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Paying the Price: Our Veterans and the Burden of Parkinson's Disease

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tags: Parkinsons Disease, Veterans Affairs



Ray Dorsey, MD is a professor of neurology at the University of Rochester Medical Center and co-author of Ending Parkinson’s Disease.

 

 

 

Parkinson’s disease is the world’s fastest growing brain disease, even faster than Alzheimer’s.  The number affected worldwide has doubled in the past 25 years and, absent change, will double again in the coming generation.  In the U.S., 1.1 million Americans bear its burden, up 35% in just the past decade.  The toll is especially great on veterans; 110,000 have the debilitating disease.

 

Veterans are at high risk for at least three reasons.  First, many were exposed to toxic herbicides like Agent Orange during the Vietnam War and other conflicts.  Richard Stewart is one of those affected.  He is a former Green Beret who served as a platoon leader in Vietnam for the U.S. Army’s famous 101st Airborne Division.  He, like thousands of other veterans and millions of Vietnamese, were often soaked by the 45 million liters of Agent Orange (“pretty nasty stuff” in his words) that were sprayed in the country.  The chemical, which derived its name from the large orange barrels in which it was stored, killed vegetation and crops and contributed to birth defects, cancer, and Parkinson’s disease.  Today, Stewart lives in upstate New York with his wife, a “flower child who peacefully protested the war.”  He still walks 2.5 miles and does 200 push-ups daily, is a member of local veterans’ groups, and says, “I only have Parkinson’s.  A lot of people are worse off.”

 

Pesticides are not the only chemical contributing to Parkinson’s disease among veterans.  Trichloroethylene, or TCE, is another.  TCE has been used to decaffeinate coffee, clean silicon wafers, and remove grease.  The military used the dangerous chemical to clean engines and vehicles.  At the Marine Corps Base Camp Lejeune in Jacksonville, North Carolina, TCE and 70 other chemicals poisoned the base and its water supply for 25 years.  Over one million service members, their spouses, and children were exposed to its toxic effects, leading to miscarriages, birth defects, cancer—and Parkinson’s disease.  Many drank contaminated water or inhaled TCE that had evaporated into their homes, like radon, from polluted groundwater.  The consequences of that exposure are still being felt 30 years later.

 

Finally, head trauma contributes to Parkinson’s disease.  A single head injury causing loss of consciousness or memory loss can triple the risk of Parkinson’s.  Repeated head trauma raises the risk even further.  These injuries are common in the military.  According to the U.S. Department of Defense, nearly 400,000 service members have had a traumatic brain injury since 2000.  Another eight million veterans have likely experienced such an injury.  Of those with moderate or severe injury, one in fifty will develop Parkinson’s within 12 years.

 

So what can we do to help our veterans? The first and most important step is to prevent those who serve from ever developing the disease.  Banning harmful pesticides and chemicals like TCE, which the Environmental Protection Agency has proposed to do, is an important step.  We also need to clean up contaminated sites throughout the country, many of which are located on current or former military bases.  In addition, service members must have proper equipment to minimize the risk of head injury.

 

Next we need to advocate for those that have already been harmed.  Veterans who have Parkinson’s and were exposed to Agent Orange are now eligible for disability compensation and health care.  Some efforts have been made to help those who have Parkinson’s tied to their service at Camp Lejeuene.  But these efforts are insufficient and have excluded many who have been injured.  For example, in 2019, the U.S. Navy denied civil claims from about 4,500 harmed at Camp Lejeune. 

 

We also need more research to prevent, measure, and treat the condition.  Despite Parkinson’s growth over the past decade, funding from the National Institutes of Health for the condition, adjusted for inflation, has actually decreased. 

 

Anyone anywhere with Parkinson’s should receive the care that they need.  The Veterans Health Administration has long had dedicated centers to research and treat Parkinson’s.  However, not every veteran lives near one of these centers.  Telemedicine is one way to expand the reach of care, but some veterans do not have internet access.  Others need in-person in-home care and support.  Increased access and novel care models can help ensure that no one suffers in silence.

 

Finally, better treatments for Parkinson’s disease are lacking.  The most effective medication for the condition is now 50 years old, and we have had no major therapeutic breakthroughs this century.  The economic burden of Parkinson’s disease is over $50 billion per year.  Federal and foundation support is less than 1% of that total.  That will not get the job done.  We must increase our research efforts ten-fold to change the course of Parkinson’s as we did for polio, HIV, and COVID-19.

 

Veterans have served and sacrificed too much to have Parkinson’s be their fate. 


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