Parkinson's Expert Sees Decline In Pope

May 24, 2001 -- When 153 cardinals from around the world gathered this week for an extraordinary meeting in the Vatican, difficult church issues such as teaching sexuality and Vatican authority over bishops were on the agenda. But there's one matter church officials do not discuss openly: Pope John Paul II's health.

The pope, who is 81, began to show signs of Parkinson's disease about seven years ago, and his physical condition appears to have worsened in the past year.

The cardinals will one day elect his successor from their own ranks. Many of them say privately they have consulted Parkinson's experts on their own — and know the pope's condition means they need to be ready for anything.

Dr. Warren Olanow, a leading expert in Parkinson's who has compared videotape of the pontiff a year ago with footage shot in recent weeks, says a decline is clearly visible.

"His voice is soft and flat. You can see a little bit of drooling. His posture is bent forward," says Olanow, who is chief of neurology at Mount Sinai School of Medicine in New York. These Parkinson's symptoms, he says, are noticeably worse than a year ago.

Mental Effects Not Seen

Parkinson's can affect the mind as well as the body. Studies have found that 50 percent of Parkinson's patients in their early 80s have some degree of dementia, and that patients struck by the disease late in life — like the pope — are more likely to be affected by dementia.

Olanow, however, sees no evidence that the pope's mind has been affected: "His ability to function, even in the presence of Parkinson's disease of this magnitude, is astonishing and a great tribute to him and to his will."

Observers at this week's Vatican conference also say the pope's thinking seems to be as clear as ever. They report that he is still challenging his cardinals with new ideas and asking them to confront complex church matters.

But, Olanow warns, "The first notable sign of dementia often comes by surprise."

If the disease were to affect the pope's cognitive abilities, it could lead to a leadership crisis in the Catholic church. Vatican law makes no provision for removing an incapacitated pope.

The pope may resign (it last happened six centuries ago), but if he waited until he appeared to be mentally disabled, he would probably be considered incompetent to resign freely.

If that happened, the church could be left effectively leaderless. It is not uncommon for Parkinson's patients to live for many years after developing dementia.