Parkinson’s disease (PD) is a multisystem alpha-synucleinopathic neurodegenerative disease and the most prevalent neurodegenerative disorder after Alzheimer’s disease with a high incidence rate in the elderly population. PD is highly multifactorial in etiology and has complex and wide-ranging pathogenic mechanisms. Environmental exposures and genetic predisposition are prominent risk factors. However, current evidence suggests that an intimate link may exist between the risk factor of sleep disturbance and PD pathogenesis. PD is characterized by the pathological hallmarks of alpha-synuclein aggregations and dopaminergic neuron degeneration in the substantia nigra. The loss of dopamine-producing neurons results in both motor and non-motor symptoms, most commonly, bradykinesia, tremor, rigidity, psychiatric disorders, sleep disorders and gastrointestinal problems. Factors that may exacerbate alpha-synuclein accumulation and dopamine neuron loss include neuroinflammation and glymphatic system impairment. Extracellular alpha-synuclein can induce an inflammatory response which can lead to neural cell death and inhibition of neurogenesis. The glymphatic system functions most optimally to remove extracellular brain solutes during sleep and therefore sleep disruption may be a crucial progression factor as well as a risk factor. This literature review interprets and analyses data from experimental and epidemiological studies to determine the recent advances in establishing a relationship between glymphatic system dysfunction, sleep disturbance, and PD pathogenesis and progression. This review addresses current limitations surrounding the ability to affirm a causal link between improved glymphatic clearance by increased sleep quality in PD prevention and management. Furthermore, this review proposes potential therapeutic approaches that could utilize the protective mechanism of sleep, to promote glymphatic clearance that therefore may reduce disease progression as well as symptom severity in PD patients.

Objective: to analyze scientific production regarding the process of caring for persons with Parkinson's Disease (PD) from the perspective of the caregiver. Method: a descriptive integrative review type study was performed, guided by the question: How does the caregiver perceive the process of caring for a person with Parkinson's? A search was performed of the Latin American and Caribbean Health Sciences, Nursing Database and Online Search System and Medical Literature Analysis databases, applying the cut-off points 2005 and 2015. Result: following Content Analysis three categories emerged: a) the process of caring for a person with PD; b) the positive and negative aspects associated with the process of caring for a person with PD; c) support for caregivers of people with PD: what can be done for them? Conclusion: The challenge of caring for a person with PD needs to be recognized by caregivers, professionals and health managers as a tool for the (re)construction of care.

Introduction: aging and dying are part of the intrinsic process to the human being. Concomitantly with increasing longevity, the proximity of individuals to the process of death becomes more evident, which is an inherent condition for the human being. The understanding of temporality, including the finitude and death of the human being, is little discussed among people because of the feelings associated with loss and the perception of their own finitude. Objective: to reflect on aging and finitude, relating three types of narratives, Roth's literary narrative, Elias's sociological narrative and Sacks's autobiographical narrative, these being "Patrimony", "The solitude of the dying" and "Gratitude", respectively. Method: This is a narrative review, with a qualitative approach, that allows the correlation of several productions, with the purpose of identifying recurrent themes, which refer to new perspectives, contributing to the consolidation of knowledge in a given area. The analysis will be carried out based on bibliographical perspective and content analysis. Result: five thematic categories related to finitude were emerged during aging: (1) The different facets of aging; (2) The finite process during human aging; (3) The process of caring for aging; (4) Aging vs. Death; (5) The arrival of the end. Conclusion: Understanding and discussing finitude and death is essential to demystify the taboos and myths that guide them in order to build a society composed of people who understand death as a natural process of life.