Emphasis on Prevention
Slide 10 of 29
Prevention – Emphasis of Public Health --
-- €Primary prevention€ averts the occurrence of the disease before it starts.
Since we do not know causes of PD, not much can be done here currently. With the help of PD lobbying efforts, in the past year the NIEHS has initiated a research program on "environmental causes of PD." Research confirms that PD is predominantly environmental and recent findings point to pesticides and herbicides
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€-- €Secondary prevention€ reduces consequences of disease by detection and treatment at an early stage.
To be beneficial here we need biomarkers that are accurate and inexpensive to find PD cases and we need treatments to slow or reverse disease progression. While research is advancing on both fronts the technology is not currently ready for widespread application.
Currently, detection and diagnosis of PD are primarily clinical; definitive biomarkers are not yet established. Research is making progress however on biomarkers using PET/Spec scans, spinal fluid and even blood tests. Tests that can be useful for screening populations to find presymptomatic cases or to identify cases in population surveys for surveillance. motor tests, smell tests, eye movements.
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€-- €Tertiary prevention€ attempts to minimize complications and severe disabling consequences of disease after it has progressed.
Most medical care is at this level. The initial emphasis of our PH efforts iin the USA is on access to quality care (maximizing functional status and quality of life) -- including as we will see later issues of specialty care, education of primary care providers, prevention of falls.