Your father's symptoms suggest Parkinson's disease complicated by diabetic complications:
**Diagnostic Confirmation:**
1. Get DaTscan or MRI brain to confirm Parkinson's
2. Syndopa 110mg without tremors is unusual - need neurologist reassessment
3. Check: BP monitoring (orthostatic hypotension),
HbA1c, renal function
4. Audiometry for hearing loss
5. Speech therapy evaluation
**Management:**
1. Continue Syndopa if confirmed Parkinson's - dosage may need adjustment
2. Speech and occupational therapy
3. Physical therapy for gait/leg stiffness
4. Optimize
diabetes control - prevent future complications
5. Consider hearing
aids
6. Manage anxiety - counseling/medications if needed
**Tests to Confirm:**
- Neurological examination by movement disorder specialist
- Brain imaging (MRI/DaTscan)
- Complete metabolic panel
The anxiety, hearing/speech issues, and slow walking could all be related to poorly controlled diabetes and possible Parkinson's.