In 2001, the budding neurologist Norika Malhado-Chang saw a tremor in her mother's hand. She wondered if the stress everyone was feeling in New York City after the 9/11 terrorist attacks was causing it.
Her heart sank when she discovered that this tremor was the first and most common sign of Parkinson's disease. Her mother's diagnosis would not only shape her career as a neurologist but will introduce her to the complicated world of caregivers of patients with this chronic disease.
The symptoms of Parkinson's disease
Parkinson's is a progressive neurological disease. It affects approximately 1.1 million Americans, with about 90,000 new cases each year. It is the second-most common neurodegenerative disorder after Alzheimer's disease.
Parkinson's destroys the cells in the brain that produce dopamine, a chemical that transmits movement control signals. It causes symptoms such as slurred speech, slowness of movement and muscle stiffness. However, some of the lesser-known symptoms of Parkinson's include hallucinations and psychosis.
The mother's condition deteriorated. Her tremor worsened, and it was harder for her to walk. At one point, she started experiencing psychotic episodes and hallucinations.
Becoming a movement disorder expert and patient advocate
After her mother's diagnosis, Malhado-Chang was drawn to studying and treating movement disorders — especially Parkinson's. She explored the new therapies emerging around the turn of the century (such as deep brain stimulation) and committed herself to treating people with this disease.
She also became her mom's caregiver. With that, she experienced the toll the disease can take on patients as well as their families. It was very hard to keep up with the planning and coordination of visits to physical and speech therapists, neurologists, neuro-pharmacists and neuro-dietitians.
"As her disease progressed, I needed to take over her medication refills and take her to all her doctor's visits and specialty care appointments. It was very stressful!" Malhado-Chang remembered. "That's when I realized how incredibly challenging it is to navigate our health care system with a chronic neurodegenerative disease."
So, Malhado-Chang decided to assemble a 'Parkinson's Dream Team' for UC Davis Health patients. With support of many Parkinson's disease specialists and patients, she launched the first Parkinson's disease Multidisciplinary Clinic in Sacramento.
"It has been my dream that people with Parkinson's can have a high caliber team of specialists all in one place, together with cutting-edge research, support services and education. My experience with my mother is the reason I created this clinic at UC Davis," she said.
Sadly, her mom passed away two months after the clinic's opening in 2023.
Education and outreach to the Parkinson's community
In addition to her clinical work, Malhado-Chang takes every opportunity to raise awareness about the disease. One example is her engagement with the Parkinson's Association of Northern California (PANC).
She is an active speaker and organizer of the PANC Annual Conference, the largest community education event for Parkinson's disease in the region. This event, sponsored by UC Davis Health, serves as a vital resource for patients, caregivers and professionals.
"PANC is a wonderful nonprofit that makes a real difference in the lives of people affected by Parkinson's. It offers education, inspiration and connection in the fight against the disease," Malhado-Chang said.
In October, the PANC conference welcomed nearly 1,000 attendees from across California and neighboring states. Multiple UC Davis Health speakers and volunteers participated in the event.
"I'm very grateful UC Davis continues to collaborate and support raising awareness about Parkinson's disease. This reflects the university's commitment to community engagement and education," Malhado-Chang added.
Celebrities advocating for patients with Parkinson's disease
This year's program also featured two high-profile speakers.
Actor Ryan Reynolds shared his personal experience as a caregiver for his father with Parkinson's disease. He emphasized the need to raise awareness about psychosis and hallucinations — the lesser-known Parkinson's symptoms.
"As a caregiver to my mother with Parkinson's, Reynolds and I had similar experiences. We both share a desire to raise awareness about the 'less talked about' Parkinson's symptoms of psychosis and hallucinations. These symptoms can be especially challenging for loved ones to navigate," Malhado-Chang shared.
The other key speaker was Jimmy Choi, a Guinness World Record holder and seven-time American Ninja Warrior competitor. He is living with young-onset Parkinson's, and his story is of inspiration, resilience and determination.
"PANC was incredible this year. We sparked meaningful conversations with patients, caregivers and advocates, and generated strong interest in UC Davis's clinical care and research programs," Malhado-Chang said.
Malhado-Chang is a professor at the Department of Neurology. She co-directs the UC Davis Parkinson's Disease Multidisciplinary Clinic, a Parkinson's Foundation Center of Excellence.
