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Parkinsonís Disease Symptoms Vary with Age of Disease Onset

The symptoms of Parkinson’s disease (PD) and disease progression vary depending on the age of diagnosis. That is the major finding of a study that appears in the March 17 online edition of Parkinsonism and Related Disorders. 

Diagnoses of PD span a wide range of ages, from 20s to 80s, with the average age of diagnosis being 60. There has been some evidence on how the age of diagnosis might be associated with disease symptoms or rate of progression, but to date there have been only a few studies focused on these data.  

To find out more, scientists led by Raja Mehanna, M.D., of the University of Texas Health Science Center reviewed the medical records of 593 people with Parkinson’s who developed the disease at ages ranging from 21 to 89, and were treated at the Parkinson’s Disease Research, Education and Clinical Center at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, TX. For the purpose of the study, participants were divided into three groups based on the age of disease onset: 60 people with young onset PD (49 years or younger), 302 people categorized as middle onset (50−69 years) and 231 with late onset PD (70 years or older).

The majority of participants, nearly 98 percent, were male, which is typical of a veterans hospital patient population. Most were initially treated with carbidopa/levodopa. The researchers compared participant data such as family history of PD, predominant first symptom, first medication prescribed, medication side effects and non-motor symptoms such as depression.

Results

  • There were differences in symptoms and disease progression among the young onset, middle onset and late onset groups – with the greatest differences found between the young onset PD group and the two older groups.
  • People with young onset PD were more likely to have a family history of PD.
  • Tremor was the most frequent initial symptom in all three groups; however, fewer people with young onset PD experienced tremor as their initial symptom.
  • Rigidity and painful cramps were more common initial symptoms in the young onset group than the older groups.
  • Gait instability was a more frequent initial symptom in the late onset group compared to the two younger groups.
  • People with young onset PD were more likely to develop treatment-related side effects such as dyskinesia (spontaneous, uncontrolled movements) and dystonia. 
  • People with young onset PD were more likely to develop depression, which had the most negative impact on their quality of life.
  • While dementia tended to increase with age, the differences among the three groups were not statistically significant in this study.

What Does It Mean?

Few studies have looked at how the age of Parkinson’s disease onset affects symptoms and disease progression. This study, the largest to date, found clear differences in disease characteristics among different age at onset groups, particularly in the young onset group compared to the two older onset groups.  

For example, people with young onset PD were more likely than those with later onset PD to have rigidity and painful cramps as initial symptoms; experience treatment-related side effects, such as dyskinesia and dystonia; and develop depression.

However, since this study included mainly male participants, its observations cannot be reliably generalized to include women with Parkinson’s disease.

More research of Parkinson’s in both sexes is needed to confirm the clinical differences in Parkinson’s disease related to the age of disease onset. It could provide valuable information to researchers in understanding how the disease develops and to clinicians in diagnosing and treating the disease.

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Do you have questions about the progression of Parkinson's? Find answers by contacting us at (800) 457-6676 or info@pdf.org or using our free resources below. 

View PD ExpertBriefing: Understanding the Progression of Parkinson's Disease

Reference: Mehanna R, Moore S, Hou JG, Sarwar AI, Lai EC (2014) Comparing clinical features of young onset, middle onset and late onset Parkinson’s disease Journ Parkreldis DOI: 10.1016/j.parkreldis.2014.02.013 http://dx.doi.org/10.1016/j.parkreldis.2014.02.013

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Source Date: May 09 2014