Local health experts are warning of an increase in Parkinson's disease cases in Malaysia, going as far as to describe it as a pandemic of sorts despite its non-infectious nature.
Speaking to MalaysiaNow, Dr Lim Shen Yang said there was no specific epidemiological data to determine the actual number of Parkinson's patients in the country.
Nevertheless, he said Malaysia might follow the trend seen in other countries where cases of Parkinson's disease have increased over the past two decades.
"It's partly due to population ageing, but there are also other factors at play such as environmental pollution," Lim, a senior consultant in neurology at the Universiti Malaya Medical Centre, added.
He said genetic factors also play a role, especially in younger patients.
"We found examples of young Malay and Chinese patients with certain genetic mutations that contribute to Parkinson's," he added.
Lim, alongside fellow medical expert Dr Tan Ai Huey, recently contributed an article on the disease to a prestigious international journal.
Their article became the cover issue of the August edition of Nature Reviews Neurology, on the link between the gut-brain axis and Parkinson's disease.
Another publication listed neurological problems as the leading cause of disability in the world, with Parkinson's taking first place.
One report estimated a doubling in number of patients to six million from 1990 to 2015.
This figure is expected to continue increasing, to 12 million globally by 2040 due to ageing.
According to United Nations projections, Malaysia is expected to become an ageing country by 2030.
This means that about 15% of the population will be aged 60 and above.
Previous studies forecast that the percentage of senior citizens in Malaysia would increase from 7% to 14% in 28 years.
The World Health Organization (WHO) recently issued a technical briefing on Parkinson's disease, stating the need for urgent public health feedback.
WHO also sought Lim's views for the publication of its health journal.
Lim said WHO was focusing on Parkinson's disease as government, social and health systems around the world were generally ill-equipped to deal with the increasing number of patients.
"For example, Malaysia is still very short of neurologists who provide expert care for these patients, with around only one neurologist per 300,000 population," he said.
"This is in contrast with, say, around 1:20,000 in Taiwan, South Korea or Japan."
He also spoke of insufficient facilities such as nursing homes for the provision of long-term care for those in the advanced stages of the disease.
Parkinson's disease occurs when part of the brain cells begin to deteriorate as individuals age.
Symptoms include tremors in some parts of the body, stiffness in the limbs, slow movements and postural imbalance.
Lim said Parkinson's can also bring about other issues such as forgetfulness or dementia, behavioural changes and bladder and sleep problems.
A major challenge in dealing with the disease is a lack of awareness about the condition and the suffering that it can cause.
This might be because the disease generally inflicts older people who are no longer socially active, Lim said.
Even more worrying is the fact that clinical services for this disease do not receive sufficient funds.
"Nurses and physiotherapists trained in dealing with Parkinson's disease are virtually non-existent in Malaysia, unlike the thousands available in the UK or the Netherlands," Lim said.
And in terms of prevention, there appears to be a lack of will to ban the use of chemicals that are highly likely to contribute to the disease.
For example, Lim said, Paraquat – a type of toxic chemical used in plant fertilisers – is banned in many other countries but still utilised in Malaysia's agriculture sector.
Calling for greater awareness and a willingness to acknowledge that Parkinson's disease was a looming crisis, he said the government and society alike needed to initiate steps and plans for the sustainable care of an ageing population.
"Within the medical profession, specialties like neurology, geriatrics, general internal medicine, family medicine, and palliative care need increased emphasis, such as by making more training positions available at university hospitals which are currently very scarce," he said.
He added that NGOs like the Malaysian Parkinson's Disease Association had played an important role in the lives of patients and their families for decades.
According to the UK's National Health Service website, there is currently no cure for Parkinson's disease, although there are treatments that can reduce the symptoms.
Lim said that progress in research on treatments was crucial, adding that the government was said to be providing assistance through its high impact research scheme.
"The industry has an important role to play, to help make the fruits of these scientific advancements available and affordable to larger segments of society," he said.