Stages of Parkinson’s.Blauwendraat C, Nalls MA, Singleton AB.The genetic architecture of Parkinson’s disease.Lancet Neurol. 2020;19(2):170-178. doi:10.1016/S1474-4422(19)30287-XCherian A, Divya KP.Genetics of Parkinson’s disease.Acta Neurol Belg. 2020;120(6):1297-1305. doi:10.1007/s13760-020-01473-5De Miranda BR, Goldman SM, Miller GW, Greenamyre JT, Dorsey ER.Preventing Parkinson’s disease: an environmental agenda.J Parkinsons Dis. 2022;12(1):45-68. doi:10.3233/JPD-212922van der Kolk NM, de Vries NM, Kessels RPC, et al.Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial.Lancet Neurol. 2019;18(11):998-1008. doi:10.1016/S1474-4422(19)30285-6Ma CL, Ma XT, Wang JJ, Liu H, Chen YF, Yang Y.Physical exercise induces hippocampal neurogenesis and prevents cognitive decline.Behav Brain Res. 2017 Jan 15;317:332-339. doi:10.1016/j.bbr.2016.09.067Seidl SE, Santiago JA, Bilyk H, Potashkin JA.The emerging role of nutrition in Parkinson’s disease.Front Aging Neurosci. 2014;6:36. doi:10.3389/fnagi.2014.00036Metcalfe-Roach A, Yu AC, Golz E et al.MIND and Mediterranean diets associated with later onset of Parkinson’s disease.Mov Disord.2021;36(4):977-984. doi:10.1002/mds.28464Pervin M, Unno K, Ohishi T, Tanabe H, Miyoshi N, Nakamura Y.Beneficial effects of green tea catechins on neurodegenerative diseases.Molecules. 2018;23(6):1297. doi:10.3390/molecules23061297Hong CT, Chan L, Bai CH.The effect of caffeine on the risk and progression of Parkinson’s disease: a meta-analysis.Nutrients. 2020;12(6):1860. doi:10.3390/nu12061860Scorza FA, Guimarães-Marques M, Nejm M, et al.Sudden unexpected death in Parkinson’s disease: Insights from clinical practice.Clinics (Sao Paulo). 2022;77:100001. doi:10.1016/j.clinsp.2021.100001Fan B, Jabeen R, Bo B, et al.What and how can physical activity prevention function on Parkinson’s disease?Oxid Med Cell Longev. 2020;2020:4293071. doi:10.1155/2020/4293071Lin HW, Tam KW, Kuan YC.Mindfulness or meditation therapy for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials.Eur J Neurol. 2023;30(8):2250-2260. doi:10.1111/ene.15839Casciaro Y.Massage therapy treatment and outcomes for a patient with Parkinson’s disease: a case report.Int J Ther Massage Bodywork. 2016;9(1):11-18. doi:10.3822/ijtmb.v9i1.287Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R.Music therapy and Parkinson’s disease: a systematic review from 2015-2020.Int J Environ Res Public Health. 2021;18(21):11618. doi:10.3390/ijerph182111618Armstrong MJ, Okun MS.Diagnosis and treatment of Parkinson disease: a review.JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360Verschuur CVM, Suwijn SR, Boel JA, et al.Randomized delayed-start trial of levodopa in Parkinson’s disease.N Engl J Med. 2019;380(4):315-324. doi:10.1056/NEJMoa1809983Mischley LK, Lau RC, Bennett RD.Role of diet and nutritional supplements in Parkinson’s disease progression.Oxid Med Cell Longev. 2017;2017:6405278. doi:10.1155/2017/6405278Tan YY, Jenner P, Chen SD.Monoamine oxidase-B Inhibitors for the treatment of Parkinson’s disease: past, present, and future.J Parkinsons Dis. 2022;12(2):477-493. doi:10.3233/JPD-212976The Michael J. Fox Foundation for Parkinson’s Research.Parkinson’s disease and diet: a practical guide.Bjørklund G, Peana M, Maes M, Dadar M, Severin B.The glutathione system in Parkinson’s disease and its progression.Neurosci Biobehav Rev. 2021;120:470-478. doi:10.1016/j.neubiorev.2020.10.004Ahn S, Springer K, Gibson JS.Social withdrawal in Parkinson’s disease: a scoping review.Geriatr Nurs. 2022;48:258-268. doi:10.1016/j.gerinurse.2022.10.010
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Parkinson’s Foundation.Stages of Parkinson’s.Blauwendraat C, Nalls MA, Singleton AB.The genetic architecture of Parkinson’s disease.Lancet Neurol. 2020;19(2):170-178. doi:10.1016/S1474-4422(19)30287-XCherian A, Divya KP.Genetics of Parkinson’s disease.Acta Neurol Belg. 2020;120(6):1297-1305. doi:10.1007/s13760-020-01473-5De Miranda BR, Goldman SM, Miller GW, Greenamyre JT, Dorsey ER.Preventing Parkinson’s disease: an environmental agenda.J Parkinsons Dis. 2022;12(1):45-68. doi:10.3233/JPD-212922van der Kolk NM, de Vries NM, Kessels RPC, et al.Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial.Lancet Neurol. 2019;18(11):998-1008. doi:10.1016/S1474-4422(19)30285-6Ma CL, Ma XT, Wang JJ, Liu H, Chen YF, Yang Y.Physical exercise induces hippocampal neurogenesis and prevents cognitive decline.Behav Brain Res. 2017 Jan 15;317:332-339. doi:10.1016/j.bbr.2016.09.067Seidl SE, Santiago JA, Bilyk H, Potashkin JA.The emerging role of nutrition in Parkinson’s disease.Front Aging Neurosci. 2014;6:36. doi:10.3389/fnagi.2014.00036Metcalfe-Roach A, Yu AC, Golz E et al.MIND and Mediterranean diets associated with later onset of Parkinson’s disease.Mov Disord.2021;36(4):977-984. doi:10.1002/mds.28464Pervin M, Unno K, Ohishi T, Tanabe H, Miyoshi N, Nakamura Y.Beneficial effects of green tea catechins on neurodegenerative diseases.Molecules. 2018;23(6):1297. doi:10.3390/molecules23061297Hong CT, Chan L, Bai CH.The effect of caffeine on the risk and progression of Parkinson’s disease: a meta-analysis.Nutrients. 2020;12(6):1860. doi:10.3390/nu12061860Scorza FA, Guimarães-Marques M, Nejm M, et al.Sudden unexpected death in Parkinson’s disease: Insights from clinical practice.Clinics (Sao Paulo). 2022;77:100001. doi:10.1016/j.clinsp.2021.100001Fan B, Jabeen R, Bo B, et al.What and how can physical activity prevention function on Parkinson’s disease?Oxid Med Cell Longev. 2020;2020:4293071. doi:10.1155/2020/4293071Lin HW, Tam KW, Kuan YC.Mindfulness or meditation therapy for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials.Eur J Neurol. 2023;30(8):2250-2260. doi:10.1111/ene.15839Casciaro Y.Massage therapy treatment and outcomes for a patient with Parkinson’s disease: a case report.Int J Ther Massage Bodywork. 2016;9(1):11-18. doi:10.3822/ijtmb.v9i1.287Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R.Music therapy and Parkinson’s disease: a systematic review from 2015-2020.Int J Environ Res Public Health. 2021;18(21):11618. doi:10.3390/ijerph182111618Armstrong MJ, Okun MS.Diagnosis and treatment of Parkinson disease: a review.JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360Verschuur CVM, Suwijn SR, Boel JA, et al.Randomized delayed-start trial of levodopa in Parkinson’s disease.N Engl J Med. 2019;380(4):315-324. doi:10.1056/NEJMoa1809983Mischley LK, Lau RC, Bennett RD.Role of diet and nutritional supplements in Parkinson’s disease progression.Oxid Med Cell Longev. 2017;2017:6405278. doi:10.1155/2017/6405278Tan YY, Jenner P, Chen SD.Monoamine oxidase-B Inhibitors for the treatment of Parkinson’s disease: past, present, and future.J Parkinsons Dis. 2022;12(2):477-493. doi:10.3233/JPD-212976The Michael J. Fox Foundation for Parkinson’s Research.Parkinson’s disease and diet: a practical guide.Bjørklund G, Peana M, Maes M, Dadar M, Severin B.The glutathione system in Parkinson’s disease and its progression.Neurosci Biobehav Rev. 2021;120:470-478. doi:10.1016/j.neubiorev.2020.10.004Ahn S, Springer K, Gibson JS.Social withdrawal in Parkinson’s disease: a scoping review.Geriatr Nurs. 2022;48:258-268. doi:10.1016/j.gerinurse.2022.10.010
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Parkinson’s Foundation.Stages of Parkinson’s.Blauwendraat C, Nalls MA, Singleton AB.The genetic architecture of Parkinson’s disease.Lancet Neurol. 2020;19(2):170-178. doi:10.1016/S1474-4422(19)30287-XCherian A, Divya KP.Genetics of Parkinson’s disease.Acta Neurol Belg. 2020;120(6):1297-1305. doi:10.1007/s13760-020-01473-5De Miranda BR, Goldman SM, Miller GW, Greenamyre JT, Dorsey ER.Preventing Parkinson’s disease: an environmental agenda.J Parkinsons Dis. 2022;12(1):45-68. doi:10.3233/JPD-212922van der Kolk NM, de Vries NM, Kessels RPC, et al.Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial.Lancet Neurol. 2019;18(11):998-1008. doi:10.1016/S1474-4422(19)30285-6Ma CL, Ma XT, Wang JJ, Liu H, Chen YF, Yang Y.Physical exercise induces hippocampal neurogenesis and prevents cognitive decline.Behav Brain Res. 2017 Jan 15;317:332-339. doi:10.1016/j.bbr.2016.09.067Seidl SE, Santiago JA, Bilyk H, Potashkin JA.The emerging role of nutrition in Parkinson’s disease.Front Aging Neurosci. 2014;6:36. doi:10.3389/fnagi.2014.00036Metcalfe-Roach A, Yu AC, Golz E et al.MIND and Mediterranean diets associated with later onset of Parkinson’s disease.Mov Disord.2021;36(4):977-984. doi:10.1002/mds.28464Pervin M, Unno K, Ohishi T, Tanabe H, Miyoshi N, Nakamura Y.Beneficial effects of green tea catechins on neurodegenerative diseases.Molecules. 2018;23(6):1297. doi:10.3390/molecules23061297Hong CT, Chan L, Bai CH.The effect of caffeine on the risk and progression of Parkinson’s disease: a meta-analysis.Nutrients. 2020;12(6):1860. doi:10.3390/nu12061860Scorza FA, Guimarães-Marques M, Nejm M, et al.Sudden unexpected death in Parkinson’s disease: Insights from clinical practice.Clinics (Sao Paulo). 2022;77:100001. doi:10.1016/j.clinsp.2021.100001Fan B, Jabeen R, Bo B, et al.What and how can physical activity prevention function on Parkinson’s disease?Oxid Med Cell Longev. 2020;2020:4293071. doi:10.1155/2020/4293071Lin HW, Tam KW, Kuan YC.Mindfulness or meditation therapy for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials.Eur J Neurol. 2023;30(8):2250-2260. doi:10.1111/ene.15839Casciaro Y.Massage therapy treatment and outcomes for a patient with Parkinson’s disease: a case report.Int J Ther Massage Bodywork. 2016;9(1):11-18. doi:10.3822/ijtmb.v9i1.287Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R.Music therapy and Parkinson’s disease: a systematic review from 2015-2020.Int J Environ Res Public Health. 2021;18(21):11618. doi:10.3390/ijerph182111618Armstrong MJ, Okun MS.Diagnosis and treatment of Parkinson disease: a review.JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360Verschuur CVM, Suwijn SR, Boel JA, et al.Randomized delayed-start trial of levodopa in Parkinson’s disease.N Engl J Med. 2019;380(4):315-324. doi:10.1056/NEJMoa1809983Mischley LK, Lau RC, Bennett RD.Role of diet and nutritional supplements in Parkinson’s disease progression.Oxid Med Cell Longev. 2017;2017:6405278. doi:10.1155/2017/6405278Tan YY, Jenner P, Chen SD.Monoamine oxidase-B Inhibitors for the treatment of Parkinson’s disease: past, present, and future.J Parkinsons Dis. 2022;12(2):477-493. doi:10.3233/JPD-212976The Michael J. Fox Foundation for Parkinson’s Research.Parkinson’s disease and diet: a practical guide.Bjørklund G, Peana M, Maes M, Dadar M, Severin B.The glutathione system in Parkinson’s disease and its progression.Neurosci Biobehav Rev. 2021;120:470-478. doi:10.1016/j.neubiorev.2020.10.004Ahn S, Springer K, Gibson JS.Social withdrawal in Parkinson’s disease: a scoping review.Geriatr Nurs. 2022;48:258-268. doi:10.1016/j.gerinurse.2022.10.010
Parkinson’s Foundation.Stages of Parkinson’s.
Blauwendraat C, Nalls MA, Singleton AB.The genetic architecture of Parkinson’s disease.Lancet Neurol. 2020;19(2):170-178. doi:10.1016/S1474-4422(19)30287-X
Cherian A, Divya KP.Genetics of Parkinson’s disease.Acta Neurol Belg. 2020;120(6):1297-1305. doi:10.1007/s13760-020-01473-5
De Miranda BR, Goldman SM, Miller GW, Greenamyre JT, Dorsey ER.Preventing Parkinson’s disease: an environmental agenda.J Parkinsons Dis. 2022;12(1):45-68. doi:10.3233/JPD-212922
van der Kolk NM, de Vries NM, Kessels RPC, et al.Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial.Lancet Neurol. 2019;18(11):998-1008. doi:10.1016/S1474-4422(19)30285-6
Ma CL, Ma XT, Wang JJ, Liu H, Chen YF, Yang Y.Physical exercise induces hippocampal neurogenesis and prevents cognitive decline.Behav Brain Res. 2017 Jan 15;317:332-339. doi:10.1016/j.bbr.2016.09.067
Seidl SE, Santiago JA, Bilyk H, Potashkin JA.The emerging role of nutrition in Parkinson’s disease.Front Aging Neurosci. 2014;6:36. doi:10.3389/fnagi.2014.00036
Metcalfe-Roach A, Yu AC, Golz E et al.MIND and Mediterranean diets associated with later onset of Parkinson’s disease.Mov Disord.2021;36(4):977-984. doi:10.1002/mds.28464
Pervin M, Unno K, Ohishi T, Tanabe H, Miyoshi N, Nakamura Y.Beneficial effects of green tea catechins on neurodegenerative diseases.Molecules. 2018;23(6):1297. doi:10.3390/molecules23061297
Hong CT, Chan L, Bai CH.The effect of caffeine on the risk and progression of Parkinson’s disease: a meta-analysis.Nutrients. 2020;12(6):1860. doi:10.3390/nu12061860
Scorza FA, Guimarães-Marques M, Nejm M, et al.Sudden unexpected death in Parkinson’s disease: Insights from clinical practice.Clinics (Sao Paulo). 2022;77:100001. doi:10.1016/j.clinsp.2021.100001
Fan B, Jabeen R, Bo B, et al.What and how can physical activity prevention function on Parkinson’s disease?Oxid Med Cell Longev. 2020;2020:4293071. doi:10.1155/2020/4293071
Lin HW, Tam KW, Kuan YC.Mindfulness or meditation therapy for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials.Eur J Neurol. 2023;30(8):2250-2260. doi:10.1111/ene.15839
Casciaro Y.Massage therapy treatment and outcomes for a patient with Parkinson’s disease: a case report.Int J Ther Massage Bodywork. 2016;9(1):11-18. doi:10.3822/ijtmb.v9i1.287
Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R.Music therapy and Parkinson’s disease: a systematic review from 2015-2020.Int J Environ Res Public Health. 2021;18(21):11618. doi:10.3390/ijerph182111618
Armstrong MJ, Okun MS.Diagnosis and treatment of Parkinson disease: a review.JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360
Verschuur CVM, Suwijn SR, Boel JA, et al.Randomized delayed-start trial of levodopa in Parkinson’s disease.N Engl J Med. 2019;380(4):315-324. doi:10.1056/NEJMoa1809983
Mischley LK, Lau RC, Bennett RD.Role of diet and nutritional supplements in Parkinson’s disease progression.Oxid Med Cell Longev. 2017;2017:6405278. doi:10.1155/2017/6405278
Tan YY, Jenner P, Chen SD.Monoamine oxidase-B Inhibitors for the treatment of Parkinson’s disease: past, present, and future.J Parkinsons Dis. 2022;12(2):477-493. doi:10.3233/JPD-212976
The Michael J. Fox Foundation for Parkinson’s Research.Parkinson’s disease and diet: a practical guide.
Bjørklund G, Peana M, Maes M, Dadar M, Severin B.The glutathione system in Parkinson’s disease and its progression.Neurosci Biobehav Rev. 2021;120:470-478. doi:10.1016/j.neubiorev.2020.10.004
Ahn S, Springer K, Gibson JS.Social withdrawal in Parkinson’s disease: a scoping review.Geriatr Nurs. 2022;48:258-268. doi:10.1016/j.gerinurse.2022.10.010
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