Parkinson’s disease (PD) is a progressive neurological condition that impacts movement and motor control. While tremors, stiffness, and slowed movements are widely known symptoms, poor balance and coordination are among the lesser-known but critical early signs of PD.

In many cases, individuals may overlook unsteadiness or frequent falls, assuming it is a natural part of ageing—when in reality, these may be among the first indicators of Parkinsonism.

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According to the Indian Academy of Neurology, India has nearly 1 million people affected by Parkinson’s Disease. In West Bengal, particularly in Kolkata, neurologists are witnessing a rise in PD cases, especially among those aged 60 years and above.

This growing trend highlights the urgent need for increased awareness about the subtle and, early symptoms of Parkinson’s—especially those related to balance.

How Parkinson’s Disease affects balance

Parkinson’s Disease impacts a part of the brain called the basal ganglia, which regulates smooth and coordinated body movement. As the disease progresses, the brain’s ability to produce dopamine—a neurotransmitter crucial for motor control—declines. This leads to a variety of motor disturbances, such as:

• Shuffling gait
• Stooped posture
• Freezing episodes (temporary inability to move while walking)
• Impaired reflexes and poor postural control

Often, the family members are the first ones to notice these subtle signs—such as the person frequently bumping into objects, needing support while walking, becoming slow and unsteady on their feet. These should not be ignored as may indicate the onset of PD and if left untreated may lead to devastating falls.

Managing balance and preventing falls in Parkinson’s

1. Early neurological assessment

Timely consultation with a neurologist helps identify subtle balance impairments that may indicate the onset of Parkinson’s. Early intervention plays a key role in improving balance through pharmacological and non-pharmacological measures and preventing falls.

2. Tailored physiotherapy plans

Structured rehabilitation programs focusing on gait training, posture correction, and balance enhancement are essential. These plans are usually developed in collaboration with physiotherapists specializing in neurological disorders.

3. Cognitive and reflex assessments

Parkinson’s can also affect reflexes and executive functioning. Periodic testing helps in identifying additional risks and customizing safety measures accordingly.

4. Patient and caregiver education

Guidance on recognizing red flags, ensuring medication adherence, and maintaining home safety plays a key role in reducing fall risks.

Balance and coordination difficulties in older adults are often overlooked or misattributed to ageing. However, they can be early warning signs of Parkinson’s disease. Raising awareness and seeking timely medical intervention can not only aid in early diagnosis but also help manage symptoms more effectively, ensuring better mobility, independence, and quality of life for those affected.

It is of paramount importance to prevent falls which can not only severely affect quality of life but are also associated with high risk of mortality in the elderly. As the adage goes, prevention is always better than cure!

(The author is a Consultant in Neurology at Fortis Hospital, Anandapur, Kolkata.)

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