When it comes to Parkinson’s disease, many people may think that it is not unfamiliar, and some may say that it is just hand trembling. In fact, Parkinson’s disease is not just hand tremors. The initial symptoms of Parkinson’s disease often begin with trembling or shaking in one hand and slowly progress to the lower extremities, head and even other parts of the body. As the disease progresses, clinical manifestations such as muscle stiffness, difficulty starting, motor slowing, and abnormal gait may also appear, and in the later stages of the disease, depression, dementia, and difficulty swallowing are often associated. Parkinson’s disease, also known as idiopathic Parkinson’s disease (PD), is characterized by the degeneration and death of more than 80% of dopaminergic nerve cells in one part of the midbrain (substantia nigra). The exact cause of cell death is not well understood and may be closely related to the interaction of genetic, environmental, and ageing factors. Diagnosis and early warning of Parkinson’s disease The diagnosis of Parkinson’s disease currently still relies on the physician’s judgment of the patient’s clinical signs and symptoms and the patient’s response to medications. Parkinson’s disease is clinically diagnosed if a person has any two of the symptoms of resting tremor, rigidity, bradykinesia and postural abnormalities, the possibility of other related diseases and the presence of secondary factors such as poisoning or brain tumors are ruled out, and the symptoms improve significantly with the administration of levodopa preparations. Studies have shown that functional abnormalities of the body with non-motor symptoms, such as constipation, loss of smell and sleep disturbances, can occur at a longer stage before the appearance of clinical symptoms, that is, before the limbs have trembled or shaken. Therefore, through various means such as Parkinson’s disease susceptibility gene testing, environmental risk factor investigation, early non-motor symptom screening, and blood biomarker testing, the risk of developing Parkinson’s disease can be determined before the appearance of clear clinical symptoms, thus providing early warning prediction for high-risk individuals. Therefore, if middle-aged or elderly people have unexplained hand tremors like counting money, difficulty starting, taking small steps forward and not being able to stop when told to do so, dull expressions as if wearing a mask, or writing with smaller and more distorted characters, they should go to the neurology department for further examination to confirm whether they have Parkinson’s disease. Risk factors for Parkinson’s disease As age increases, the likelihood of developing Parkinson’s disease increases, and men are more likely to develop the disease. About 10% of people with Parkinson’s disease have relatives who also have Parkinson’s disease. In these familial families with Parkinson’s disease, there can be multiple cases of the disease, and these patients tend to develop the disease at a younger age. For individuals without a family history, it has been found that mutations in some genes may lead to an increased risk of developing Parkinson’s disease, such as individuals carrying mutations in the LRRK2 gene have a risk of developing the disease that is about two to six times higher than normal. In addition to genetic factors, recent studies have found that environmental factors may play a very important role in the development of Parkinson’s disease. People exposed to pesticides, insecticides and chemicals have a significantly increased incidence of Parkinson’s disease; and drinking green tea may have a protective effect on Parkinson’s disease. In addition, traumatic brain injury and frequent exposure to heavy metals (lead, mercury, arsenic, manganese, etc.) increase the risk of Parkinson’s disease; while drinking green tea, coffee, and long-term use of non-steroidal anti-inflammatory drugs have a protective effect against Parkinson’s disease. Care and self-management of patients with Parkinson’s disease Patients and their families can develop a daily exercise program, such as hand and trunk exercises and gait training, under the guidance of a physician according to the patient’s living habits, family and community environment. For patients with intermediate to late stage, the first step in home care is to prevent falls to avoid complications caused by the patient’s fall. Secondly, the speed of eating should be controlled and food should be soft to avoid food choking into the trachea due to slow swallowing, which can cause lung infection. In addition, some people with Parkinson’s disease may experience significant depression, so family members should be more open and encouraging. The diet should be light, with a green diet; women should eat more soy products, such as soy milk and soy milk, and less high-fat food. Life must be regular, normal work and rest, and must ensure sufficient and reasonable sleep; in addition, Chinese medicine and acupuncture may have some curative effect. The difference between primary Parkinson’s disease and Parkinson’s syndrome Parkinson’s disease is a tremor-based movement disorder without a clear cause, also known as primary Parkinson’s disease, while Parkinson’s syndrome is often secondary to some other diseases of the nervous system, including cerebrovascular disease, traumatic brain injury, intracranial inflammation, brain tumors, or caused by toxic substances, drugs, so Parkinson’s syndrome is also called ” secondary Parkinson’s disease”. In terms of onset, Parkinson’s syndrome can occur in any age group, and Parkinson’s disease usually starts in middle and old age. Clinically, Parkinson’s syndrome has the same manifestations as Parkinson’s disease, but often has residual manifestations of the primary disease, such as seizures, hemiparesis, headaches, ataxia, ocular motility disorders, slurred speech, postural hypotension, and dementia. On imaging, there are no characteristic changes in the presentation of primary Parkinson’s disease, while Parkinson’s syndrome often has corresponding characteristic changes. In terms of treatment, treatment with levodopa replacement therapy is more effective in Parkinson’s disease and less effective in Parkinson’s syndrome. Therefore, it is important to carefully distinguish whether a patient has Parkinson’s syndrome, or Parkinson’s disease, before starting anti-Parkinson’s disease treatment, as there are major differences in treatment and prognosis.