"You can suffer with Parkinson's disease, but don't let it keep you from your goals."

By Anna Almendrala

Former U.S. Attorney General Janet Reno died of complications related to Parkinson's disease on Nov. 7, 2016. She was 78 years old.  

Janet Reno, the first woman to serve as U.S. attorney general, died Monday from complications related to Parkinson's disease. She was 78 years old, and her remarkable life — including a career that continued for years after her initial diagnosis — reveals just how productive and purposeful life can be with the neurological condition.

The way people experience Parkinson's disease can be vastly different, and there is no one way the progressive disease typically unfolds. In some people, symptoms can be mild for many years, while others will be hit with severe disability and cognitive impairment early. About one-quarter to one-third of people who are diagnosed with Parkinson's disease will go on to develop dementia, while the same percentage of people will have a mild cognitive impairment. The condition is not fatal — though of course patients can, like Reno, die from complications related to the illness.

In the face of the unknown, Reno chose to approach her diagnosis by persevering in her mentally vigorous job and committing to outdoor sports. This decision may have played a role in how Reno was able to stave off the worst effects of this neurodegenerative disorder, experts say.

Reno was 57 when she was diagnosed with Parkinson's disease in 1995, which is around the average age of diagnosis. In an interview with Neurology Now in 2006, she described the symptom that led her to seek specialized care, as well as the forthright way her doctor broke the news about her diagnosis:

It was March of 1995... I noticed a tremor in my early-morning walks around the Capitol. At first it was just a faint twitch, but it got progressively worse, and so I went to the doctor. He asked me some questions, examined me, and told me that I had Parkinson's and that I'd be fine for 20 years. Then he started talking to me about violence issues related to the criminal justice system!

After researching the condition, she told President Bill Clinton about the diagnosis, got his support for her to continue in her role, and then plowed ahead as attorney general.

Reno was a trailblazer in her role and led the Justice Department through a vast, ever-changing legal landscape. During her tenure, the Justice Department successfully prosecuted and convicted terrorists like the Unabomber and the Oklahoma City bombers. Reno sued Microsoft for violating antitrust laws in what experts called one of "the most important antitrust cases of its generation." Her tenure lasted from 1993 until 2001, making her the longest-serving attorney general in 150 years, the New York Times notes. 

After she left her post, Reno ran for governor of Florida in 2002, but lost in the Democratic primary election.

She did all this while being treated for Parkinson's disease — a stirring reminder to the million other Americans with the condition that life does not need to end after diagnosis, said Dr. Michael Okun, national medical director of the Parkinson's Foundation and chair of the neurology department at the University of Florida.

Okun was one of Reno's long-time healthcare providers, and he remembers that the former attorney general brought a can-do attitude toward her treatment and therapy at the Center for Movement Disorders and Neurorestoration. She was the center's first patient when it opened in 2011, and was active as a volunteer for fundraising walks, a national advocate for people with Parkinson's disease, and was also a listening ear to patients and families at the clinic, according to Okun.

"The message she brings is a message of hope, for people around the U.S. and also globally," he said. "You can suffer with Parkinson's disease, but don't let it keep you from your goals."

How physical activity can protect the brain 

In addition to her positive approach to treatment, Reno's life was also an example of how continuing to challenge oneself, mentally and physically, can do a lot to postpone the most debilitating symptoms of Parkinson's disease for several years, according to Dr. Barbara Changizi, a Parkinson's disease expert and an assistant professor of medicine of neurology at The Ohio State University Wexner Medical Center's Neurological Institute.

"Someone who remains physically active, and I would also add mentally active, as she was, really can stave off the severity of the disease longer than those who become couch potatoes," said Changizi, who didn't treat Reno.  

As Reno noted in her 2006 Neurology Now interview, a major part of her care plan included walking, biking, swimming and kayaking. And scientists now know that exercise can have a neuro-protective effect, helping the brain be less burdened by the disease.

Studies show that when people with Parkinson's disease exercise, they have significant improvements in walking speed, cardiovascular fitness, muscle strength and motor skills scores. But the benefits of exercise don't just extend to the physical symptoms of the disease. People with Parkinson's disease have a higher risk of dementia and other kinds of mental deterioration in their later years, but the physical benefits of exercise also extend to a lower risk of cognitive impairment and depression, as well as a lower overall risk of cardiovascular disease, diabetes and stroke — all conditions that can take a toll on brain health.  

"People come in, and when I say that they have Parkinson's disease, they really view this as the end," said Changizi. "I'm hoping the other patients will realize that it's not a death sentence, and that a lot of people are living with Parkinson's and go on to do great things and have good times ahead."

While there is no cure for Parkinson's disease, people like Reno demonstrate that the condition doesn't necessarily have to interrupt a good quality of life for years, and even decades, after their initial diagnosis, thanks to medications, physical therapy and exercise.