Early-Onset Parkinson’s in Younger Adults Is Rising Worldwide, Global Study Finds

Parkinson’s disease (PD) is often thought of as a condition that affects older adults — and most of the time, it does. But roughly 5% to 10% of people with Parkinson’s are diagnosed before age 50, a form of the disease known as early-onset Parkinson’s disease (EOPD).

Early-onset Parkinson’s carries a distinct set of challenges. People diagnosed in their 30s and 40s are often at the peak of their careers and raising families, and the disease can affect work, finances, relationships and mental health in ways that differ from a diagnosis later in life. Understanding how many people are affected — and how this varies across the world — is the first step toward directing research and resources to address the problem.

A new study published in npj Parkinson’s Disease set out to assess how common early-onset Parkinson’s is around the world and whether that picture has changed over time. Researchers in China analyzed three decades of data from the Global Burden of Disease Study 2021, a large international project that tracks hundreds of health conditions across 204 countries and territories. They estimated that between 1990 and 2021, the global burden of early-onset Parkinson’s more than doubled.

Study Results

Among adults ages 20 to 49, researchers investigated EOPD burden by looking at:

1. New cases each year (incidence)
2. The total number of people living with the disease (prevalence)
3. Years lived with disability, a standard measure of how much a condition affects daily life

All three roughly doubled or more over the study period. New cases rose from about 28,000 per year in 1990 to about 81,000 in 2021. The total number of people living with early-onset Parkinson’s grew from roughly 190,000 to nearly 484,000.

Some of that increase reflects population growth — there are more people in the world than there were in 1990. But the researchers also calculated age-standardized rates, which adjust for population size and age structure. Those adjusted rates rose too, meaning early-onset Parkinson’s became more common, not just more numerous.

The rising rates were not spread evenly across the age range. Even among adults under 50, risk climbed sharply with each age bracket — people in their late 40s were diagnosed at dozens of times the rate of those in their early 20s. That pattern isn’t surprising, since Parkinson’s risk increases with age. But this oldest bracket also saw the fastest growth over the study period, meaning the rise in early-onset Parkinson’s is being driven largely by people in their late 40s.

The same adjusted rates also reveal that the increase was not evenly distributed worldwide. 

• In 2021, rates were highest in Andean Latin America — Peru, Bolivia and Ecuador — followed by East Asia, particularly China. 
• Of the 204 countries and territories studied, more than 170 showed rising rates, with the steepest growth in middle-income and upper-middle-income countries. 
• Two countries with the fastest-rising rates were China and Norway. 
• While most regions showed growth in EOPD rates, three regions were exceptions: high-income parts of North America, Central Europe and Central Asia. 

One pattern researchers noticed is that countries with heavier pesticide use per acre of farmland tended to have higher rates of early-onset Parkinson’s. Both Andean Latin America and China have large agricultural sectors with widespread pesticide use. This is a correlation across countries, not proof that pesticides caused these cases, but it lines up with existing research linking pesticide exposure to Parkinson’s risk.

That same idea — chemical exposure — may help explain another pattern in the data. Men had roughly 1.5 times the rates of women, and that gap has widened over time. The researchers suggest that men’s greater occupational exposure to pesticides, industrial chemicals and heavy metals may be one possible explanation, along with the potential protective effects of estrogen in women. 

Highlights

• The global number of people diagnosed with early-onset Parkinson’s disease — between ages 20 and 49 — more than doubled between 1990 and 2021.
• New cases rose from about 28,000 per year in 1990 to about 81,000 in 2021
• People living with EOPD grew from about 190,000 to nearly 484,000.
• More than 170 of 204 countries showed rising rates. High-income North America was an exception, with rates declining slightly.
• The steepest growth in early-onset Parkinson’s occurred in middle-income countries, especially in East Asia and Andean Latin America.
• Higher national pesticide use was associated with higher rates of early-onset Parkinson’s disease.
• Men were diagnosed with early-onset Parkinson’s at about 1.5 times the rate of women.

What Does This Mean?

This study reminds us that Parkinson’s is not only a disease associated with aging; younger adults are also affected, and the number of younger adults living with it is growing worldwide. Given the earlier age of onset, those diagnosed with EOPD often experience the highest disease burden, spending many years living with PD. 

Accordingly, study authors noted that the increased burden of EOPD may reflect improvements in healthcare and better diagnosis— as health systems improve, more cases of EOPD get identified and recorded, and people live longer with the disease as treatments improve. However, the analysis also demonstrated a clear association between pesticide usage and rates of EOPD, indicating that PD remains closely linked with exposure to environmental contaminants even in younger adults.

Overall, the findings point to a need for earlier recognition of Parkinson’s in younger adults and for research and support services designed with this population in mind.

What Do These Findings Mean for People with Parkinson’s Right Now?

This study provides a global snapshot of the overall burden of early-onset Parkinson’s, not an explanation of what causes PD. However, these findings highlight that Parkinson’s can affect people at younger ages, reinforcing the importance of greater awareness of early- and young-onset PD. In addition, studies like this are needed to help influence policy decisions that ultimately improve the wellbeing of people living with PD. 

Earlier recognition of PD symptoms can help people seek care sooner, potentially leading to living better with PD in the long-term. The study also underscores the unique challenges many people with YOPD face, including managing careers, raising families and navigating financial responsibilities during some of the most active years of their lives.

Learn More

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about early- and young-onset PD through our resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.

• Young-Onset Parkinson’s
• Early-Onset Community Network
• Golf Course Pesticides, Drinking Water & Parkinson’s Risk