HEALTH & WELLNESS
By Megan Wroe, MS, RD, CNE, CLEC
Parkinson’s Disease (PD) affects nearly one million Americans, and that number is rapidly increasing. Characterized by tremors, stiffness, and slowed movement, there are also many other symptoms of coordination, cognition, and quality of life that impact both the person with PD and their loved ones. PD also represents a healthcare utilization challenge due to increased fall risk, hospitalizations, and cognitive decline that all cost money and require medical oversight.
While PD is incredibly complex in how it impacts each person individually and often requires a unique concoction of medical management for each patient, it is also unique in how responsive it is to lifestyle management. From symptom management to slowed progression, there are a host of strategies people with PD can employ alongside medication to make a true impact on how their condition affects their lives. This is because of the concept of neuroplasticity, which is the brain’s capacity to adapt and form new neural connections. The more neuroplasticity, the better cognition and the slower progression of decline. Certain lifestyle interventions act as signals to stimulate neuroplasticity. Movement, learning, recovery, and nourishment all improve coordination, reaction time, and cognitive function. What’s even better is that this is true for ALL aging populations—with or without PD! For Parkinson’s Awareness Month, let’s focus on what we can do for overall function and discuss ways to move, think, and live more independently.
Lifestyle Strategy #1: Exercise
Exercise is one of the most well-supported interventions in Parkinson’s care. Research shows that regular movement can improve gait, balance, strength, brain function, and even more day-to-day symptoms such as constipation and sleep. While all of these are reasons to start exercising, possibly the most meaningful benefit to the healthcare industry is the reduced fall risk.
Falls are one of the leading causes of emergency room visits and hospitalization in people with Parkinson’s (and seniors in general). Changes in gait, posture, and reaction time increase the likelihood of tripping or losing balance. Once a fall occurs, confidence often declines, and other injuries can surface, leading to reduced activity and further deconditioning (which is again true for all seniors, not just those with PD).
In addition to reducing fall risk, targeted exercise programs focused on both cardiovascular and cognitive challenge can minimize symptoms acutely for many with PD and can improve how they interact with the physical world around them, from walking and talking to remembering routines to handling a gait freeze in a doorway.
There are several research-backed fitness programs for managing Parkinson’s, such as PWR!, Big & Loud, and Rocksteady. While each program uses different modalities of movement, they all share similar components such as:
- Strength training to support posture and stability
- Balance and mobility work to improve gait mechanics
- Rhythmic or patterned movement to enhance coordination
- Higher-effort intervals (when appropriate) to support brain activation
- Dual-tasking (physical movement paired with cognitive challenges)
With PD, the key to getting positive outcomes from exercise is consistency. Finding an exercise program that is accessible and fun is key since this should be a lifelong fitness prescription commitment.
Lifestyle Strategy #2: Sleep
Sleep disturbances are extremely common in Parkinson’s and often under-addressed. Poor sleep impacts not only energy but also cognitive function, mood, motor control, and even immune function. Chronic sleep disruption can worsen cognitive symptoms and increase daytime fatigue, which in turn raises fall risk, reduces coordination and activity levels, and impairs overall quality of life. Some people may need more invasive interventions for true sleep disorders, but often all that is needed are some very simple routine changes to significantly improve both sleep onset and length of sleep. The following strategies seem almost too simplistic but are often not being followed consistently. Like exercise, consistency is key to outcomes, and also like exercise, sleep strategies help even those without PD.
- Daytime light exposure. Yep, this one is something to do while awake during the day! Early morning and midday natural light give the circadian rhythm a timestamp, which allows for a more regular onset of sleepy hormones in the evening.
- Minimize evening light. Dim the lights and swap out blue lights for red and orange one or two hours before bedtime. This tells your body that sleep is approaching.
- Eliminate cognitive stimulus pre-bedtime. From excitement to stress, anything that creates heightened emotions will spin in your head when you finally hit the pillow. No global news, difficult conversations, or even books so invigorating you can’t put them down an hour before bed.
- Environment for sleep. A cool bedroom, zero lights, and as silent as possible are the ingredients for a happy sleep room.
- Routine. Human brains love routine, and we respond very well to it. Does just the smell of coffee in the morning perk you up? Find some similar triggers to tell the brain it’s bedtime. Brush your teeth, wash your face, and do some stretching all in the same order at the same time. Your brain will catch on.
- Breath work. Sometimes we just can calm the racing thoughts. Forcefully slowing down breath tricks the body into thinking it is calm. A simple count of inhale for four seconds, hold for seven, and exhale for eight, repeated 15-20 times will have you snoozing in no time! This is also a great technique for chronic stress at any time of the day.
Lifestyle Strategy #3: Nourishment
Nutrition plays a key role in supporting brain and body function in PD. Acutely, adequate protein and calories help to ensure the muscles and bones are fed and prevent both sarcopenia and osteoporosis. Fiber and hydration are critical for maintaining healthy bowel movements as well as a strong immune system. Eating to manage insulin resistance is also important for minimizing inflammation, which can translate to exacerbated decline within the brain.
Key considerations for nutrition with PD include:
- Adequate protein to preserve muscle mass and strength
- Fiber-rich foods to support gut health and digestion
- Anti-inflammatory dietary patterns to support overall brain health
- Preparing homemade food and minimizing ultra-processed foods for both the anti-inflammatory effect as well as the social and joyful effects of cooking and eating alongside others
While each of these lifestyle strategies is powerful on its own, their impact is amplified when combined into an integrated approach.
- Movement improves coordination.
- Cognitive fitness training sharpens response.
- Sleep restores the brain.
- Stress management calms the system.
- Nutrition fuels the process.
From outpatient staff to community centers to insurance brokers, I talk with other professionals in the healthcare field who are outside of acute medical offices. I find that we all share a common goal: to close the gaps in healthcare continuums in order to help our community thrive independently and keep them out of the hospital. It becomes our responsibility then to provide education and resources on lifestyle health management so our community can choose the interventions that work best for them, the PD community being no exception. While Parkinson’s presents real challenges, it also presents an incredible opportunity to approach health in a more integrated, proactive, and hopeful way.
For Parkinson’s Awareness Month, let’s focus on what we can do for overall function and discuss ways to move, think and live more independently.
Upcoming Programs at St. Jude Wellness Center
See schedule & book here: Programs & Events – St. Jude Wellness Center
Parkinson’s Empowerment Program
An early intervention program for those with recent PD diagnoses and their care partners. This four-week program combines education from an integrative team of health and wellness experts along with caregiver support and PD exercise. Participants receive personalized recommendations for the next best fitness program. Cohorts are free of charge and offered every one to two months. The next cohort is Thursdays from 2 PM – 4 PM and begins May 7.
Brain Fit
Our signature brain gym circuit course focused on utilizing dual-tasking exercises for enhancing neuroplasticity and reducing the risk of cognitive decline. This course is for active, independent agers who are not currently managing cognitive conditions. Brain Fit is a twice-weekly, six-week series offered consistently throughout the year for $165. The next cohort is Wednesdays and Fridays from 12 PM – 1 PM starting May 6.
Wellness Center Tours: For those new to our center, we offer bimonthly tours free of charge to give you the behind-the-scenes scoop of what we offer.
Megan Wroe, MS, RD, CNE, CLEC, is a registered dietitian and Manager of St. Jude Wellness Center, an integrated program of Providence St. Jude Medical Center. She leads a multidisciplinary team providing nutrition, fitness, mind-body therapies, and preventive wellness services that support the hospital’s mission of whole-person care. Megan partners with community organizations and insurance professionals to advance preventive health strategies that help reduce chronic disease risk, promote healthy aging, and improve quality of life for Medicare and senior populations. From single offering services and packages to virtual comprehensive programs for larger employee populations, the wellness center team will create a wellness package based on the health needs and interests of your clients and groups. Learn more about the wellness center and their upcoming programs at their website.