The onset of parkinson’s disease is between 50-60 years old. this disorder is caused by

Young-onset Parkinson’s disease (YOPD) occurs in people younger than 50 years of age. Most people with idiopathic, or typical, PD develop symptoms at 50 years of age or older.

YOPD affects about four percent of the one million people with PD in the U.S. Symptoms are similar to late onset PD but it is important to understand the challenges YOPD individuals often face at a financial, family and employment levels.

In rare instances, Parkinson's-like symptoms can appear in children and teenagers. This form of the disorder is called juvenile Parkinsonism and is often associated with specific, high-PD risk genetic mutations.

Symptoms

Young-onset PD is diagnosed similarly to late-onset PD with symptoms including:

• Tremors of the hands, arms, legs, jaw and face
  • The tremors in people with YOPD can sometimes appear faster and somewhat different from the classic parkinsonian resting tremor seen in those with late-onset PD.
• Rigidity of the limbs and trunk
• Bradykinesia (slowness of movement)
• Postural instability or impaired balance and coordination

People with YOPD may experience the same non-motor symptoms as others with PD, including:

• Depression
• Sleep disturbances
• Changes in memory and thinking
• Constipation or urinary problems

How is young-onset PD different?

People diagnosed with YOPD have a more frequent family history of Parkinson’s disease and a longer survival. People living with young-onset PD may experience:

• Slower progression of PD symptoms over time, staying functional and cognitively intact for longer duration
• Less frequent cognitive problems such as dementia
• More side effects from dopaminergic medications, such as more frequent dyskinesias (involuntary body movements)
• Earlier and more frequent dystonias (cramping and abnormal postures) such as arching of the foot

Why is distinguishing young-onset Parkinson's important?

Socially, people who are affected by PD at a younger age experience the disease differently — they may be at a different stage of their career and often have less time to engage in their own care. They may also have children or are planning to have children and have questions regarding passing on PD genes.

Medically, doctors tailor treatment when it is a younger person with PD. The younger you are, the more likely the disease is genetic. Your care team may offer genetic testing or counseling. Younger brains also have higher neuroplasticity (the brain’s ability to grow and change response to therapy) potential which allows the brain to handle and respond to disease and therapy differently.

Navigating YOPD After Diagnosis

While a diagnosis can be disruptive and unexpected, it doesn’t have to stop you from reaching your goals. When you are ready, think about your current family and career responsibilities, and set up a new long-term plan. Take one step at a time as you move toward achieving your priorities.

Therapy and Treatment

When it comes to medical treatment, people with YOPD have a significantly greater risk of developing the following:

• Dyskinesias (involuntary movements) and dystonias (cramping and abnormal postures), sometimes as a side effect of carbidopa/levodopa (the drug prescribed most often to treat Parkinson’s)
• Motor fluctuations when taking levodopa

Each person’s treatment is unique and can require fine adjustments of multiple medications. Deep brain stimulation remains a surgical option for people with young-onset PD.

Page reviewed by Dr. Jun Yu, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

When someone who is 21-50 years old receives a diagnosis of Parkinson’s disease, it is referred to as early onset Parkinson’s disease, or young onset Parkinson’s disease (YOPD). While the symptoms of the disease are mostly the same at whatever age it develops, younger people will experience the disease differently due to their unique life circumstances. Managing the disease can be particularly challenging for a younger person and their family from a medical, psychological and social standpoint.

Spotlight on Young Onset Parkinson’s Disease: Exploring Treatment & Managing Options

Speaker: Joel S. Perlmutter, MD

Broadcasted on 10/12/17

What sets young onset Parkinson’s apart from a diagnosis at an older age?

Because the majority of people who get Parkinson’s disease are over the age of 60, the disease is often overlooked in younger people, leading many to go undiagnosed or misdiagnosed for extended periods of time.

However, once it has been diagnosed, the rate of the disease’s progression is usually much slower in younger than older people, due in part to the fact that younger people have fewer general health problems and are more capable during physical therapy treatment.

Symptoms of young onset Parkinson’s disease

While common symptoms of Parkinson’s may be similar no matter what age you are, the progression is often different:

• Young people often have more involuntary movement problems due to the most commonly prescribed Parkinson’s disease medication, levodopa. For this reason, young onset patients are usually initially treated with alternatives to levodopa.
• Other problems associated with Parkinson’s such as memory loss, confusion, and balance difficulties tend to be less frequent in young people with the disease.

Who gets early onset Parkinson’s disease?

About 10%-20% of those diagnosed with Parkinson’s disease are under age 50, and about half of those are diagnosed before age 40. Approximately 60,000 new cases of Parkinson’s are diagnosed each year in the United States, meaning somewhere around 6,000 – 12,000 are young onset patients.

Is it genetic or hereditary?

The cause of Parkinson’s disease is not yet known. However, Parkinson’s disease has appeared across several generations of some families, which could indicate that certain forms of the disease are hereditary or genetic. Many researchers think that Parkinson’s disease may be caused by genetic factors combined with other external factors. The field of genetics is playing an ever greater role in Parkinson’s disease research, and scientists are continually working towards determining the cause or causes of PD.

Treatment for young onset Parkinson’s

To date, there is no known cure or way to prevent Parkinson’s disease. However, research is ongoing and remarkable progress is being made. There is very real hope that the causes, whether genetic, environmental, or some combination of the two, will soon be identified and the precise effects of these causes on brain function will be understood. Although there is no cure for the disease at this time, by identifying symptoms and determining a proper course of treatment, most people with the disease are able to remain active and lead fulfilling lives.

Are there doctors who specialize in Parkinson’s disease?

Doctors who are specially trained to diagnose and treat conditions of the brain and nervous system are called neurologists. Some neurologists have a subspecialty in movement disorders and work extensively with patients who have Parkinson’s disease and other similar conditions. These doctors also may have experience dealing with early onset Parkinson’s symptoms. You can ask your physician if they have specific experience with younger patients, or whether they can refer you to a doctor who does.

How do I find a Parkinson’s disease specialist?

Larger hospitals or university systems often have movement disorders centers. If you do not live in or near a large city, you may have to travel further for an appointment. While not as convenient, you may find it worthwhile to work with a physician who deals exclusively with movement disorders. Often, once stabilized, in-person appointments are not required very frequently.

Bryan’s Early Onset Parkinson’s Diagnosis

Bryan is a 35-year-old nurse, rock climber, husband, and new father to a four-month-old baby boy. He is also someone who is living with YOPD. YOPD is defined as Parkinson’s that is diagnosed before the age of 50 and includes about 10% of people living with PD. Younger people will experience the disease differently than those who are diagnosed older, in part due to their different life circumstances.  Employment, new relationships, and parenthood add particular challenges that those who are diagnosed older may not have to navigate. When and how to disclose the diagnosis is also of particular concern.

SMART PATIENTS

A Parkinson’s Disease Community

In partnership with the American Parkinson Disease Association