The diagnosis of young-onset Parkinson's disease is the same as idiopathic, or typical, Parkinson's disease except for the age of the patient. The average age of diagnosis is around 62. When an individual is diagnosed with PD before the age of 50, the disorder is called young-onset Parkinson's disease.
Why Is Young-Onset Parkinson's Important?
First, people who are affected by Parkinson's at a younger age experience the disease differently – they may be parents of young children, they may be at a different stage of their career and less able to deal with the challenges of a disabling condition, and they often have less time to engage in their own care. If you develop Parkinson's under age 50, your peers are more likely to be healthy and may struggle to deal with your illness more than an older group. Also, your doctor might not be familiar with Parkinson's.
Second, younger people are different from a medical and scientific perspective. The younger you are, the more likely it is that your disease is genetic or caused by exposure to a specific toxin. Younger people have younger brains; if you have young-onset Parkinson's, your brain may be more responsive to exercise or other treatments that rely on your brain's ability to adapt to change – what scientists call "neuroplasticity."
Because of these issues, different scientists will refer to young-onset Parkinson's as starting at 40, 50 or even 55. Scientists focused on the social aspects of Parkinson's – dealing with job stress and families – may use 50 or 55. Scientists focused on genetic Parkinson's often use a younger age as the cut-off, typically 40. A group of patients who had onset before 40 is very likely to include people with genetic Parkinson's.
How Many People Have Young-Onset Parkinson's?
Approximately 2% of the 1 million people with the disease are thought to be below the age of 40. Since Parkinson's disease is still often overlooked as a diagnosis in younger patients, it is thought that the number of cases occurring in individuals below the age of 40 may actually be higher than the estimated 2% of the population with the disease.
Connect with people affected by young-onset Parkinson's by joining NPF's online Young-Onset Forum.
What Are the Common Symptoms of Young-Onset Parkinson's?
Available evidence suggests that there are some symptoms that are more common in young-onset PD patients.
- A slower disease progression
- An increased rate of dystonia (sustained abnormal postures, such as turning in or arching of the foot and toes) at onset and during treatment.
- A lower rate of dementia
- An increased rate of dyskinesias in response to L-DOPA treatments.
As is the case with the older-onset Parkinson's, the speed and severity of the progression of young-onset Parkinson's disease can vary greatly among individuals.
How Does Genetics Play a Part in Young-Onset PD?
There are genes that increase your risk for young-onset Parkinson's disease, such as the LRRK-2 and parkin9 mutations. A recent study found that 65% of people with Parkinson's onset under 20 years old and 32% of people with uonset between 20 and 30 had a genetic mutation that scientists believe increases the risk of Parkinson's.
To the best of our knowledge, there are no genes that guarantee that you will develop Parkinson's. However, there are several that increase your risk of Parkinson's at a young age. Most of the common genes that increase your risk of young-onset Parkinson's. Up to 50% of young-onset Parkinson's patients may have a gene associated as a potential cause also are risk factors for older-onset Parkinson's – and people with these genes might not get Parkinson's at all.
Research continues to be done to understand the role of genes and environment as potential causes in PD. Theories suggest that genes may play a larger role in young- onset PD, and environment may be more significant in idiopathic, or typical, PD. Understanding the roles of environment and genes will ultimately allow us to identify the multiple causes of PD.
Is Medication Treatment Different for Young-Onset PD?
Medical management of young-onset Parkinson's disease requires an understanding of the significantly greater tendency of this group to develop:
- Dyskinesias or involuntary movements (most commonly, dystonia)
- Motor fluctuations when taking Levodopa
As a patient, it is in your best interest to seek a physician who has an understanding of the unique treatment of young-onset PD. Such a doctor will be able to help you maximize your quality of life.
Is There Such a Thing as Juvenile Parkinsonism?
In rare instances, Parkinson's-like symptoms can appear in children and teenagers. This form of the disorder, called "juvenile Parkinsonism," is often associated with specific, high-Parkinson's risk genetic mutations.
For more tips on young-onset PD, listen to the podcast episode "Young-Onset Parkinson's 101."