Neil Diamond was in denial of his Parkinson’s diagnosis, a disease that starts slowly with subtle symptoms. Here’s are the signs to look for

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Legendary singer-songwriter Neil Diamond recently sat down with CBS’ Sunday Morning to discuss his 2018 diagnosis with Parkinson’s disease—and acceptance.

“I still haven’t given it up, yet,” Diamond, 82, said regarding touring. “It’s very hard.”

Diamond said he was in denial for a year or two after being diagnosed with the condition, a degenerative neurological disorder that ended his touring days, for the most part.

“When the doctor told me, I was just not ready to accept it,” he recalled. “I said, ‘Oh, okay. I’ll see you, you know, whenever you wanna see me. But I have work to do, so I’ll see you later.’”

Parkinson’s disease affects at least half a million Americans, according to the U.S. National Institutes of Health. The actual number may be as high as a million, however, because many individuals go undiagnosed or misdiagnosed. That’s because symptoms—some of them subtle and odd—onset slowly.

What are the early symptoms of Parkinson’s disease?

While most people with Parkinson’s disease are diagnosed after age 60, 5% to 10% of patients with the condition begin to experience symptoms before age 50—some as early as 20.

Just what should you be on the lookout for, if you’re concerned about Parkinson’s?

The first symptom may be a minor tremor in just one hand—or even your finger or chin—while you’re resting. Here are some other early tells, according to the Parkinson’s Foundation:

  • Smaller handwriting than in the past
  • Loss of smell
  • Difficulty sleeping due to sudden involuntary movements
  • Arms that don’t swing when you walk like they used to
  • Stiffness in your arms, legs, or trunk
  • Constipation
  • A change in your voice that makes it very soft, breathy, or hoarse
  • A new lack of facial expression
  • Dizziness or fainting

As symptoms progress, people with Parkinson’s may find themselves experiencing more motor-related symptoms, like the following, according to the Cleveland Clinic:

  • Slow movements (These aren’t due to muscle weakness, but to muscle control problems, experts say.)
  • Resting tremors
  • “Lead-pipe rigidity,” described as “constant, unchanging stiffness when moving a body part”
  • “Cogwheel stiffness,” which leads to a stop-and-go appearance of movements when lead-pipe rigidity is combined with tremors
  • Stooping or hunching over
  • Blinking less than usual
  • Drooling
  • Trouble swallowing

While there isn’t a cure for Parkinson’s, a variety of medications and treatments—like dopamine, medications that stimulate dopamine, medications like block dopamine metabolism, and deep-brain stimulation—can significantly improve symptoms. 

There are experimental treatments, too, like stem cell transplants, neuron-repair treatments, gene therapies, and gene-targeted treatments, meaning more hope is on the horizon for more patients.

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