Diet and exercise

People with Parkinson’s should be encouraged to have a healthy, well-balanced diet and work towards improving their overall physical health. Fitness is thought to be beneficial in preventing Parkinson’s and, although not proven, good fitness can help a patient’s strength and balance and improve mental wellbeing.

Fitness referral schemes are available in some parts of the UK and reduced gym membership fees may be available. Referral to a dietitian or physiotherapist can be helpful if a patient has particular problems.

While being overweight can reduce mobility and body strength, being underweight can affect cognition, so patients should focus primarily on being as healthy as possible. Common symptoms, such as constipation and postural hypotension, which are problematic in Parkinson’s, can be managed in part by patients remaining hydrated.

Travel and leisure

Parkinson’s shouldn’t prevent people from pursuing travel and leisure activities. Understanding their particular limitations, preparing and being organised can help reduce associated anxiety.

This includes checking accommodation accessibility, finding out what support is available in the local area and, if they’re going abroad, checking with the embassy or high commission whether there are restrictions on medicines being brought into the country. It’s recommended that patients should carry a clear list of their medication when travelling. This can be obtained from their GP.

Driving

People with Parkinson’s must tell the Driver and Vehicle Licensing Agency (DVLA) about their diagnosis, otherwise they may be fined up to £1,000. The DVLA will assess them and they may be asked to take another test, have a shortened licence (one, two or three years) or adapt their vehicle. They must also inform their insurance company.

Practice point

One of your patients with Parkinson’s is planning a longhaul business trip and he asks for advice about making his journey easier. What options would you discuss with him?